Postpartum hemorrhage (PPH) means heavy bleeding after childbirth, usually within 24 hours but can happen later. It can be sudden. Feeling weak, dizzy, soaking through a pad in an hour, or a fast heart rate are red flags. If bleeding is heavy or you feel faint, call emergency services right away.
Most PPH is caused by the uterus not contracting well after birth (uterine atony), but tears in the birth canal, retained placenta pieces, or blood-clotting problems can also cause it. Risk factors include high blood pressure, prolonged labor, multiple births, large baby, or having had PPH before. Still, PPH can happen with no risk factors at all.
At the first sign of heavy bleeding, caregivers focus on stopping blood loss and keeping the person stable. They check the uterus and press it to help it contract (uterine massage). They give uterotonic medicines like oxytocin to make the uterus tighten. If needed, tranexamic acid can be given to help with clotting. IV fluids and blood transfusion replace lost volume. If the bleeding source is a tear or retained tissue, the provider repairs the tear or removes the tissue.
If medical measures don't stop the bleeding, more advanced steps follow: a uterine balloon can compress the inside of the uterus, surgeons can tie off bleeding vessels, or in rare cases a hysterectomy is needed to save life. Quick transfer to a higher-level hospital makes a big difference.
If you had heavy bleeding, expect close monitoring for a few days. Your provider will check blood counts and watch for signs of anemia: tiredness, shortness of breath, or a fast heartbeat. Iron supplements and, in some cases, a blood transfusion help recovery. Breastfeeding is usually safe and can actually help the uterus contract through natural oxytocin release, but always follow your provider's advice if you had major treatment or transfusion.
Ask your team about why the bleeding happened and what it means for future pregnancies. If you've had PPH before, tell your obstetrician early in your next pregnancy so they can plan active management of labor. Learn postpartum warning signs: heavy bleeding that soaks a pad in an hour, fever, severe pain, lightheadedness, or a wound that looks infected, get medical help fast.
Simple prevention steps during delivery reduce risk: active management of the third stage (giving a uterotonic right after the baby), careful removal of the placenta, and watching for excessive bleeding in the first hours after birth. Hospitals often use PPH checklists and emergency kits to act fast.
Surviving PPH is common when teams act quickly. If you're worried about bleeding after birth, speak up. Clear communication with your care team and knowing the warning signs helps you get the right treatment fast and lowers the chance of long-term problems.
Keep a written birth plan and emergency contacts handy; it can speed care and give you peace of mind. Share it with family.
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