Heavy bleeding after childbirth
Postpartum haemorrhage is heavy bleeding after childbirth — usually in the first 24 hours, but it can happen up to 12 weeks later. It is one of the main causes of death of mothers in Afghanistan and worldwide, and a woman can lose a dangerous amount of blood within minutes. Giving birth with a skilled birth attendant in a health facility, where bleeding can be treated quickly, saves lives.
Symptoms
- Heavy bleeding that soaks a pad in less than an hour, or keeps flowing
- Passing large clots
- Dizziness, feeling faint or fainting
- Fast heartbeat, pale face, or cold and sweaty skin
- The womb feels soft instead of firm when the belly is pressed
- Fever or bad-smelling discharge with bleeding days after birth
Causes
- The womb does not tighten well after birth — the most common cause
- Parts of the placenta left inside the womb
- Tears in the birth canal or cervix
- Blood that does not clot well
- Higher risk after a long labour, twins, a very large baby, many previous births, anaemia or a previous heavy bleed
Prevention
- Give birth in a health facility with a skilled birth attendant
- An injection of oxytocin straight after the baby is born, given by the health worker
- Take iron and folic acid in pregnancy to prevent anaemia
- Go to all antenatal visits and make a birth plan, including transport and a possible blood donor
- Breastfeed soon after birth — it helps the womb tighten
Treatment
- Emergency care in a health facility — this cannot be treated at home
- Rubbing the womb through the belly to help it tighten
- Medicines by injection or drip to make the womb contract
- IV fluids and blood transfusion
- Removing any placenta left inside and repairing tears
- Surgery in severe cases
Common questions
How much bleeding after birth is normal?
Some bleeding (lochia) is normal for up to 4 to 6 weeks; it is heaviest in the first days and slowly becomes lighter and paler. Soaking a pad in an hour, large clots or bleeding that gets heavier is not normal.
Why should I give birth in a clinic and not at home?
Serious bleeding can start suddenly, even in a woman who has had easy births before. In a health facility the staff can give medicines, fluids and blood right away, which can save your life.