One page summary: Postpartum hemorrhage

In two sentences

Postpartum hemorrhage means heavy bleeding after birth. It is defined as blood loss of 1,000 mL or more, or bleeding accompanied by signs that the body is short of blood volume, within 24 hours of birth. ¹

It is one of the leading causes of severe illness and death in childbirth worldwide, and most of it is treatable when it is recognized quickly. Hospitals are expected to have a written protocol and a stocked kit for exactly this, because the treatment is a sequence and speed matters. ¹

The numbers, with their sources

• The definition. Cumulative blood loss of 1,000 mL or more, or blood loss with signs of low blood volume, within 24 hours of birth ¹
• The four causes. Tone, meaning a uterus that does not contract; tissue, meaning retained placenta; trauma, meaning tears or rupture; and thrombin, meaning a clotting problem ¹
• The most common cause. Uterine atony, a uterus that does not contract down after birth, which is the cause in the majority of cases ¹
• Why blood loss is underestimated. Visual estimation of blood loss is unreliable, which is why quantitative measurement is recommended ¹
• The expected response. A written protocol, a hemorrhage cart, defined stages of response, and blood products available ¹
• Follow-up that matters. Postpartum care is an ongoing process rather than a single visit, and severe hemorrhage warrants specific follow-up ²

What to do this week

1. Request the delivery record and the quantified blood loss, using the records request builder.
2. Ask what caused it: tone, tissue, trauma or clotting.
3. Ask for a blood count and ask specifically about intravenous iron if you are exhausted.
4. Ask what procedures were done and what that means for future pregnancies.
5. Ask for a debrief appointment with the team who were there.
6. Tell someone if you are having intrusive memories or panic. It is common and treatable. ³
7. Ask what should be in your notes for a future pregnancy.

Questions to take with you

Take these with you. Write the answers down in the moment, because you will not remember them later.

For the obstetrician

• What was my measured blood loss?
• What caused the bleeding?
• What medicines and blood products did I receive, and when?
• What procedures were done, and what do they mean for future pregnancies?
• What should I tell a future maternity team?

For your own recovery

• What is my hemoglobin now, and what should it be?
• Should I have intravenous iron rather than tablets?
• Why am I still this tired, and what would you check?
• Who can I talk to about how frightening this was?

You can also build a printable list with the question generator.

Where to read more

The full page on this condition covers how it happens, causes split into what happens even with perfect care and what is associated with gaps in care, signs by age, diagnosis, treatment, outlook, daily life and lifetime cost.

Read the full page on Postpartum hemorrhage

Related pages are listed at the bottom of it, including the events that can lead to this condition and the guides that cover therapy, school and money.