Hemorrhage, even this word by itself without any other context, can instill fear and also create a bad impression. In general, hemorrhage is the loss of blood through some bodily organ and can be a cause for concern when postpartum hemorrhage occurs. Childbirth is a delicate event for the female body. The uterus housed a baby for nine months, nourished, fed, and oxygenated it. The uterus increases up to 45 times its original size and, immediately after birth, it starts to contract back to its original size. The problem arises when these contractions do not happen as they should and the bleeding becomes excessive, leading even to postpartum hemorrhage.
Postpartum hemorrhage can trigger several problems for the mother, including leading to death, so it must be treated as soon as possible, even if using invasive procedures to preserve the mother’s life. Heavy bleeding often begins right after the placenta leaves the uterus. Still in the maternity ward, heavy bleeding is detected by the woman herself or by professionals who are accompanying her after the birth of the baby. But postpartum hemorrhage can also happen even up to a month after the procedure. This is all because the uterus is still contracting slowly and not returning to its previous form, as it still contains remnants of the placenta from the delivery.
But the most common form of hemorrhage is still the one that occurs 24 to 48 hours after childbirth. The body is led to produce oxytocin, the hormone that causes these contractions; if there is a deficiency, the body cannot create the ideal contractions, leading to postpartum hemorrhage. It is considered hemorrhage when the amount is equal to or greater than 500ml of blood, which leads to two points:
Blood transfusion: A procedure that replenishes the body’s blood so that other organs are not harmed by the reduced oxygen supply.
Checking the need for hysterectomy: Sometimes, removal of the uterus is necessary to preserve the woman’s life due to uterine postpartum hemorrhage.
In most cases of postpartum hemorrhage, using intravenous oxytocin can induce contractions to start and stop the bleeding quickly. But the doctor must stay alert, and if the bleeding returns, may need to use other techniques such as uterine massage to help the contractions.
What are the causes of postpartum hemorrhage?
There are several causes of postpartum hemorrhage. The most recurrent is a lack of the hormone that stimulates uterine contractions. Difficulty with blood clotting is also a recurring factor. It is advised that the doctor managing the prenatal care request coagulation tests before delivery to check the mother’s capacity and, if necessary, use the appropriate medications on the day of delivery. Some medications also contribute to hemorrhage, such as those that thin the blood. Baby aspirin for thrombophilia management or to prevent a stroke is one of them. Women who take these medications should stop using them about three weeks before childbirth to avoid hemorrhage.
Muscle relaxants and medications rich in magnesium can also contribute to excessive bleeding. Therefore, you should check about any medications you are taking with your doctor. The size the uterus reaches during pregnancy can also be a factor that increases the risk of uterine postpartum hemorrhage. In this case, the doctor will decide on the administration of muscle contractors to reduce greater risks.
There is also what is known as secondary postpartum hemorrhage, which happens after apparent recovery. Menstrual flow after coming home from the hospital may seem excessive, demanding frequent pad changes. If this happens, it is advised that the mother return to the maternity ward to check whether she needs treatment for this condition. Absolute rest is advisable, sexual abstinence, and avoiding going up and down stairs during postpartum recovery. Avoiding heavy lifting also helps reduce the risk of secondary hemorrhage. Postpartum bleeding tends to lessen significantly by the third day after birth; if this reduction does not occur or if the flow increases and contains clots, it is best to consult a doctor.
See also: Postpartum Menstruation – When It Returns to Normal and Pregnancy Risks
Photo: gaelx
