Postpartum hemorrhage (PPH) is severe or excessive bleeding after childbirth. It’s a serious, potentially life-threatening condition. Signs are dizziness, feeling faint and an increase in heart rate. PPH can occur after delivery or up to 12 weeks postpartum. Early detection and prompt treatment can lead to a full recovery. Get help right away if you’re experiencing symptoms of PPH.
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Postpartum hemorrhage (PPH) is severe bleeding after giving birth. It’s a serious and dangerous complication that requires immediate treatment. PPH usually occurs within 24 hours of childbirth, but it can happen up to 12 weeks after delivery (postpartum). With PPH, you can lose large amounts of blood very quickly. It causes a sharp drop in blood pressure, which can restrict blood flow to your heart, brain and other organs. When your organs don’t get enough blood flow due to active bleeding, this is called hypovolemic shock which can be deadly. The labor and delivery team needs to find and stop the bleeding as quickly as possible.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Bleeding excessively after giving birth can be scary and traumatic. You probably didn’t expect your birth experience to go this way. It’s important to share any concerns about excessive bleeding after delivery with your pregnancy care provider so they can identify signs of PPH as soon as they occur. With early detection and prompt treatment, most people make a full recovery. Most PPHs occur immediately after delivery.
Postpartum hemorrhage occurs in about 1 to 5 of every 100 deliveries (1% to 5%), and most cases aren’t life-threatening with prompt treatment.
Postpartum hemorrhage is when:
AND/OR:
There are two types of PPH: primary and secondary (late).
The most common symptom of postpartum hemorrhage is persistent, excessive vaginal bleeding after delivery. This can include passing several large blood clots (anything larger than a golf ball may be a sign of a problem).
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Other signs of PPH are:
Tell your healthcare providers about any concerning symptoms or changes you notice after delivery. In some cases, PPH doesn’t cause symptoms until after you’ve left the hospital. Contact your healthcare provider immediately if you feel any of the symptoms above in the days or weeks after giving birth.
There are a few reasons why postpartum hemorrhage occurs.
Your placenta attaches to the wall of your uterus and provides food and oxygen to the fetus during pregnancy. After your baby is born, your uterus continues to contract to deliver the placenta. Contractions also help to compress the blood vessels where the placenta was attached to your uterine wall. Sometimes, these contractions aren’t strong enough to stop the bleeding. This is the cause of up to 80% of postpartum hemorrhages.
Postpartum hemorrhage can also happen if parts of the placenta stay attached to your uterine wall or if your reproductive organs are damaged during delivery.
Most cases of PPH happen within 30 to 60 minutes of giving birth.
The causes of postpartum hemorrhage are often called the four Ts (tone, trauma, tissue and thrombin). The following conditions or factors summarize the most common causes of PPH:
Postpartum hemorrhage can affect anyone after childbirth. There are many risk factors for PPH, but approximately 40% of hemorrhages occur without any risk factors. Healthcare providers may not be able to prevent PPH from happening, but identifying risk factors before delivery can help reduce the chances of severe blood loss.
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Your risk of postpartum hemorrhage is higher if you have a condition that affects your placenta. These conditions may include:
Certain factors during labor and delivery can increase your risk of hemorrhage:
Other health conditions that can increase your risk for postpartum hemorrhage are:
An overdistended uterus also increases the risk for PPH. This is when your uterus is overstretched from:
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Excessive blood loss can cause several complications like increased heart rate, rapid breathing and decreased blood flow. These symptoms can restrict blood flow to your liver, brain, heart or kidneys and lead to shock. Shock is when your organs don’t receive enough blood. It can lead to organ failure or death.
Most of the symptoms of PPH are the same in a C-section as a vaginal delivery. Some of those signs include:
Healthcare providers diagnose postpartum hemorrhage through visual and physical examinations. Lab tests and a thorough review of your health history may also be important to assess the risk and impact of a PPH.
Postpartum hemorrhage is diagnosed based on the amount of blood you’ve lost. Counting or weighing the blood-soaked pads or sponges from delivery is one common way to approximate blood loss.
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Other tools that may be used to evaluate you if there’s concern for a PPH are:
Healthcare providers treat PPH as an emergency in most cases. Stopping the source of the bleeding as fast as possible is the main goal of treatment.
Your provider may use any of the following treatments depending on what’s causing your bleeding and how severe the bleeding is:
In rare cases, or when other methods fail, your healthcare provider may perform a laparotomy or a hysterectomy (removing your uterus). A laparotomy is when your surgeon makes an incision in your abdomen to locate the source of bleeding.
Recovery is different for everyone. Recovering from a postpartum hemorrhage depends on the severity of blood loss and how your healthcare provider treated it. Be sure to take care of yourself in the days following delivery — eating healthy, drinking lots of water and resting as much as possible. Your healthcare provider may recommend an iron supplement to help with anemia.
The best way for healthcare providers to prevent postpartum hemorrhage is to identify people at a higher risk for postpartum hemorrhage before delivery. You can help your provider by sharing your full medical history and letting them know if you have symptoms of postpartum hemorrhage after delivery.
Yes, it’s usually safe to have another baby. Talk to your healthcare provider about your risk of hemorrhage with future deliveries. While your risk is slightly higher than normal, it’s still low. Your provider can go over your risk factors and determine if any precautions should be taken in future deliveries.
It can be difficult to care for a newborn while also caring for yourself, but getting rest and taking care of yourself can help you feel better. Your self-care is important. Some tips for prioritizing your wellness include:
Experiencing excessive bleeding can be traumatic. It’s OK if it takes time to heal emotionally from your birth experience. You may need support from your family, friends, healthcare providers or others. Share how you’re feeling and ask for help when you need it.
Most cases of postpartum hemorrhage occur at delivery or right after when you’re still at the hospital or birthing center. If you bleed heavily or experience any symptoms of postpartum hemorrhage once you’re home, contact your healthcare provider immediately. If your provider’s office is closed or you can’t get in contact with someone, you should go to the nearest emergency room.
Contact your healthcare provider immediately if you’re experiencing severe bleeding after childbirth. Other signs of postpartum hemorrhage are dizziness, feeling faint and shortness of breath. Postpartum hemorrhage is a serious condition that requires medical attention as soon as possible.
If you or a loved one had a postpartum hemorrhage, it’s understandable if you feel traumatized or scared from your experience.
Early detection and prompt treatment can help prevent serious complications. It’s important to be open with your healthcare provider about your medical history so they can determine if you’re at a higher risk for postpartum hemorrhage.
Last reviewed on 11/12/2024.
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