Blood volume actually increases by 50% in pregnancy–pregnant women actually make anextra 1250ml blood. So women can actually afford to lose a little bit of blood following birth.And this is normal. What is not normal is bleeding in pregnancy or bleeding during labour. It means something is happening to the placenta–it needs immediate attention. Call your birth unit–they will ask you to come in.
Normal blood loss following birth is less than 500mls–this can actually look quite a lot.Midwives are skilled at measuring blood loss. Often they can visually assess it sometimesthey have to measure it. If the blood loss is less that 500mls then all is good to go, notreatment required. Feed your baby, stay hydrated.
A primarypostpartum haemorrhage (PPH) is more than500ml blood loss in the first 24hours of giving birth. A minor PPH is 500–1000mls, amajor PPH is > 1000mls. A secondary PPH is excessive bleeding > 24hrs–12 weeks. Women mayhave no symptoms of blood lossor some women experience shock. There are guidelines in place at all hospitals on how totreat PPH and shock.But basically the first line of treatment for a PPH is a drip of a largedose of oxytocin “synto”andhands on your belly to rub the top of your uterus. If it doesn’tstop there are many other options. A blood transfusion is only given on assessment of bloodloss, haemoglobin level and how you are coping.
There are some identifiable risk factors but most PPH’s don’t have them. The biggest cause of PPH is the simple fact that the uterus won’t contract after the baby is born. Women who have had a PPH before will be given a cannula (drip)on admission just in casea synto drip is needed to contract the uterus after birth. Anaemia is important to be treated in pregnancy. A low haemoglobin and platelets(lessclotting factor)at birth time does not help if she was to have a PPH. This is easily checked with a blood test. There is nothing you can do to prevent a PPH. But your midwife will know exactly how to handle it.
Warm wishes
Jacqui