Am I at risk of having a postpartum haemorrhage?

It is not always possible to predict who will have a PPH.

Some conditions known during pregnancy can increase the risk. These are listed below with the estimated increase in risk of having a PPH:

Placenta praevia (low lying placenta)	12x
Multiple pregnancy	5x
Pre-eclampsia/high blood pressure	4x
Having a first baby	3x
Had a PPH in a previous pregnancy	3x
Ethnic Asian	2x
Obese	2x

There may also be additional risks if you have had many children, have had bleeding during pregnancy, have fibroids, have problems with blood clotting or if you are anaemic.

Some procedures or conditions arise during labour or the birth and increase the risk of having a PPH.

Emergency Caesarean	9x
Elective Caesarean	4x
Retained placenta	5x
Operative delivery (forceps or ventouse)	2x
Labour lasting more than 12 hours	2x
Large baby (more than 4kg)	2x

In general, having medical interventions can increase your risk of having a PPH. Avoiding unnecessary interventions is one way of decreasing your risk of having one.

The overall incidence of PPH is estimated to be in the region of 5%. Statistics for England 2004-05 record it to be 6.7%, although the proportion of women having problems as a result may be much lower. A Scottish study showed 0.3-0.4% of women to have a severe PPH (more than 2500mls - 5 pints - of blood loss).