What happens if I lose a lot of blood after my baby is born?

If the healthcare professionals are worried that you are bleeding excessively after giving birth or if the placenta has not been delivered within the usual time frame, they will follow a number of procedures. The precise treatment may vary from hospital to hospital, and from country to country.

Delivering the placenta

If the placenta has not been delivered, they will try to ensure that this happens quickly. This will involve giving drugs to make the uterus contract (called uterotonics or oxytocics) if they haven't already been given as part of your routine medical treatment.

They may also try ‘controlled cord traction’ which involves pulling gently on the umbilical cord to help the placenta to come out.

They may also try to massage the abdomen to help the uterus contract so that the placenta can be delivered.

If the placenta is still in, they may put in a catheter to empty your bladder (or you may try to pass urine yourself if you are able) and then try again to deliver the placenta.

If this still does not work, you may need to have it manually removed under a general anaesthetic, spinal anaesthetic or epidural. If this happens it is likely that you will need to have a drip put up, and blood samples taken for cross-matching in case you need a blood transfusion.

Bleeding after the delivery of the placenta

If excessive bleeding occurs after delivery of the placenta (postpartum haemorrhage), uterotonic drugs may be given if not given already, and the bladder emptied by a catheter. You may need to have additional uterotonic drugs to control the bleeding. Again, the uterus can be massaged through the abdomen to stimulate a contraction. These actions may be sufficient to stop the bleeding.

If bleeding continues or is severe

If you are losing a lot of blood quickly, additional medical staff will be alerted. You will be closely observed, with your pulse and blood pressure checked. Blood samples will be taken and a drip will be put up.

You may be given fluids to replace the blood you are losing, to ensure that your blood pressure does not drop too low. If bleeding continues you may be given blood products to replace the blood you are losing.

You will be checked to find out where the blood is coming from, for example whether you have suffered some damage during the birth rather than the blood coming from where the placenta was. If this is the case, this will need to be repaired. It is also possible that some of the placenta has been left behind, in which case you may need an operation to remove this.

If bleeding continues from the placental site, bimanual compression of the uterus may be done. This involves pressing the abdominal wall flat with one hand while the other hand dips down behind the top of the uterus so that it is compressed and pulled up at the same time.

If the woman experiencing the postpartum haemorrhage is under an anaesthetic, the bimanual compression can be done internally.

If the bleeding continues, the woman will be prepared for emergency procedures. The blood may be tested to see how well it is clotting in case this is the cause of the problem. There are a number of surgical techniques which can be used to stop the bleeding but once all other possible procedures have been exhausted without success, a hysterectomy may have to be performed. Studies have suggested that this might happen to 1 in 2000 to 1 in 2500 women giving birth.