What is the effect of losing a lot of blood?

The effect of a postpartum haemorrhage (PPH) depends on

• the amount of the blood loss,
• the speed with which a woman loses blood,
• her body's ability to cope with the loss.

Although PPH is often taken to be a loss of more than 500mls (about a pint), it is more common after a caesarean birth to lose 1000mls and women can usually manage to lose up to this amount with no ill effects. Opinions vary as to how much blood can be lost without a problem and also it can be hard to estimate blood loss with accuracy.

Women also vary in their ability to tolerate blood loss with no obvious effects. Women who are not anaemic and are healthy and well nourished can tolerate blood loss better than malnourished or anaemic women but in any woman, excessive bleeding can cause

• anaemia,
• shock (low blood pressure, increased heart rate, fast breathing),
• collapse, and
• in the worst case, death.

This is why PPH is taken very seriously. The risk of dying from PPH has been estimated in the UK to be 3 - 5 per million women giving birth (about 1 - 3 women on average per year in the UK).

Countries will vary in the rate of maternal death due to PPH - in Poland it is about 30 per million giving birth and in parts of Africa it has been reported to be about 565 per million giving birth, over 100 times the rate in the UK. Improvements in health, hygiene and healthcare practices can reduce the number of problems resulting from PPH but in many areas of the world these are still a major issue.