Postpartum Haemorrhage FAQ

Although medical interventions during birth are common these days, the majority of women give birth without serious complications for either the mother or the baby. In Europe, birth is very safe. However, sometimes situations can arise which might seriously affect the mother's or baby's health. One such issue that can affect the health of the mother is postpartum haemorrhage.

What is Postpartum Haemorrhage (PPH)?

When a woman loses a lot of blood after she has given birth this is called a ‘Postpartum Haemorrhage’. [More information]

Is it normal to lose blood after the baby is born?

Losing blood is a normal part of the process after a baby is born, as the placenta (afterbirth) comes away from the womb, but there can be problems if there is a large blood loss, although this is very uncommon. [More information]

What happens if you lose a lot of blood?

Most women can lose some blood with no problem at all, but large amounts of bleeding can cause

• anaemia (low numbers of blood cells which causes tiredness)
• shock (low blood pressure, increased heart rate, fast breathing)
• collapse
• 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 (this is an average of 1 - 3 per year in the UK). [More information]

Why does it happen?

PPH happens when the normal process of delivering the placenta (afterbirth) goes wrong. It can also happen when there has been a difficult birth, or with some medical conditions. [More information] Sometimes it is not clear exactly why a PPH has happened.

Am I at risk of having a PPH?

It is not always possible to predict who will have a PPH. However, some women are more at risk than others. [More information]

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

If you seem to be bleeding more than is considered normal, those looking after you (midwife, doctor or nurse) will act very quickly to stop the bleeding, using a variety of methods. These can include massaging the abdomen or giving you drugs. [More information]

I am at risk of having a PPH. How can it be prevented?

If you are at risk of having a PPH, you can have the delivery of the placenta managed in a way to minimise your chances of having one. This includes giving you a drug to contract the uterus. Some women at risk of PPH still want to allow the placenta to arrive naturally. For more information about the delivery of your placenta, including minimising your risk of having a PPH, see our Third Stage Pages.

If you had already had one PPH, you may be particularly worried about your risk of having another one. Click here for more information.

I do not want to be given any drugs to help the placenta be delivered. Can I let things happen naturally after my baby is born?

For most places of birth, it is routine for you to be given drugs to help contract the uterus and deliver the placenta. However having a natural delivery of your placenta can give you a calm, relaxed, special time with your baby and letting things happen naturally should be a choice open to you.

If you wish to choose this, you may have to ask clearly for it. You should discuss in advance with the health professionals caring for you if it is possible for this to happen and to make sure that they have the necessary confidence to assist you in this. For more information about the delivery of your placenta, including considering having a natural third stage, see our Third Stage Pages.

If I have a natural third stage, what can I do to try to reduce the amount of bleeding?

Third stage of labour is largely under the control of natural hormones which contract the uterus, especially oxytocin. There are several things you can do to ensure that you are producing oxytocin. [More information]

I am planning to have a home birth. What happens if I have a PPH?

Your risk of having a PPH will vary depending on your medical history and any previous pregnancies you have had.

If you are at a high risk of PPH, you will probably be strongly advised to give birth in hospital, although the choice of place of birth may well be your own decision in the end.

Birth attendants, such as midwives, who are experienced in assisting women to give birth at home will know how to deal with a PPH and will arrange transfer to hospital if necessary. For more information about home birth in relation to PPH, visit the Home Birth Reference Site.

I have had a previous caesarean and am considering my choices for my next birth. What should I take into account?

There are many things to consider when you have had a previous caesarean and your risk of PPH is only one of them. You may be considering whether to have another caesarean or whether to have a vaginal birth (VBAC).

If you are thinking about a VBAC you may be considering the setting for this, whether to be at hospital or at home. These decisions are beyond the scope of this website but your risk of PPH may affect these decisions.

For further information on PPH and previous caesareans, click here.

I have had a PPH and have lots of questions about what happened and why I feel like I do about it.

It's natural to want to understand what happened to you and come to terms with the experience. Hopefully the answers to the questions on this page may go some way to explaining why you had the PPH and why you received the treatment you did.

Having a PPH can also be a very traumatic event, both while it is happening and also when thinking about it afterwards. You may like to read about other women's experiences of having a PPH and compare their stories and emotions to your own. Women's experiences of having a PPH, in their own words.

If you have had a PPH and are particularly worried about your risk with future labours, click here.

If your wife/partner had a PPH, you may want to read A Husband's Experience of PPH.

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