Having a Baby After a Previous PPH

If you had already had one postpartum haemorrhage (PPH), you may be particularly worried about your risk of having another one.

Questions you may be asking yourself and others are “Is it likely to happen again?” “Can it be avoided?” “Will it affect how I should labour and give birth?”

Research has shown that in general you are three times more likely to have one than women with no risk factors. There is no easy answer about what to do and you may have to make choices about:

• Where to have your baby (hospital, home or any community-based alternatives available to you).
• Whether to have a managed third stage or to deliver your placenta naturally.
• Whether a caesarean is a choice.

For some women these choices will be easy. You are likely to be strongly advised to give birth in hospital where specialist care is available, and to have drugs to contract your uterus as soon as your baby is born to prevent excessive bleeding. You may also be advised against using a birth pool, and it is possible that your medical team will prefer you to labour with a cannula in your hand or arm in case you need fluids urgently through a drip.

Some women, however, choose to have a non-medicalised birth to reduce their risk of PPH. If you do this, then it is important to make sure that you and your birth attendants are knowledgeable about what to do in the event that you do begin to bleed excessively.

The choices you make will depend on your particular circumstances and the support you have for those choices. Postpartum haemorrhage can be very serious but in most cases it is either preventable and treatable. You should discuss your choices carefully with the health professionals looking after you during your pregnancy.