After giving birth, some bleeding is normal. Heavy postpartum bleeding, or postpartum hemorrhage, is different from the normal bleeding experienced after vaginal and C-section deliveries. Treatment options for this problem can range from uterine massage to medications to additional surgery. The particular treatment used will depend on individual factors.
Some bleeding is normal following both vaginal and C-section deliveries. Most postpartum bleeding occurs right after birth. This is due to contractions of the now partially empty uterus, causing the placenta to detach. When the placenta detaches, the blood vessels that attached the uterus to the placenta begin to bleed. This bleeding continues until the uterus contracts around the blood vessels, shutting any that are open. If the uterus fails to contract, postpartum bleeding will be heavier than normal. In this case, it's called postpartum hemorrhage.
Postpartum bleeding usually occurs immediately after birth, but can occur slowly over the first 24 hours. In rare cases, postpartum bleeding and postpartum hemorrhage can occur more than 24 hours after delivery. During labor and delivery, bleeding may result from problems with the placenta or tears in the vagina, rectum, or uterus. Postpartum hemorrhage happens in about 5 to 8 out of 100 deliveries.
The most common cause is called uterine atony. This means that the uterus does not contract during and after delivery of the placenta. The second most common cause is retained placenta. This is when the placenta does not come out after the baby is delivered, or when it breaks up and parts of the placenta are left behind. Other causes of postpartum hemorrhage can include:
- Low placental implantation, which is when the placenta implants lower in the uterus than it should (also called low-lying placenta)
- Blood-clotting problems.