WHY DOES HEAVY BLEEDING HAPPEN SOON AFTER BIRTH

 If you have bleed after the birth, you may feel the blood trickling out of your vagina, or it may build up inside your womb or vagina and gush out when  you move or stand up. You may not even be aware of PPH  until other signs and symptom  appear, such as;

a drop in your blood pressure;

a rise in your pulse rate;

feeling faint and dizzy.

Your midwife will regularly check the top of your womb after you've  given birth, to make sure it stay firm and contraction . If it's  soft, she will encourage a contraction by massaging your tummy,. She'll  also monitor your vaginal blood loss to make sure it isn't too heavy. Your midwife will treat you with drugs via a drip, injection, or a suppository to help your womb to contract down, . If you have a tear, your midwife or doctor will carefully stitch it. Your doctor may also give you iron tablets yo help your blood levels return to normal . If you lose a lot of blood, you may need a blood transfusion,  but this is rare.

There are several other reasons why heavy  bleeding  may occur after the birth, which are less common that uterine atony. These include:

Retained placenta or membranes left behind in your womb after the birth, which stop the blood vessels sealing off properly.

Injury to you during the birth, as a result of a planned or emergency caesarean birth.  Greater blood loss is expected on average during a caesarean birth when compared with vaginal birth, particularly in an emergency caesarean.

 Injury to you during an assisted birth. This is usually associated with forceps rather than ventouse, episiotomy or tears to your vaginal or perineum,  or more rarely, an injury to your cervix.

Complications that affect the ability of your blood to clot including pre- eclampsia , gestational hypertension or having a fever in labour.

Losing 500ml or more of blood  between  24 hours and 12 weeks after having your baby is called secondary PPH. It's most common in the second week. However secondary PPH only happens in under one per cent of births.

If you're at home and you pass a clot larger than a 50p piece or have a sudden gush of blood, then  contact your midwife or maternity unit as soon as possible. If you can keep hold of the clot you  have passed then this will help the midwife assess the situation when she examines you.

 You're more likely to have secondary PPH if you've had  a primary PPH or a retained placenta. The bleeding may be due to small pieces of the placenta or membrane being retained in the womb, or an injection ,.  If this is the case, you may need to have antibiotics to clear the infection. Or  your doctor may need to perform a minor operation to remove tissue fragments from your womb.

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