When you’re in labor, the last thing you want is to worry about complications. However, Complications can happen to anyone. This is the case with postpartum hemorrhage, a scary situation involving substantial blood loss after childbirth.
But here’s the good news: something as simple and beautiful as skin-to-skin contact with your newborn can work wonders to prevent postpartum hemorrhage naturally.
In this article, we will talk about how to prevent postpartum hemorrhage naturally along with:
- What is postpartum hemorrhage?
- How can I recognize signs and symptoms?
- How can you proactively reduce risks naturally?
Table of Contents
What is Postpartum Hemorrhage?
As rare as it is, postpartum hemorrhage usually happens within 1 day (24 hours after) of giving birth, but it can happen during the last stage of pregnancy or occur up to 12 weeks after having a baby. The blood loss may be accompanied by other signs or symptoms, like low blood pressure, low body temperature, and difficulty breathing.
In 2017, the American College of Obstetricians and Gynecologists (ACOG) updated the definition of postpartum hemorrhage as a cumulative blood loss greater than or equal to 1000 ml (0.27 gallons or almost 5 cups of tea!). This amount of blood loss causes hypovolemia, a drop in the amount of fluid and blood circulating in your body, which is the principal explanation for the signs.
In the U.S., about 1-5 in 100 women who have a baby experience postpartum hemorrhage, which is the fourth cause of maternal death (12%), according to the Pregnancy Mortality Surveillance System (CDC). Meanwhile, according to the WHO (World Health Organization), severe bleeding after childbirth is the leading cause of maternal mortality worldwide, where about 14 million women per year experience postpartum hemorrhage and about 70,000 maternal deaths globally.
But When and How Does Postpartum Hemorrhage Happen?
All pregnant women have a risk of suffering from this type of bleeding since it can happen in patients without risk factors. Most of the time, about 98%, happens immediately post-delivery, and the main reason is a problem in normal contraction of the uterus after birth. Normally, the uterus contracts to push out the placenta, and this helps to put pressure on vessels where the placenta was attached to close them. But, if these contractions are not strong enough, the vessels will bleed.
What about the other 2% of the time? It can also occur days or weeks after delivery.
The reasons for postpartum hemorrhage are multiple. Some are more common than others, and include problems with the uterus (like atony, the medical name for uterus abnormal contractions explained before) or problems with the placenta (for example, when the placenta separates earlier than usual, placenta abruption) Other reasons are related to past uterus surgeries, anesthesia or medicines that are supplied during labor, among others.
Postpartum hemorrhage is one of the most common pregnancy complications and has a wide range of outcomes from anemia to death. Although every woman has a small risk of suffering from postpartum hemorrhage, some conditions like infections, gestational hypertension, or obesity increase that risk.
If This is Going to Happen, How do I Know? There Symptoms? Are There Treatments?
Well… Few symptoms will alert you that you are suffering from postpartum hemorrhage. Always bear in mind these symptoms happen in the very minute you are suffering from bleeding and it is important to act on them quickly. The first and most critical symptoms will depend on the causes of the postpartum hemorrhage.
You may feel a swelling or pain in the vagina or feel nausea right before the start of the bleeding. If the bleeding is heavy your pressure will drop quickly and you may hear a ringing in you ear, your skin may turn pale and you may feel dizzy, like you are going to pass out.
If you have any of these symptoms, 911 right away!
Most of the time, postpartum hemorrhage happens in the delivery room during the delivery or right after the baby is born. In those cases, doctors and health care providers will work quickly to stabilize you.
In those cases where the bleeding starts in your home, or during the travel to the hospital, it is considered a medical emergency and you need to be treated immediately.
Knowing what causes the bleeding is critical for the healthcare team. If retained placenta, tearing in the uterus, or other surgical problems are suspected, you are transferred to the opening suite. Doctors will perform a series of blood tests and pelvic exams to determine the actual cause. The main treatments are related to the causes of the bleeding -I repeated it several times since it is the most important thing- but all women in this situation will receive:
- Manual uterine massage to stimulate the uterus contraction.
- Oxytocin is the first treatment since is the hormone that induces uterine contractions.
- Methylergonovine which helps oxytocin. However, it is not indicated in hypertension patients.
What About Prenatal Care? Is there Something There that Prevents Postpartum Hemorrhage?
The most important thing is to go to the prenatal care checkups, as soon as you find out that you are pregnant, make an appointment. Talk to your doctor about your health conditions and your pregnancy history.
Do not be shy! Your doctor needs to know all your family health history. Do not be afraid if he asks you lots of questions, it is all confidential.
Your doctor will perform some physical exams, like a check of your overall health, pelvis exams, and lab tests to check your blood parameters and blood type and Rh factor, know if you have some infections -like HIV, among a long list of test (all in blood and urine samples).
All these data will help your doctor (and the healthcare team) to find if you have risk factors for any pregnancy complication, preeclampsia for example. Also, it gives information if you have to take some medication, like iron supplementation.
Are There Any Natural Methods to Reduce the Risk of Postpartum Hemorrhage?
Of course, there are plenty of them! Nutrition, physical activity, and Birth Plan, among other new, and not so new, techniques are available for you!
The first method, and advice, is to follow a balanced diet. Your nutrition is one of the most important issues in this new stage of your life, not only to ensure a healthy pregnancy, but for your baby’s growth and health, and your life as a mother -that will require a lot of energy. Be sure to include different vegetables and fruits, consume rich-fiber meals, try to avoid ultra-processed food -since it has amounts of salt and unhealthy fats, and limit coffee and tea.
Keep your body in movement, but according to your pregnancy stage. Practice yoga, mindfulness, or walking. Physical activity is important to your body and your mood. For example, moderate-intensive activity keeps your heart and lungs healthy during and after pregnancy.
Supportive Medical Provider
Prenatal support and confidence are essential. Prenatal care checkups have a psychological impact. You will have the opportunity to choose and know the doctor who will stay with you during labor. One of the goals of this appointment is to get confident and trust your doctor. To share your fairs and desires, how you deliver your baby… all this is known as the Birth Plan!
Have you heard about fundal massage? It is not a pleasure type of massage but is fundamental to uterus contraction and prevention of postpartum hemorrhage. After the delivery of the placenta, your nurse or midwife has to locate the upper part of your uterus and massage from there to eliminate clots and blood that may be retained. This massage helps the natural contraction of your uterus and closes the vessels -avoiding extremal bleeding- although it may be painful and uncomfortable. A randomized controlled trial 176 with pregnant women showed that postpartum uterine massage -fundal massage- reduces the incidence of postpartum hemorrhage.
Skin to Skin Contact or Breastfeeding
Knowing these things, and getting informed is essential while you are pregnant. Why? Because it makes you feel in control and safe. And I will tell you what those things shut in your body: hormones. Hormones that are related to uterine contraction, to lactation, and make you feel strong. The most important of those hormones is oxytocin. But, there is a second hormone as important as oxytocin which is melatonin. Oxytocin is responsible for uterine contractions, and melatonin is related to our internal clock. But during pregnancy, these two hormones, with others, are released synchronously, improving contractions as the labor date approaches.
After birth, the first contact with your baby will trigger oxytocin! That is why skin-to-skin contact and immediate breastfeeding help to prevent postpartum hemorrhage and are considered innovative and crucial ways for the optimal management of this complication.
A study with 7548 pregnant women showed that skin-to-skin contact and immediate breastfeeding reduce the risk of postpartum hemorrhage by 50%! The suction of the baby during lactation increases oxytocin levels in the blood, helping uterus contraction as well as milk release.
The literature is plenty of these types of studies, encouraging skin-to-skin contact and breastfeeding immediately after the baby is born. And it is nothing more natural to be in touch with your baby since the first minute you find out you are pregnant.
Taking a natural approach to preventing postpartum hemorrhage is about physical well-being and empowering mothers with knowledge and support during childbirth.
Understanding the risk factors and causes of postpartum hemorrhage allows you to take proactive steps, such as prenatal care and open communication with your healthcare providers. These actions ensure a safe and joyful birthing experience. Moreover, embracing natural techniques, like skin-to-skin contact and immediate breastfeeding, plays a pivotal role in this preventive strategy.
By focusing on both the physical and emotional aspects of childbirth, we can strive for a natural approach to postpartum hemorrhage prevention.
Monica has a Ph.D. specializing in molecular and cell biology. with more than 10 years in reproductive medicine, she has now turned to medical and scientific communication through writing. She is passionate about scientific writing, and her goal is to turn the complex language of science into simple and relatable words.