Postpartum hemorrhage can turn a normal birth into an emergency fast. If you or someone close to you is bleeding heavily after delivery, quick action matters. Knowing the signs and basic steps can protect health and save lives.
Postpartum hemorrhage usually means heavy bleeding after birth — more than about 500 ml after a vaginal birth or 1,000 ml after a C-section. Common signs: soaking a pad in under an hour, a fast heartbeat, feeling faint, low blood pressure, extreme tiredness, or visible large clots.
If you see heavy bleeding, call emergency services right away. While help is on the way: have the person lie down with their feet raised, keep them warm, and try to stay calm. If someone present knows how to do a fundal massage (pressing the top of the uterus), that can help the uterus contract and slow bleeding. Avoid giving anything by mouth unless a clinician says it’s safe.
In hospital, care focuses on finding the cause and stopping the bleeding. Causes include uterine atony (the uterus not contracting), tears in the birth canal, retained placenta, or blood-clotting problems. Treatments often used are:
- Uterotonics: drugs that make the uterus contract. Oxytocin is the most common IV or IM option. Ergometrine and misoprostol are alternatives in some settings.
- Tranexamic acid: an antifibrinolytic medicine given IV early in bleeding to reduce death from hemorrhage.
- Fluids and blood transfusion if blood loss is large.
- Mechanical measures like a balloon tamponade to put pressure inside the uterus, and surgery if needed (artery ligation or hysterectomy in severe cases).
Pharmacists can’t treat PPH at home, but they play a useful role before and after birth. They can explain what uterotonics and tranexamic acid do, review drug interactions (for example, with certain blood thinners), and help families understand prescriptions and side effects. If you’re planning maternity care, ask your pharmacist about iron supplements — treating anemia before birth lowers PPH risk.
Prevention is practical: active management of the third stage of labor (routine use of oxytocin after delivery, controlled cord traction, and uterine massage) cuts PPH rates. Knowing risk factors helps too: past PPH, multiple pregnancy, a very large baby, prolonged labor, or anemia increase the chance of heavy bleeding.
If you have questions about medicines mentioned here or want to know how to prepare after delivery, talk with your care team and a pharmacist. And if heavy bleeding happens, get emergency medical help right away — time matters.
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