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Postpartum haemorrhage

Postpartum haemorrhage (PHH) is heavier than normal bleeding from the vagina from any time up until 6 weeks after your baby's birth.

To help prevent PPH, you will be offered an injection of oxytocin when your baby is born. This helps your womb to contract and helps prevent heavy bleeding.

Normal bleeding after birth

It is normal to bleed from your vagina after having a baby. This bleeding can last for up to 6 weeks. It is usually heaviest straight after the birth and reduces a lot in the days that follow.

The blood is bright red at first. It usually changes colour to shades of brown over the next few weeks.

Bleeding happens after vaginal births and after caesarean births.

Heavy bleeding after birth

Heavy bleeding means losing 500 ml (a pint) or more of blood in the first 24 hours after your baby is born.

Contact your midwife, obstetrician, GP or maternity hospital after the birth if:

  • your bleeding is getting heavier
  • you notice a bad smell from the blood coming from your vagina
  • you are bleeding and you feel unwell

There are 2 types of PPH that can cause heavy bleeding after birth.

These are:

  • primary postpartum haemorrhage (early PPH)
  • secondary postpartum haemorrhage (delayed PPH)

Primary postpartum haemorrhage

This is also called, early PPH. It is where you have heavy bleeding in the first 24 hours after giving birth.

Read more about primary postpartum haemorrhage

Secondary postpartum haemorrhage

This is also called, delayed PPH. It's when you have unusual or heavy bleeding from 24 hours until 6 weeks after the birth of your baby.

Read more about secondary postpartum haemorrhage

Risk of postpartum haemorrhage

Around 5 in 100 women will lose around 500ml of blood after giving birth. This is sometimes called, a minor PPH. More severe PPHs or major PPHs are much less common. They happen to 6 in 1,000 women.

Certain things may increase your risk of a heavy bleed in the first 24 hours after giving birth.

Read more about risk factors for primary postpartum haemorrhage

The effects of postpartum haemorrhage

Losing a lot of blood after you give birth can make you feel very tired and weak.

Most women can cope with a minor post-partum haemorrhage, where around 500ml of blood is lost (1-2 pints). But a minor PPH can get worse.

If it does, it might become a major PPH. A major PPH can be life-threatening. This is why it is important that haemorrhages are treated quickly.

Treating postpartum haemorrhage

Haemorrhages should be treated quickly. The treatment you will have will depend on when you are heavily bleeding - if it is in the first 24 hours after giving birth or later.

Read about treating a primary postpartum haemorrhage (heavy bleeding within the first 24 hours)

Read about treating a secondary postpartum haemorrhage (heavy bleeding after the first 24 hours)

If you have a haemorrhage your obstetrician may advise a blood transfusion.

If you don't want to get blood or blood products, tell your obstetrician and midwife at an early antenatal appointment. This will help them to make sure your wishes are known. It can be written clearly in your medical notes.

After a postpartum haemorrhage

You may be invited to a follow-up appointment in the hospital after a PPH. This is to see how you are doing. You can ask any questions or talk about concerns you may have. You may also be offered extra healthcare support.

Some women experience symptoms of post traumatic stress disorder (PTSD) after a PPH.

Symptoms of PTSD can include:

  • unwanted thoughts
  • flashbacks about the birth
  • increased anxiety
  • inability to sleep

These symptoms can be treated with the right support.

If you are experiencing these symptoms, talk to your GP, midwife or obstetrician.

Your next pregnancy after having a postpartum haemorrhage

You are at increased risk of another PPH during another pregnancy, if you had one before.

If you get pregnant again, you will likely be advised to:

  • see an obstetrician at the hospital for most of your appointments
  • take an iron supplement in pregnancy to reduce the chance of anaemia

At any of your next births, you will have an IV drip inserted. You will be advised to have medication to contract the uterus after the baby has been delivered. This is to reduce the risk of PPH having again.

Page last reviewed: 13 January 2021
Next review due: 13 January 2024

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This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 8.