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24 hours to 6 weeks after giving birth

Postpartum haemorrhage

Heavy bleeding that starts anytime from 24 hours after you have given birth, to up to 6 weeks later, is called secondary postpartum haemorrhage (PPH). It's also known as 'delayed PPH'.

Causes of secondary PPH

Secondary PPH can happen because of:

  • an infection – usually in the lining of your womb (endometritis)
  • placenta remaining in your womb after the birth (retained placenta)

Symptoms of secondary PPH

You may notice:

  • your vaginal bleeding is getting heavier
  • clots in the blood.
  • a bad smell from the blood
  • that you start to feel unwell
  • aches and pains
  • shivering
  • a high temperature (greater than 38 degrees C)

Contact your midwife, GP or obstetrician if you develop any of these symptoms.

How a secondary PPH is treated

A secondary PPH is usually treated with antibiotics.

You may need to go back to the maternity hospital if your bleeding is heavy or you keep bleeding after taking the antibiotics.

If you have to go to hospital

You might need a scan to check if any placenta remains in your womb. If your obstetrician thinks there may be placenta in your womb, you may need an operation to remove this.

You may also be given antibiotics through a drip.

Your baby can stay with you. You can continue to breastfeed. Make sure the doctors and midwives treating you know that you are breastfeeding.

Tell your midwife, obstetrician or GP if you prefer not to receive blood or blood products for religious or cultural reasons. This can be written clearly in your medical notes.

page last reviewed: 30/04/2021
next review due: 30/04/2024