Understanding Postpartum Bleeding for a Safer Delivery

Childbirth is both an eagerly awaited and thrilling moment. The birthing process also carries medical risks that must be considered, one of which is postpartum hemorrhage, also known as the puerperium. Postpartum hemorrhage can be a serious condition and poses a risk to the mother's life. Knowing the symptoms, prevention methods, and when to see a doctor is crucial for every pregnant mother.

Postpartum hemorrhage (PPH) is excessive blood loss after childbirth, whether through vaginal delivery or cesarean section. According to the American College of Obstetricians and Gynecologists, this condition occurs when you lose 1,000 ml or more of blood after giving birth. According to data from the Indonesian Ministry of Health, hemorrhage contributes to approximately 19.3% of all maternal deaths in Indonesia, making it one of the leading causes of maternal mortality (MMR) in the country.

Postpartum Symptoms

It's important to be aware of postpartum symptoms to save the lives of both mother and baby. Some conditions to watch out for after giving birth include:

  • Vaginal bleeding that does not decrease or stop, even tending to exceed one sanitary napkin per hour.
  • Blood pressure drops drastically (hypotension)
  • Increased heart rate (tachycardia)
  • The body feels weak, dizzy, and even loses consciousness.
  • Cold sweats and swelling in some parts of the body
  • Postpartum abdominal pain does not improve

If you experience one or more of these symptoms, especially within 24 hours of delivery, this condition should be considered a medical emergency that requires immediate medical attention.

Why Does Bleeding Occur?

There are several main causes of postpartum hemorrhage, including:

1. The uterus does not contract properly

After the baby and placenta are delivered, the uterus should contract to help stop bleeding from the placental site. If the uterus doesn't contract optimally, bleeding can occur. This condition is called uterine atony and is one of the most common causes of PPH.

2. Remaining placental tissue

Some placental tissue remaining in the uterus can inhibit the uterine contraction process, causing bleeding.

3. Tears in the birth canal

Tears in the vagina, cervix, or tissue around the birth canal can cause bleeding after delivery.

4. Blood clotting disorders

In some mothers, blood clotting disorders can make it difficult for the body to stop bleeding normally.

5. Placenta-related conditions

Some conditions of the placenta, such as placenta previa or placenta accreta, can increase the risk of bleeding during or after delivery.

Who is at risk for postpartum hemorrhage?

Postpartum hemorrhage can occur in anyone, including women who previously had no problems during pregnancy. However, certain conditions can increase the risk, such as:

  • Twin pregnancy
  • Big baby
  • Prolonged labor
  • Previous history of postpartum hemorrhage
  • Abnormalities or problems with the placenta
  • Overstretched uterus
  • Blood clotting disorders
  • Delivery with certain actions

Postpartum Prevention

Although postpartum hemorrhage can happen to anyone, a number of preventive measures can significantly reduce the risk, including:

  • Carry out regular pregnancy check-ups ( antenatal care ) so that doctors can detect risk factors early.
  • Maintain nutritional and iron intake during pregnancy to prevent anemia which can worsen the impact of bleeding.
  • Choose to give birth accompanied by professional medical personnel in an adequate health facility.
  • Monitor the condition of the uterus and signs of bleeding closely in the first 24 hours postpartum.

Postpartum hemorrhage is an important condition for mothers and their families to understand as part of preparing for the postpartum period. With the right information, mothers can better understand the changes occurring in their bodies, recognize the signs to watch for, and know when to consult a healthcare professional. Good knowledge can help mothers navigate the postpartum period with greater calm, preparedness, and confidence.

Contact an obstetrician and gynecologist (OBGYN) immediately if you experience heavy bleeding that doesn't stop, accompanied by excessive weakness, dizziness, cold sweats, or decreased consciousness, either while you're still in the hospital or after you return home. Don't wait for symptoms to worsen; prompt treatment is key to preventing life-threatening complications.

Your health and that of your baby are your top priority throughout every stage of pregnancy, including delivery. Regular prenatal checkups with the experienced team of obstetricians and gynecologists at EMC Hospital Cikarang will help you detect risks early and ensure a safe and comfortable delivery.

This article was written by Dr. Djoni Nurung, Sp.OG, Subsp. Urogin-RE (Obstetrics and Gynecology Specialist, Subspecialist in Reconstructive Urogynecology, EMC Cikarang Hospital).