11.1  What is postpartum haemorrhage?

Postpartum haemorrhage (or PPH) is defined as excessive bleeding from the reproductive tract at any time following the baby’s birth and up to six weeks after delivery. Some 70–90% of PPH cases occur within the first 24 hours after delivery and are due to failure of the uterus to contract properly after the placenta detaches. Firm uterine contraction is necessary to close off the torn blood vessels in the placental bed.

Risk factors are existing underlying conditions which make a condition more likely to happen or more dangerous.

PPH is an unpredictable and rapid cause of maternal death. It is unpredictable in that two-thirds of women who develop PPH have none of the known risk factors (doctors refer to an adverse condition as idiopathic if there is no known reason why it occurred). In other cases, a woman with PPH does have one or more of the known risk factors (we review them later in this study session), or the PPH is due to mismanagement of the third stage of labour by the healthcare provider.

Learning Outcomes for Study Session 11

11.1.1  How much bleeding is ‘excessive’?