Postpartum haemorrhage (PPH) is one of the most serious complications that can occur after childbirth, and it can become life-threatening if not treated quickly. Yet, with proper care, awareness, and timely medical intervention, many cases can be prevented and successfully managed.

In this Health Matters feature, Dr Michael Mbulo explains why heavy bleeding can occur after birth, the common causes and risk factors, and why regular antenatal care and hospital-based delivery are essential for protecting the health and wellbeing of both mother and baby.

BY DR MICHAEL MBULO, OBGYN

Postpartum Haemorrhage: What Every Parent Should Know

A Simple Guide to Understanding Bleeding After Birth and How to Prevent It

Why Does Bleeding Happen After Birth?

Having a baby is a wonderful event, but sometimes things do not go as planned. One of the most serious dangers after childbirth is heavy bleeding, also called postpartum haemorrhage (PPH). It is a worldwide issue and one of the main reasons mothers lose their lives after giving birth. But the good news is, with good care, it can be prevented and treated.

It is important to know that towards the end of pregnancy an incredibly large amount of blood flows through the placenta. The placenta is a temporary vital organ that connects the mother and the baby, and it supplies the baby with oxygen and nutrients, removes waste products, and produces hormones necessary to maintain the pregnancy. Following the delivery of a baby, the placenta separates from the uterine wall and gets delivered as well.

With separation of the placenta, the blood vessels on the placental bed of the uterus get torn and bleeding is initially controlled by contraction of uterine muscles which compresses the bleeding vessels. This is then followed by clotting and subsequent obliteration of these vessels. Failure of the uterus to contract after placental separation leads to excessive placental site bleeding.

What Causes Bleeding?

Weak Uterine Muscles (Uterine Atony)

Normally, after the baby and placenta are delivered, the uterus squeezes tightly to help stop bleeding. Sometimes the muscles don’t squeeze hard enough, especially if the uterus is stretched from a big baby, twins, too much fluid or the presence of fibroids.

Long or very fast labours, labour induced with medicines, or many previous pregnancies can also make it harder for the uterus to work well. When this happens, too much blood can be lost.

Birth Injuries

Some injuries from childbirth are easy to see, while others may happen inside the uterus and are not obvious right away. Because of this, it is safest for all pregnancies to be delivered in a hospital where help is immediately available.

Retained Placental Tissue or Clots

Sometimes, pieces of the placenta or clots stay behind in the uterus after birth. If this happens, the uterus cannot squeeze properly, and bleeding continues.

Low Placental Implantation

When the placenta attaches lower down in the uterus, there are fewer muscles to help squeeze it after delivery. This means the uterus may not be able to control the bleeding at the site where the placenta was.

Blood Clotting Problems (Coagulation Disorders)

Some rare inherited conditions affect the blood’s ability to clot. More commonly, diseases like high blood pressure or kidney issues can cause blood to take longer to clot. This makes it harder for the body to stop bleeding quickly after birth.

Prevention and the Importance of Antenatal Care

Postpartum haemorrhage can be deadly and can happen quickly. But if the mother is in the right place—like a hospital—it can be treated. And most importantly, it can often be prevented with proper antenatal care (the check-ups you get during pregnancy).

Antenatal care is a key part of primary health care. It is all about keeping the mother healthy during pregnancy and making sure she and her baby get the best possible care.

In Summary

Bleeding after childbirth is a serious problem, but it does not have to be fatal. Knowing the risks and making sure you have regular antenatal care, and a safe delivery can save lives. If you are pregnant or supporting someone who is, remember: hospitals are the safest place for delivery, and antenatal check-ups are essential. They help keep both mother and baby healthy.

BY DR MICHAEL MBULO, OBGYN