Childbirth, heavy bleeding - What will happen?

What will happen to you if you bleed heavily after having a baby depends partly on whether you have risk factors. It also depends on how healthy you were before you went into labour.

To learn more about risk factors for heavy bleeding after childbirth, see What is heavy bleeding after childbirth?

In the UK most women can lose a half to one litre of blood (one to two pints) and still recover well. It's rare to die in childbirth. And safe blood transfusion is also available if you need it.

But women in poor countries tend not to be as healthy. It's also more common for people to be anaemic (when you don't have enough red blood cells) in poor countries. Women who are anaemic when they deliver their baby may not recover well if they lose a lot of blood. Around the world, about a quarter of all women who die in childbirth die from heavy bleeding.[1]

If you've been bleeding, you should tell your doctor or midwife. It's especially important that you tell someone if:[2]

You feel faint
You feel dizzy
You feel your heart beating quickly or irregularly.

Heavy bleeding can sometimes lead to other complications:[3]

You may go into shock. This is when you lose more blood than your body can take. Some symptoms of shock are pale and cool hands or feet, a rapid heartbeat, shallow rapid breathing, and feeling very tired, dizzy or confused
You may need a blood transfusion
You may need surgery, such as scraping out the inside of your womb (uterus), to help stop the bleeding. The operation is called dilatation and curettage (D and C)
There may be problems with the way your kidneys work
There's a small chance you may need to have a hysterectomy (an operation to remove your womb).

If you're having heavy bleeding and your placenta (afterbirth) hasn't come out on its own, you may need to have it taken out. This is called manual removal of the placenta. It's done as a small operation under a general anaesthetic, so you'll be asleep.

A few women who bleed heavily after childbirth get a condition called Sheehan's syndrome. This is when you stop making certain hormones, such as thyroid hormones, oestrogen and progesterone. One symptom of Sheehan's syndrome is not having milk in your breasts after your baby is born. Other symptoms include tiredness, hair loss and no periods. You'll need to take replacement hormones for the rest of your life if you get Sheehan's syndrome.

References

World Health Organization. Making pregnancy safer: reduction of maternal mortality. Available at http://www.wpro.who.int/internet/files/pub/360/115.pdf (accessed on 20 February 2008).
National Collaborating Centre for Primary Care. Routine postnatal care of women and their babies. July 2006. NICE clinical guideline 37. Available at http://www.nice.org.uk/cg037 (accessed on 20 February 2008).
Chelmow D, O'Brien B. Postpartum haemorrhage: prevention. April 2006. BMJ Clinical Evidence. Available at http://www.clinicalevidence.com (accessed on 20 February 2008).

Glossary

anaemia: Anaemia is when you have too few red blood cells. Anaemia can make you get tired and breathless easily. It can also make you look pale. Anaemia can be caused by a number of different things, including problems with your diet, blood loss and some diseases.
red blood cells: Red blood cells are the part of your blood that makes it red. Their main job is to carry oxygen from your heart and lungs to the tissues of your body. Once these cells unload oxygen, they pick up carbon dioxide. They take carbon dioxide back to your lungs so it can be breathed out of your body.
blood transfusion: If you've lost too much blood from your body, you may need a blood transfusion to replace it. People with diseases of their blood, like sickle cell anaemia, sometimes need blood transfusions to replace blood that doesn't work properly.
general anaesthetic: You may have a type of medicine called a general anaesthetic when you have surgery. It is given to make you unconscious so you don't feel pain when you have surgery.
kidney: Your kidneys are organs that filter your blood to make urine. You have two kidneys, on either side of your body. They are underneath your ribcage, near your back.
hysterectomy: A hysterectomy is an operation to take out a woman's womb (also called her uterus). Sometimes the ovaries and fallopian tubes are removed as well.
hormones: Hormones are chemicals that are made in certain parts of the body. They travel through the bloodstream and have an effect on other parts of the body. For example, the female sex hormone oestrogen is made in a woman's ovaries. Oestrogen has many different effects on a woman's body. It makes the breasts grow at puberty and helps control periods. It is also needed to get pregnant.
thyroid gland: Your thyroid gland is a small organ that sits in your neck, just in front of your windpipe. It sends out a hormone called thyroxine. This acts on receptors within cells. By acting on the receptors it gives the cells a message to speed up their metabolism and work harder.
oestrogen: Oestrogen is the name given to three female sex hormones: oestradiol, oestrone and oestriol. Oestrogen causes women's sexual development during puberty: it is needed to develop breasts, have periods and get pregnant. Oestrogen is also thought to affect women's health in other ways. It may influence their mood, cholesterol levels and how their bones grow. Men have very low levels of oestrogen in their bodies, but doctors aren't completely sure what it does. Oestrogen is an important ingredient in most types of contraceptive pill and hormone replacement therapy.
progesterone: Progesterone is a hormone that plays a part in a woman's menstrual cycle and in pregnancy. A form of this hormone made in the laboratory, called progestogen, is often added to contraceptive pills and hormone replacement therapy (HRT).

This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.