Postpartum hemorrhage is certainly a valid fear of many women, especially women that are choosing to birth unassisted. The best way to squash fear is with education. So let’s analyze how rare true hemorrhaging is and how to handle it if you do end up in that small statistic!
*IF medical assistance is needed, do not hesitate to call for it. Remember, your life is more important than the pride of not having to go to the hospital. This article is not medical advice!
What is postpartum hemorrhage?
Postpartum hemorrhage is generally defined as approximate blood loss of 500ml following a vaginal delivery or 1000ml following a cesarean delivery. Typically this bleeding occurs within 24 hours, if not immediately, but can be experienced up to 12 weeks postpartum. It is important to note that the blood loss is estimated. It is very hard to measure exact blood loss in a birth setting. The mother may be in the birth pool or sitting on pads. No one is holding a measuring cup under her. A provider may weigh the pads the mom is wearing to estimate blood loss, as well.
The best way to identify postpartum hemorrhage is actually by observing the mother’s condition. Signs that a mom may be facing PPH include:
- a sharp decrease in blood pressure,
- increased heart rate,
- swelling in the vagina and/or perineum,
- and paleness.
PPH is frequently over-diagnosed, as some women may lose over 500ml and be in great health. On the other hand, a woman may lose less than 500ml and feel the symptoms of PPH and need treatment.
Only 1-5% of women have a postpartum hemorrhage, and it is more likely to occur after a C-section. In studies across the board and around the world, a majority of those that experience PPH have precursors, such as hypertension or pre-eclampsia. Prolonged labor, poor uterine tone, perineal trauma, and retained placenta are close runner-ups. Pitocin, though it is a method of treating PPH, can actually CAUSE it, so those being induced are at more of a risk.
How do providers typically handle treatment of PPH?
They may give you a blood transfusion, along with an IV of saline. They may give Pitocin or Misoprostol in attempt to make the uterus contract down more forcefully. Massaging and clamping down on the uterus by hand is usually done in conjunction with medication. If the issue is retained placenta, they may manually extract the remaining piece of placenta. In the absolute worst case scenarios, they may embolize the blood vessels that supply the uterus or have to perform a hysterectomy (uterine removal) or a laparotomy (opening of lower abdomen to find the source of bleeding and cease it).
Treatment at home
How can you treat PPH in an unassisted birth setting?
First, let it be noted that as a preventative measure, having a well-balanced and nutritious diet may help decrease your risk of PPH. Vitamin C, Vitamin K, and Iron are crucial for healthy blood flow, uterine strength and proper clot factors in the blood. Burdock root, comfrey, valerian root, mushrooms, beets, citrus, basil, nettle, and leafy greens are prime sources of these nutrients that are safe to take while pregnant. You may also take red raspberry leaf tea or partridge berry tea to encourage uterine tone, too.
Prevention of postpartum hemorrhage
If you are birthing naturally, freely and at home, you are also taking a preventative measure. Management and intervention of the third stage of delivery (meaning forcefully extracting the placenta with no medical need to do so) is certainly a factor in some cases of PPH. The placenta should be allowed to deliver itself naturally and undisturbed. Providing there are no complications are present that would require a manual extraction. Taking a visit to a pelvic floor therapist before and during pregnancy can be beneficial by ensuring you have strong pelvic floor muscles. Which, in turn, can reduce your risk of bleeding due to poor uterine tone. Seeing them after birth will certainly do you justice, as well!
One of the most simple solutions to PPH is to suck on the umbilical cord or a piece of the placenta. This has naturally occurring hormones, stem cells, and nutrients that can help your uterus to clamp down and your body to body to clot.
Some herbal remedies that are most beneficial in the form of a tincture include:
- Angelica Root,
- Comfrey Root,
- Cottonseed Root,
- and Shepherds Purse.
It is important for you to be aware that Comfrey Root and Shepherds Purse should only be used after the placenta has been delivered. They cause rapid clotting, which can actually increase PPH through placental retainment. You, a partner or support person may clamp down on the uterus as well, via hand massage, helping along the contractions that are necessary for the uterus to bear down.
Taylor, Birthkeeper of HERBAL LLC