What is postpartum hemorrhaging?

Dr. Jeanne Morrison, PhD
Family Practitioner

Post partum hemorrhage (PPH) is defined as blood loss of 500mL or more after a vaginal birth and 1000 mL or more after a cesarean birth.  Excessive blood loss in the first 24 hours following the birth is classified as an early PPH and beyond 24 hours it is a late PPH. 

The most common cause of early PPH is uterine atony or failure of the uterus to contract after the birth.  PPH due to uterine atony usually occurs in the first 4-6 hours after birth.  Some factors that increase the risk of uterine atony are: labor induction or augmentation, medication that result in muscle relaxation, chorioamnionitis, a large baby, multiple gestation or a full bladder.  A second cause of PPH in the first 24 hours is trauma to the genital tract, which is the uterus, cervix, vagina, or labia. Trauma to the genital tract can lead to disruption of the soft tissue and tearing of blood vessels

Late PPH is due to retained placental fragments that delays healing and leads to bleeding from the former placental site.

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