The majority of women do not experience hemorrhaging in childbirth, and on average, natural births cause the least blood loss. In cesarean births, or C-sections, blood loss typically is twice as high at about 1,000 milliliters.
The risk of postpartum hemorrhage — severe bleeding following a birth — increases significantly following a C-section, and risk is greatest within the first 24 hours following the birth. A hemorrhage that occurs so soon after birth is known as primary postpartum hemorrhage, while a secondary hemorrhage occurs past the first 24 hours following birth.
Hemorrhaging may happen either before or after delivery of the placenta, and fast blood loss can cause a woman’s blood pressure to drop severely. Without treatment, postpartum hemorrhage can result in shock and death.
In some cases, the blood lost in hemorrhage does not exit a woman’s body. Instead, the bleeding may occur internally. Without an outlet, blood can move toward tiny crevices between tissues, forming a hematoma, which can become dangerous if it affects internal organs or if bleeding continues.
If you have suffered an injury because of internal bleeding after childbirth, what do you need to know to recover compensation? By working with an experienced medical malpractice attorney, you can protect your rights.
Causes of Internal Bleeding
Why might internal bleeding occur after a birth? After the baby is born, the uterus typically contracts, and the placenta is delivered. The contractions then compress local blood vessels to stop bleeding; if contractions are too weak, hemorrhage can result. Bleeding also is more likely if small remnants of the placenta remain attached.
Some women have higher risk of hemorrhage after childbirth. Factors that can increase risk include premature detachment of the placenta, uterine distention resulting from multiple pregnancies, high blood pressure due to pregnancy, multiple prior births, obesity, medication-induced labor, general anesthesia, and very lengthy labor. In addition, a vacuum-assisted delivery or the use of forceps to remove the baby can increase the risk of internal bleeding.
Other potential causes include tears in the vaginal tissues, cervix or uterine blood vessels. Problems with placental attachment to the uterus also can result in bleeding. In rare cases, the cause can be a ruptured uterus, which can threaten the life of the mother. Prior C-sections, scarring of the upper uterus, and surgery for fibroid tumors can increase the chances of a ruptured uterus.
Bleeding most often happens within 24 hours of birth, but it can occur even several weeks later, depending on the cause. In some cases, doctors know in advance that a woman is at higher risk of bleeding and may admit the woman to the hospital for monitoring prior to the birth. In other cases, bleeding develops unexpectedly after birth.
Postpartum Hemorrhage Following C-Section
Blood loss is common during a C-section, but some factors can increase the risk of severe internal bleeding. An emergency during the birth can cause excessive bleeding, as can blood vessels not being stitched completely or an organ being accidentally cut.
In some cases, the incision made for the C-section is not large enough for the baby to fit through, and the incision may tear and cause bleeding. If the doctor notices the tear right away, it may be repaired before severe blood loss happens. Laceration tears sometimes impact blood vessels, arteries and veins near the uterus. In addition, an accidental cut of the bladder during C-section surgery can cause heavy bleeding.
Some lacerations may require additional repairs, and a second surgery may be necessary if an organ is damaged.
Symptoms, Diagnosis and Treatment
Common symptoms of internal postpartum hemorrhage can include an increased heart rate, low blood pressure, and pain and swelling around the vaginal area. To diagnose the condition, a doctor will conduct a physical examination and review the patient’s medical history. Symptoms typically dictate the diagnosis, and lab tests including a red blood cell count and blood clotting factors confirm it.
The condition is treated with internal womb compression to stop blood loss, along with medications to encourage uterine contraction. The uterus and pelvic areas are examined, and remaining portions of the placenta may be removed. The doctor also may pack the uterus with sterile materials to help stop bleeding, and blood vessels may be tied off.
Blood transfusions and IV drips may be used if needed, and X-ray guidance may be required to block blood vessel hemorrhage. A hysterectomy may be performed if the blood loss becomes life-threatening.
The severity of bleeding — and the amount of blood lost — determine the required treatment. Some women may be monitored over several hours, while others require immediate surgical intervention.
Have You Suffered Harm from Internal Bleeding After Childbirth?
If you or your baby were injured during childbirth and you feel that a medical professional acted improperly, it is important to discuss your case with a medical malpractice attorney. Depending on the facts of your case, you may be entitled to compensation for your injuries, including medical bills and time lost from work. For a consultation, please contact Kaire & Heffernan, LLC.