Postpartum hemorrhage usually occurs in the third stage of labor of the 5 percent of women, who deliver vaginally. The blood loss associated with this condition is about 500 milliliters (about two cups) of blood during the first twenty-four hours after birth.
Postpartum hemorrhage is caused by uterine atony (poor uterine muscle tone), lacerations or tears of the cervix or vagina, and retention of the placenta or placental fragments. Uterine atony is the most important cause of the hemorrhage.
Uterine Atony
 Nursing your baby stimulates the secretion of oxytocin, a hormone, which facilitates effective uterine contractions. Uterine massage by your obstetrician also stimulates it to contract. Placental fragments lacerations in your cervix, vagina and vulva may also cause the bleeding. In spite of adopting these methods, you may be administered drugs, such as Pitocin or Ergotrate to induce contraction of the uterus thereby reducing blood loss. If hemorrhaging is serious, you may need a blood transfusion.
Lacerations
Bleeding could be controlled by suturing the lacerations or the tears of the cervix, vagina, or perineum. Occasionally, packing the vagina with sterile gauze is also required to stop bleeding.
Retention of the Placenta
The blood vessels at the placental site may bleed freely, if the placenta or its fragments interfere with the contractions, when they are not expelled from the uterus after the baby`s birth. Manual removal of the placenta, clots or fragments has to be undertaken. This procedure is painful, but neces-sary. Pitocin needs to be administered then. By massaging your uterus and by breastfeeding your baby you may be able to alleviate your problem. Learn the techniques of uterine or fundal massage.
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