Abnormal bleeding after birth Why it leads to death

MRS. Wilson, having carried her pregnancy to its full term, fell into labour that Tuesday evening, around 8.00 p.m.She was immediately driven to the maternity centre where she was registered . There and then, she was duly attended to by the midwives on duty. The husband therefore expected that within the end of the hour, the wife would have put to bed. Though the labour seemed to be progressing, but it was at a slow rate, thus, Mrs. Wilson experienced a prolonged labour which lasted for several hours.

Women, after delivery.Few minutes after 8.00 a.m of the following day, she was deliverd of a baby boy. That evening a now fit Mrs. Wilson was discharged with her baby.

About two hours after her arrival at home, she started complaining of severe stomach upset; which became so unbearable that she started to press and squeeze her tummy. It was during this process that bleeding started.

Within few minutes, the bleeding became worse, as though a tap was turned on. It was at that point that her next-door neighbour gave them an eye-opener, that the bleeding was not the normal one following delivery.

Before she knew what was happening, she had landed on the hospital bed, receiving treatment. But the joy of it all was that, Mrs. Wilson was back home two days after, in preparation for her baby’s christening.

Similar to Mrs. Wilson’s experience was that of Hajia Abdulsalam, who after the delivery of her 4.2kg baby, started bleeding profusely and it was the unfettered intervention of the doctor that saved her life.

These are just two of the many cases of abnormal postpartum. While it is true that all women experience afterbirth (postpartum) bleeding in the days and weeks following delivery of their babies but, some, according to medical experts, may experience an abnormal afterbirth bleeding (postpartum haemorrhage) which can be life threatening and requires immediate medical attention.

A medical practitioner, Dr. Olufemi Aluko said, poStpartum haemorrhage is the abnormal bleeding following labour and delivery. To the understanding of a layman, Dr. Aluko defines postpartum haemorrhage (abnormal afterbirth bleeding) as bleeding through the vagina after delivery in the excess of 500ml (an equivalent of a sachet of pure water) or 1000ml or more after a ceasarean section.

He said if this significant loss of blood occurs within 24 hours of childbirth, it is considered to be primary postpartum haemorrhage and that,the one which occurs after 24 hours is referred to as secondary postpartum haemorrhage.

In one medical documentation, it was stated that the majority of the abnormal afterbirth bleedings occur within 24 hours after labour and that the condition is the leading cause of maternal mortality, especially in developing countries . The World Health Organisation (WHO) also suggests that as many as 25 per cent of maternal deaths worldwide are caused by this postpartum haemorrhage.

Corroborating this assertion, Dr. Aluko said that without proper medical attention, a woman can die within two hours of haemorrhage (bleeding).

While speaking on the causes of postpartum haemorrhage, the expert said, “once a baby is delivered, the uterus normally continues to contract, that is, tightening of uterine muscles to expel the placenta. After the placenta is delivered, it is the contractions that help to compress the bleeding where the placenta was attached.” It is the failure of the uterus to contract after delivery (uterine atony), that causes the abnormal bleeding.

Also, according to him, if small pieces of the placenta remain attached, haemorrhage may occur. Inability of the blood to clot (blood dyscrasia) and infection of the uterus can also increase the risk for postpartum haemorrhage.

Prolonged labour, as experienced by Mrs. Wilson, overdistended uterus, that is, excessive enlargement of the uterus which may be due to the delivery of a large baby with birth weight of over 4kg, as applicable in Hajia Abdulsalam’s situation, are also part of the causes of the postpartum haemorrhage.

Other conditions that may increase the risk for postpartum haemorrhage according to the medical documentation include induced labour, pregnancy-induced hypertension, obesity.

Dr. Aluko added that fibroid, tears in the cervix or vagina, (cervical or vaginal lacerations), among others, may also predispose postpartum haemorrhage.

The symptoms that may be noticeable that suggest postpartum hemorrhage, as explained by Dr. Aluko are, uncontrolled bleeding in excess of 500ml of blood, that is, when a woman who had just delivered soaks a pad in less than one hour, noticing of foul smell, having blood clots that are size of golf balls or larger, and feeling of dizziness or fainting.

On the measures that could be followed to prevent postpartum haemorrhage, Dr. Aluko advised that, pregnant women should book in well established hospital(s) or government-approved maternity centres for proper pregnancy management, make attendance of antenatal regular and that once signs of labour commence, they should go to the hospital and try not to deliver at home where facilities are not available, should any complication set in.

It has also been discovered that immediate breast feeding after delivery, helps in uterine contractions and the expulsion of the placenta naturally, thus preventing postpartum haemorrhage.

At any point in time, whether within 24 hours after delivery or during the initial weeks following delivery, that you begin to notice any or all of the earlier mentioned symptoms, you are advised not to take it for granted but visit your doctor for proper diagnosis and adequate treatment, he concluded.

Risk of being underweight during pregnancy

Pregnancy is a very exciting experience which could be very stressful in life.. During such stress, some women may turn to food for comfort, whereas others may start neglecting their diet, in fear of gaining weight during pregnancy from those so famous pregnancy craving symptoms.

But if women start neglecting their diet during pregnancy, they may expose their unborn babies to serious harm, since the growing baby in the uterus depends on you for nourishment, eating right during pregnancy is extremely important if you want to have a healthy baby.

If you are underweight during pregnancy, you might put your baby at a higher risk of developing serious birth defects and even undergo a premature birth. According to the American Dietetic Association, if your diet does not include at least 400 micrograms of folic acid, you put your baby at a higher risk of being born with Spina Bifida, a condition where the spine of the baby fails to close during pregnancy. Babies born with Spina Bifida experience quite a number of physical challenges.

So, to be on the safe side, pregnant women should try to include at least 600 to 800 micrograms of folic acid into their diet by eating foods rich in it. Some foods that are high in folic acid include:

* Beans * Legumes * Spinach * Asparagus * Orange Juice * Bread * Breakfast cereals/oats