Previously written and published by Dr. Wheeler in 2018
Any obstetrician, nurse, medical assistant, tech, anesthesiologist, etc, who spends enough time on labor and delivery will witness a patient undergo hemorrhaging around the time of delivery. Most of these can be controlled using medications and non-surgical techniques.
Our labor and delivery unit has fast and efficient protocols that we initiate when needed. The most severe cases require surgery, such as dilation and curettage (D&C), uterine artery embolization (from our radiology team at WakeMed), or hysterectomy for life-threatening cases. Fortunately, we deliver our patients in a high acuity tertiary care center that also does large traumas, and thus, we have plenty of blood products available (this is not the case for every hospital). And honestly, more than anything, it is the blood products that save lives in the most serious cases.
Risk Factors for Labor & Delivery Hemorrhaging
Risk factors for hemorrhage make up an extensive list. But sometimes, it is just very unpredictable and can happen to anyone. I do not want to bore you all with all the risks but I would like to name a few. The first is abnormalities of the placenta, such as placenta previa (when the placenta is in front of the cervix), placenta abruption (when the placenta detaches from the uterine wall early), or retained placenta (that means it is hard to get out) after the delivery.
Closing Off Large Uterine/Placenta Blood Vessels to Avoid Hemorrhaging
Labor that is successful or unsuccessful after prolonged pushing having hypertensive diseases in pregnancy such as preeclampsia, large babies, maternal obesity, operative delivery (c-section, vacuum or forceps), long inductions of labor, multiples (twins, triplets), infection, fast labors, fibroids and very very very rare events like amniotic fluid embolism are risks too. The easy way to think about is like this… the uterus is a muscle, and that muscle needs to contract down after delivery to close off the large blood vessels that were going to the placenta. So anything that you can imagine would make that more challenging for that muscle can lead to more bleeding.
Donating Blood Can Save Your Life
Back to the main reason I am writing this blog. Everyone should really consider donating blood. It is an easy way to save a life. A small amount of time on your part can help keep a mother with her child or children. According to the Red Cross there is a severe shortage of blood. YOU can help! There are donation centers all over Wake County and surrounding counties. Enter your zip code into the search function on the front page of the Red Cross site, and please please please try to schedule an appointment at your local blood drive.
On behalf of all my partners, I thank those of you in advance who read this and go donate blood. And my promise to you is that I, too will donate. PS: Blood is used to save lives in gynecology too!
