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Delivery is surely associated with bleeding. This bleeding can be swift and sometimes life-threatening. But many times it is within limits and can be controlled. Many mothers who face delivery harbour a fear of bleeding and its consequences. Preparedness of this bleeding and curbing the precursor causes is easily doable.This, therefore, is an attempt to understand one’s own normal physical processes better. So let us go ahead and read this to be able to fearlessly face delivery
There are various genital tract sources of bleeding. Slight bleeding occurs when the cervix ( opening of the womb ) stretched or dilates to aid the delivery of the baby. Such stretching causes mild bleeding. And this bleeding is to be expected and is many a times sign of onset and progress of labour. As the baby delivers immediately after that the placenta delivers (a structure formed within the womb to supply nourishment to the baby from the mother ) by separating from its attachment to the womb and this can cause bleeding. But this bleeding is self-limiting and controlled by inbuilt bodily mechanisms.In addition, if any cuts are required such as the episiotomy or the ones taken at the time at cesarean delivery they can bleed and are controlled by stitching.
Sometimes a cut is necessary at the area from which the baby finally is delivered outside the mother’s body. It helps in widening the delivery passage and helping the delivery of the baby without hindrance. The cut is a small one and heals well within no time.
During pregnancy, the body of the mother undergoes several adaptive changes to accommodate the baby as well as to make provision for delivery.One of these adaptations is the increase in the blood volume, increased heart pumping ability and many such changes wherein the body develops reserves to be able to tolerate the requisite bleeding.
Most important precaution is maintaining a normal hemoglobin level in the range of 12 g/ dl. Hemoglobin determines the oxygen-carrying capacity of the body and its tissues. This aids to bring about proper growth of the baby and the adaptations of the mother’s body to endure delivery.
This bleeding can be for a week or fortnight and is much controlled in the first 2 days post delivery. Later it is similar to menstrual bleeding and then much less as the genial tract heals and goes back to pre-delivery state.
Yes bleeding more than expected which can challenge the normal reserves of the mother’s body can occur rarely and is called a postpartum hemorrhage and if acted upon immediately can be tackled. It may need fluids and blood and blood products to be administered to the mother. Rarely a surgical intervention may be necessary to tackle the source of bleeding, tie up the blood vessels or sometimes remove the bleeding womb
Such a bleeding is anticipated in conditions such as twin pregnancy, large baby, placental abnormalities, prolonged labour, anaemia, raised blood pressure in the mother and operative deliveries and obstructed deliveries. Sometimes it can be unanticipated and most of the facilities and doctors are on guard. Protocols to prevent such a postpartum haemorrhage or excessive bleeding is universally practiced in most of the facilities.
When a mother comes for antenatal checks blood group is always assessed to be prepared beforehand in case she suffers haemorrhage during delivery. In addition, periodic checks are done for haemoglobin estimation and iron supplements prescribed to correct the iron deficiency anaemia. The ‘mothers-to-be’ should also cooperate and take the responsibility of maintaining their health status by following instructions offered and complying with the medications and undergoing tests to assess their anaemia status. Also, they should not fear the fact that the blood is sent for crossmatching to the blood bank. This is a safety measure undertaken to help reduce delay in case of an unpredicted situation.
Be fearless and look forward to a lovely baby and be confident about the care is given by your obstetrician your and your baby’s caretaker.
Dr. Girija Wagh, MD (Obstetrics & Gynaecology), FICOG, FICP, Diploma (Endoscopy, Infertility), Fellowship of Indian College of Ob-Gynec, Women health care specialist, Academician, Acclaimed Orator & Researcher, B. J. Medical 1990-1992, Topper University Of Pune 1992
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