Normal postpartum bleeding is similar to a heavy period, necessitating changing pads every 4 to 6 hours. Blood may pool when lying down and seem to gush when standing up, but still be within normal limits. Soaking a pad an hour and continually passing large clots are signs of a hemorrhage. Hemorrhage occurs when the uterus relaxes and loses tone. Action and home remedies may quickly stop excessive postpartum bleeding. Women should know what to do and when to seek help to prevent shock and other complications.
Emergency
Within hours or days of giving birth, get medical assistance or call 911 if there is repeated passage of large clots, or if symptoms of dizziness, nausea, faintness upon standing, pale and clammy skin, restlessness, anxiety and thirst are present. These symptoms of impending shock can also develop with a slow hemorrhage that initially may not have seemed serious. Blood loss can quickly escalate to a dangerous situation as blood pressure, pulse and respirations become unstable.
Uterine Tone
After giving birth, the uterus contracts into a hard ball that puts direct pressure on the open wound left by the placenta. Excessive bleeding occurs when the uterus becomes soft and flabby. The most common reason the uterus relaxes is because it is displaced by the mother's full bladder. As soon as she urinates, the problem resolves. A uterus can also have poor tone because of maternal nutritional deficiencies, particularly of vitamin K, or it may be due to traumatic birth factors, such as a long hard labor or the rapid delivery of a large baby. A soft uterus is more likely in mothers who have several children and in those who are not breastfeeding.
Breastfeeding stimulates the release of hormones in the mother's bloodstream that contract the uterus and prevent hemorrhage. Getting the baby to latch on may be all that is needed to stop a heavy flow.
Massaging the uterus will trigger contractions. Place one hand below the uterus to support musculature while massaging the fundus, or top. Don't forget to rub the sides as well. Do this vigorously until a firm ball is felt in the abdomen. Check and repeat every 15 minutes until it has remained firm for at least 2 hours.
Elevating the feet and placing an ice pack over the uterus may also help slow blood loss and prevent shock, but the ice pack must be removed and the fundus checked for firmness periodically.
Herbal Remedies
Plant sources of hormones that contract the uterus include Blue Cohosh, Cotton Root Bark and Cannabis. They work well when given with herbs that constrict blood flow such as Witch Hazel or Lady's Mantle. Tinctures work quickly when given under the tongue.
The favorite of midwives, Shepherd's Purse, is a blood coagulant, or vasoconstrictor, and promotes uterine contractions. Used alone, one teaspoonful under the tongue can stop a hemorrhage in less than 30 seconds. According to Susun S. Weed, author of "Wise Woman Herbal for the Childbearing Year," dried Shepherd's Purse loses potency quickly, and the best tinctures are made from fresh herbs.
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