Bringing a baby into the world is an incredible experience, but childbirth also comes with risks—one of the biggest being postpartum hemorrhage (PPH), or excessive bleeding after birth. In recent years, PPH cases have been increasing, and while this might sound alarming, understanding the reasons behind it can help new moms and their healthcare teams be better prepared. Let’s take a closer look at why postpartum hemorrhage is on the rise and what can be done to lower the risks.
What the Research Says About the Increase in Postpartum Hemorrhage
Over the last two decades, postpartum hemorrhage rates have climbed significantly. In the U.S., PPH cases went from 2.7% in 2000 to 4.3% in 2019—a 59% increase (PubMed).
So, why is this happening? Several factors play a role, and while some are beyond our control, there are steps that can be taken to reduce the risks.
Why Postpartum Hemorrhage Is Becoming More Common
1. Uterine Atony (The Uterus Not Contracting After Birth)
One of the most common causes of PPH is uterine atony, which happens when the uterus doesn’t contract properly after delivering the baby and placenta. Without these contractions, blood vessels remain open, leading to excessive bleeding. Research suggests that rising rates of uterine atony are a major factor behind the overall increase in PPH (ACOG).
2. More Cesarean Births
Cesarean sections (C-sections) are more common than ever, and while they can be life-saving, they also come with a higher risk of bleeding compared to vaginal births. The risk is even greater if the C-section happens after a long labor or if a woman has had multiple C-sections in the past (Mayo Clinic).
3. Moms Are Giving Birth at Older Ages
More women are having babies later in life, and while this is absolutely possible with good prenatal care, advanced maternal age (35+) comes with higher risks of complications like placenta previa and placenta accreta, which are both linked to increased bleeding during and after birth. Pre-existing health conditions like high blood pressure or diabetes also increase the likelihood of PPH.
4. Obesity Is a Risk Factor
Obesity rates are increasing, and research shows that moms with higher body weight are at greater risk for postpartum hemorrhage. Obesity can lead to longer labors, increased chances of C-sections, and a higher likelihood of uterine atony, all of which can contribute to excessive bleeding.
5. More Twin and Multiple Pregnancies
Thanks to advancements in fertility treatments, more women are carrying twins or multiples. While exciting, carrying more than one baby stretches the uterus more than usual, increasing the risk of uterine atony and postpartum hemorrhage.
What Can Be Done to Reduce the Risk?
The good news is that healthcare providers are more aware of these risks than ever before and are working on ways to better prevent and manage PPH. Here’s how moms and their doctors can stay ahead of the game:
- Early Risk Assessment: Before birth, doctors assess whether a mom has any risk factors for PPH, such as a history of excessive bleeding, high blood pressure, or placenta issues.
- Proactive Monitoring During Labor: Hospitals are more prepared than ever to recognize signs of PPH early, with medications like oxytocin readily available to help the uterus contract after delivery.
- Good Prenatal Care: Managing conditions like high blood pressure, gestational diabetes, or anemia before birth can help lower risks.
- Healthy Lifestyle Choices: While we can’t change all risk factors, staying active, eating well, and keeping a healthy weight during pregnancy can improve outcomes.
Looking Ahead: Prioritizing Safety for Moms and Babies
Postpartum hemorrhage is becoming more common, but that doesn’t mean there’s nothing we can do about it. With better awareness, improved medical care, and a focus on preventing complications before they start, doctors and expecting parents can work together to make childbirth as safe as possible.
If you’re expecting or planning a pregnancy, talk to your healthcare provider about any concerns you have about bleeding risks. The more informed you are, the more confident you can feel about welcoming your baby into the world safely.
