Dangerous post-birth bleeding on the rise

Sarah Wiedersehn

The number of women at risk of excessive, potentially life-threatening bleeding immediately following childbirth is rising.

An analysis of Victorian patient data from 2003 to 2013 has found postpartum haemorrhage soared by 50 per cent relative to birth rate, leading to a rise in the need for blood transfusions and admissions to intensive care.

Of the more than 700,00 women in the study, one in five (21.8 per cent) who gave birth experienced postpartum haemorrhage.

For one in 71 of them the bleeding was severe, according to findings published in the Australian and New Zealand Journal of Obstetrics and Gynaecology on Wednesday.

Those who had a caesarean section or forceps birth were at the greatest risk of excessive post-birth bleeding.

The highest incidence of haemorrhage was among women undergoing an unplanned c-section, while women who had a forceps birth were the most likely to experience a severe heamorrhage.

A "de-skilling" of obstetricians in forceps birth due to a rise in c-sections could be partly to blame for the concerning trend likely to be seen right across Australia, the researchers say.

"Excessive blood loss following childbirth is a leading cause of maternal deaths worldwide," said lead author Margaret Flood at La Trobe University's Judith Lumley Centre.

While the death rate is rare in Australia, the impact on women and their families is substantial, Ms Flood said.

Anaemia, a longer stay in hospital, needing a blood transfusion or surgery are some of the serious consequences of suffering postpartum haemorrhage, she said.

"Breastfeeding is also affected.

"The women and their families are affected by these things," a concerned Ms Flood said.

The researchers recommended maternity health providers conduct drills, establish response teams and review management protocols and documentation to address the concerning trend.

"Our findings support the need for vigilance in the early postpartum period to enable clinicians to promptly detect and initiate treatment for excessive blood loss," Ms Flood said.

The findings warrant further research into the risk factors, said added.