What are the causes of postpartum hemorrhage?

Written by Zhao Li Li
Obstetrics
Updated on March 20, 2025
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Under normal circumstances, postpartum hemorrhage is one of the most severe complications that can occur during childbirth.

Postpartum hemorrhage can be caused by several reasons: The first is mainly due to uterine atony leading to bleeding, which is relatively common and generally requires the administration of potent oxytocics to promote uterine contraction; The second is mainly due to local tears in the vagina or cervix leading to bleeding; The third is primarily caused by issues such as placental adhesion or implantation; The fourth is due to disorders in the body's coagulation function, leading to uncontrolled bleeding.

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Written by Du Rui Xia
Obstetrics
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How long does it take to recover from postpartum hemorrhage?

Postpartum hemorrhage is a relatively common and serious complication clinically, but how long does it take to recover from postpartum hemorrhage? This depends on the physical condition of the mother. Typically, recovery takes about 4-6 weeks after delivery. Women with weaker constitutions may take longer to recover. When postpartum hemorrhage occurs, appropriate measures should be taken based on the cause. If there are lacerations in the birth canal, timely suturing is necessary. Additionally, if there is weak uterine contraction, medications that stimulate uterine contraction should be used to promote contraction and stop the bleeding.

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Written by Zhang Lu
Obstetrics
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Should the uterus be removed due to severe postpartum hemorrhage?

Whether postpartum hemorrhage requires hysterectomy primarily depends on the severity of the hemorrhage and the specific causes of the postpartum hemorrhage. First, if the amount of postpartum hemorrhage is very substantial, leading to conditions like DIC in the pregnant woman, and if not removing the uterus may cause ongoing bleeding, it is essential to remove the uterus quickly to reduce vaginal bleeding. Second, if the postpartum hemorrhage is caused by issues like amniotic fluid embolism or poor contraction of the uterus, and conservative treatments are ineffective, it is also necessary to make a prompt decision to remove the uterus.

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Written by Liu Wei Jie
Obstetrics
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Why is uterine curettage necessary for postpartum hemorrhage?

We encounter a situation where postpartum hemorrhage is caused by the presence of residual material inside the uterus, which can influence the contraction of the uterus. This condition can lead to severe postpartum hemorrhage. The most important solution for postpartum hemorrhage is to immediately stop the bleeding. Therefore, by removing the residual material from the uterine cavity, the uterus can return to its normal contraction, achieving the purpose of immediately stopping the bleeding. It is also very common to need uterine evacuation after childbirth, as this process might cause some trauma to the uterus. Although it can be somewhat traumatic, this trauma is minimal compared to severe postpartum hemorrhage. In such cases, we must carefully weigh the pros and cons and decisively decide to proceed with the evacuation of the uterus.

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Written by Yue Hua
Obstetrics and Gynecology
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Causes of Late Postpartum Hemorrhage

Late postpartum hemorrhage is most commonly caused by retained placenta and membranes. About ten days after childbirth, the patient may experience significant bleeding due to the degeneration and necrosis of the retained placental and membrane tissues within the uterine cavity. When these necrotic tissues are shed, it can cause the blood vessels to open and lead to bleeding. Additionally, poor healing of the placental site on the uterus can also cause bleeding, as can infections, with endometritis being relatively common. Inflammation can lead to poor healing of the placental attachment site or poor uterine contraction, resulting in significant uterine bleeding.

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Written by Zhao Li Li
Obstetrics
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How long will postpartum bleeding last until it stops?

Generally, in normal childbirth or after cesarean section surgery, there is usually a small amount of vaginal bleeding, which typically subsides completely within about a week. If there is heavy bleeding after delivery, it is crucial to closely monitor the vaginal bleeding to rule out the possibility of delayed postpartum hemorrhage. If the uterus contracts well and there is no retention of placental fragments, the area will generally be clean within about a week, albeit with some bloody discharge. Therefore, if there is abnormal vaginal bleeding postpartum, it is recommended to promptly re-examine to exclude the possibility of late bleeding, so as to avoid endangering life.