Bleeding after birth
If the mother is bleeding heavily and the womb is hard, she may be
bleeding from a tear in her vagina. You may need to feel inside with a
gloved hand to check for a tear. See pages 248 and 356 to learn about
tears and how to sew them.
If you are not able to sew a tear that is bleeding heavily, try to slow
the bleeding and get medical help immediately. Roll up 10 to 15 pieces
of sterile gauze or another small, sterile cloth into a thick pad and push
it firmly against the bleeding part of the tear. Hold it there until you get to a
When someone bleeds heavily she may go into shock. If a mother is bleeding,
before or after the placenta comes out, watch for these signs:
• feeling faint, dizzy, weak, or confused
• dropping blood pressure
• pale skin and cold sweats
• fast breathing
• fast pulse, over 100 beats a minute,
that feels thin and faint
• sometimes loss of
A woman in shock needs help fast. You must treat her for shock to
save her life.
To help a woman in shock, get medical help. On the way:
• have the woman lie with her feet higher
than her head, and her head turned to
• keep her warm and calm.
• give her fluids. If she is conscious, she can
drink water or rehydration drink (page 160).
If she is not conscious, give her rectal fluids
(page 342) or an IV (page 350).
• if she is unconscious, do not give her
anything by mouth — no medicines,
drink, or food.
You may be able to get an anti-shock garment
that uses pressure on the legs and lower body to
help prevent shock in emergencies. See page 502.
Note: Women who are in poor health before giving birth are more
likely to have serious problems from bleeding after the birth. Helping
women eat well and avoid sickness during pregnancy is one of the best
ways to prevent problems during birth.
A Book for Midwives (2010)