Only days after I found out that I’m pregnant I stumbled across a virtual summit called Sex, Spirit & Birth. It changed everything for me: pregnancy and birth didn’t seem daunting anymore or like something you want to be over and done with as quickly as possible. Well, I was never really afraid of it or never not wanted to experience it but, you know, all the horrible birth stories you hear, all the women who had a bad experience…

Unfortunately the summit was in German, otherwise I’m sure I would have mentioned it earlier. But a while ago I got an email with a very informative video. Kiria, the host who is also a midwife, is talking about how to avoid postpartum bleeding. This video is so good that I thought I have to let you know about it! Unfortunately most of my readers don’t speak English so here is my translation of her video.

Get all the information you can

Having all the knowledge you can get is always important, no matter where you are planning on giving birth – a hospital, a birth centre, at home, assisted or unassisted. But especially in case of the last option you definitely have to know what could happen during a birth and how to avoid it or react to it.

It is also important in terms of having a natural, maybe even orgasmic birth: If there is anything that you are afraid of (or your birth partner/s is/are afraid of), you can’t fully relax. And we all know what happens then: The baby senses that it is not safe to come and might not want to be born, that means you might get induced, which can lead to further medication and so on and so forth.

How likely is it to suffer from postpartum hemorrhage?

Hemorrhage can be a serious problem but only 1 in 1000 women worldwide actually suffer from life-threatening bleeding. Furthermore, it is estimated that 70 – 80 % of all these cases could be avoided. Bleeding is often a homemade problem, for example when the placenta is forcefully teared out instead of waiting till it comes out naturally.

On average, a woman loses 300 ml (a bit more than 1 cup) of blood during a birth. About 500 ml (2 cups) are considered a lot and when more than 6 cups (1500 ml) are lost, there is the danger of acute circulatory failure.

But, as I said before, if you are having a natural birth, chances that you are bleeding are much smaller. The main problem that causes hemorrhage is interventions, for example artificial oxytocin to initiate a birth or the Kristeller maneuver at the end of a birth (when the doctor/midwife tries to push out the baby by pressing on the belly; apparently not that uncommon in Germany).

Other reasons for postpartum hemorrhage can be a curettage after a previous birth or a coagulation disorder.

Let’s look at all the things now that you can do to avoid postpartum hemorrhage

1) Healthy eating

This is probably a no-brainer: if you put healthy stuff into your body, it is better prepared for the strenuous labour.

2) Eating dates

Apart from eating healthy in general, a study showed that pregnant women who ate 6 dates daily during the last 4 to 6 weeks of pregnancy were less likely to bleed excessively. Dates are rich in nutrients and minerals and can help with having a shorter first stage of labour. There were also less premature ruptures of membranes.

3) Establishing a good connection with your child

It is important to have a good bond with your baby from as early on as possible. The way the placenta is nesting into your belly has everything to do with your mother-child connection. Of course this is not meant as a reproach if you have a placenta previa for example. But you can encourage your body or some problems might dissolve when you establish a strong bond with your unborn child. This doesn’t only mean that you should think about your baby but really feel everything: take some time every day to look deep inside yourself, connect not only with baby but also with your uterus and the placenta and visualise that everything is healthy and thriving.

4) Feeling safe and secure during birth

The atmosphere during birth is very important for everything to go smooth. This is where oxytocin comes into play. Oxytocin, the so called love hormone, is (among other things) responsible for starting the contractions. Often artificial oxytocin is given to start contractions or to avoid bleeding. But you don’t need artificial oxytocin if you are producing the real stuff which is so much better. Your body only produces it though, if you are feeling safe and sound, almost like during a romantic night of love.

5) Relaxation

After birth, the uterus has to contract to stop the bleeding that was caused by the placenta detaching from the womb. This is only possible though if the uterus isn’t exhausted and overstrained. It can’t do its work anymore if it was pestered and pushed to its limits. But this happens through induction and augmentation. Especially if artificial oxytocin is given for too long or too high a dosage, the womb can’t cope and basically stops “working” which leads to more medication or, in the worst case, the uterus has to be removed surgically.

(The focus here is on uterine bleeding. Of course there could be other reasons for bleeding too like an injury during birth.)

6) Allowing breaks

To make sure your womb get the breaks it needs to not be exhausted you shouldn’t force the pace of the birth. In a hospital setting this is easier said than done because they have schedules they have to work with. A natural birth though does not always follow statistics or standardised numbers that some doctors would like to see. So as long as neither mum nor baby are in danger, it is important to accept natural breaks during the birthing process and let the body rest.

7) Avoiding forced pushing

In this context it is also important to avoid forced pushing. During the second stage when baby comes out, you should not have to push excessively.

8) Upright posture

Contributing factors to not overstrain your body are an upright posture instead of lying on your back and not to push unless you feel the urge to. Your body knows exactly how to birth a baby, so just listen to what it’s telling you. Birth needs patience.

9) Food and drinks during birth

Keep your energy up with eating and, even more important, drinking during the birth.

10) Calcium

Especially calcium rich foods and drinks are important to give your uterus enough energy.

11) Immediate breastfeeding after birth

Having your baby skin to skin and breastfeeding as soon as baby is ready is another very important point. While breastfeeding, your body produces oxytocin again that helps the uterus to contract.

12) Emptying your bladder

Another factor to help your uterus contract is an empty bladder (a full bladder can also be a reason during birth that contractions get weaker).

13) Honey

I, as a vegan, don’t agree with Kiria on this one but she says that honey, by the spoonful straight into your mouth, gives you an extra kick of strength.

14) Something cold

In case you are bleeding more than normal and want to stop it naturally, use something cold to put on your belly to help it contract. You can use a proper ice pack for this or just whatever you have in the freezer. This is recommended by conventional medicine.

15) Acupressure liver 1

TCM (tradition Chinese medicine) has a different view regarding cold and doesn’t recommend it. According to TCM there is a hemostatic trigger on your big toes. The outer nail groove is the beginning of the liver meridian. Pressure on these two points helps to stop bleeding.

Factors that contribute to postpartum hemorrhage

Medicine like aspirin makes bleeding more likely as is having a c-section and of course every other uterine surgery in the past.

To sum it up you could say that the less interventions and force, the less likely you are to experience postpartum hemorrhage. Therefore a home or birth centre birth is actually less risky in terms of bleeding than a hospital birth. Should you be high risk though, especially if you have a coagulation disorder, then you should opt for a hospital birth.