The way a postpartum haemorrhage is treated will depend on when and why it is occurring. It will also depend on the amount of blood the woman has lost and how she is physically reacting to the blood loss. The treatments outlined below are generally for a primary postpartum haemorrhage (unless otherwise stated) and can include:
Rubbing up the uterus
Giving an oxytocic injection
Delivering the placenta
Empty the bladder
Taking blood
Intravenous drip
Oxygen
Bimanual compression
Prostaglandins
Repairing tears
Blood transfusion
Platelets, fibrinogen and FFP
Transferring to and / or staying in hospital
Natural therapies
Rubbing up the uterus. The quickest and easiest way for a caregiver to stimulate a contraction to help control heavy bleeding or facilitate the complete birth of the placenta, is to place one hand on the woman's belly, locate the uterus (which will feel soft and 'boggy' or spongy) and gently 'rub it up' to stimulate a contraction (if the uterus is hard and contracted but the bleeding is heavy, it is probably due to a large tear in the cervix or vagina).
Bleeding more than a slow trickle of blood (which is normal after a vaginal birth), indicates to the caregiver that the placenta has either started to separate (if it has not been expelled yet), or that the uterus is relaxing and not contracted. Rubbing up the uterus may be done to deliver a partially separated placenta or to encourage a relaxed uterus to contract, if the placenta has already been delivered. Both these conditions can lead to a postpartum haemorrhage.
Giving an oxytocic injection. An oxytocic injection such as Syntocinon, Syntometrine or Ergometrine can be given as a routine part of the active management of the third stage or 'as needed' if the 3rd stage is being naturally managed. Further injections may be given if the woman is experiencing a postpartum haemorrhage and the first doses were unable to adequately stimulate a contraction.