Medical Question: Bleeding after Delivery

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Carol Asks: A woman has a baby in a major US city. Right now I've got her basically bleeding to death when they can't stop post partum hemorrage. I don't know why she's hemorraging [and in the text I've left it at 'we can't stop the bleeding'] and the doc takes her to have a hysterectomy [which her hubby is told will take a couple hours?]. She then dies in surgery. I've left it pretty vague because I can't find any stats or anything. I'm glad in one sense because that means it doesn't happen very often, but doesn't help me with research.

Do you have any suggestions? Or if I leave it vague [it's his memory - it's gonna be blurry at best] is that good enough?




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Jordyn Says: Carol, thanks so much for your question. I did some searching on Google under "causes of post-partum hemorrhage" because, medically this is what is happening to your character. Here are some of the causes:
1. Uterine atony: After a child is delivered, the uterus should contract down to "clamp off" all the blood vessels that are bleeding. This is what the OB nurse is checking for after delivery. The uterus should feel "hard as a rock". If it doesn't, it may feel boggy (mushy), and the OB nurse will massage it to get it to firm up. If the uterus won't firm up, clamp down on those blood vessels, the patient will continue to bleed.

http://www.uptodate.com/contents/overview-of-postpartum-hemorrhage

2. Other causes: Retained placental tissue (where parts of the placenta stay inside the uterus), laceration of tissues or blood vessels in the pelvis and genital tract (a laceration would be a cut), and maternal coagulopathies (some sort of bleeding disorder in the mother where the blood is unable to clot). An additional, though uncommon, cause is inversion of the uterus during placental delivery (this is where the uterus would be turned inside out).

This is a good overview:

http://emedicine.medscape.com/article/796785-overview

Photo from: http://blog.timesunion.com/parenting/1626/the-line-on-your-pregnant-belly-will-go-away-%E2%80%94-eventually/

Hope this is helpful. What suggestions do you have for Carol? We'll have to see if Heidi is able to weigh in!

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Carol Moncado lives with her husband in Southwest Missouri. When she isn’t writing Inspirational Romance or Romantic Suspense, she’s teaching American Government at a community college, hanging out with her four kids, reading, or watching NCIS. You can find her at: http://www.carolmoncado.com/, http://www.carolmoncado.wordpress.com/ , and her newest blog, Pentalk Community Blog, where she serves as editor-in-chief: http://www.pentalkcommunity.blogspot.com/ .