Does perineal repair treat postpartum haemorrhage?

After birth, heavy bleeding can come from several places. A tear in the perineum, vagina or cervix may need stitches to close damaged tissue and control that source of bleeding. Perineal repair is therefore useful when a perineal injury is contributing to the blood loss.

Postpartum haemorrhage can also result from the uterus not tightening, retained placental tissue, or problems with blood clotting. Repairing a tear does not correct these causes. The maternity team may examine the birth canal, check the uterus and placenta, give medicines or fluids, and use other procedures according to what they find.

Tell the midwife, obstetrician or emergency team immediately if bleeding is heavy or increasing after birth. Do not wait to see whether stitches solve it. If you are at home, call emergency services and follow their instructions; keep the person lying down if faint, and do not drive if dizzy or weak.

In hospital, describe when the bleeding began, whether clots are passing, and any medicines or medical conditions that may affect clotting. The team will treat the bleeding while identifying its source.

Seek emergency help for bleeding that soaks pads quickly, large clots, faintness, confusion, shortness of breath, a racing heartbeat, severe weakness or worsening abdominal pain. These signs can indicate significant blood loss and require immediate medical care, whether or not a perineal tear is present.

Ask which source is causing the bleeding, whether a perineal or vaginal repair is needed, and what other treatment is being used. You can also ask what warning signs to monitor after discharge and when the repair should be checked.