Placental Abruption at Birth: What to Know

Placental abruption is separation of the placenta from the uterus before the baby is born. During labour, it may appear as vaginal bleeding, persistent abdominal or back pain, a tense or tender uterus, contractions that feel unusually close or strong, or changes in the baby's heart rate. Bleeding can be hidden behind the placenta, so the amount seen is not a reliable guide to seriousness. The condition can reduce the baby's oxygen supply and can cause blood loss for the mother.

The team will assess your circulation, pain, bleeding, uterine activity, and the baby's heart rate. They may place intravenous access, take blood samples, give fluids or blood products when needed, and involve senior obstetric, anaesthetic, and newborn clinicians. If you and the baby remain stable and labour is progressing, vaginal birth may be possible with close monitoring. If the baby is distressed, bleeding is heavy, or labour cannot proceed safely, urgent Caesarean birth may be recommended. The choice depends on the clinical picture at that moment.

Tell your midwife or doctor immediately about fresh bleeding, worsening abdominal or back pain, a hard abdomen between contractions, dizziness, weakness, shortness of breath, or a change in fetal movement. If you are not already in hospital, call emergency services rather than waiting for a routine appointment. After birth, seek urgent help for heavy bleeding, faintness, severe pain, fever, or feeling suddenly very unwell.

Ask how the baby's heart rate is being interpreted, whether labour can continue safely, what would lead to an urgent Caesarean birth, and how bleeding will be treated. After delivery, ask how the placenta will be examined and which postpartum symptoms require immediate review.