Gynecologists, midwives, and other researchers are very much so still in the infancy of their research into what is and what ought to be with respect to postpartum hemorrhaging. Looking at the literature, I’ve found, can actually be rather confusing because of the vast collection of conflicting information.
Long term studies, for example, have found high neonatal weight, perineal injury, and complications during birth to be associated with PPH. An article review however, claimed there to be strong evidence for 4 other specific causes including clotting defects, abnormal placental implantation and uterine atony, previous history of PPH, and genital tract trauma ie cervical tears. It also mentioned that caesarean section, multiparity, preterm birth, age, multiple gestation, epidural were more common causes where the evidence is more conflicting or weaker overall.
It is hard to assess what is real and what is truly a causal relationship when it comes to a complication like PPH because often times, everyone’s experience is different. Because PPH is such a frequent killer, data begins to pool and researchers are more capable of assessing trends.
One of the biggest potential confounders in this situation is geographic location in the world. The culture of each country influences what they view as being a top priority and how they choose to address the issue. The country’s economic capabilities is another large part of the healthcare providers’ abilities to provide care.
Like any health problem that you can read about online, it is important to keep in mind that at the end of the day, your doctor knows you and your symptoms better than anything you will read on the internet. Should you decide to do some light reading via the Internet however, I encourage you to read a variety of articles. In doing so, you will gain a more whole view of PPH and become better educated.
PPH: Postpartum Hemorrhage or Postpartum Happiness? 