Blood Loss During Delivery (Obstetric Haemorrhage)

Our clients, Mr and Mrs Joshi recently spoke to the BBC about their tragic experience. Mrs Joshi had a uterine rupture. Her baby sadly passed away.

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This is a medical emergency and can be fatal.  An obstetric haemorrhage is when there is excessive bleeding during pregnancy, childbirth, or the postpartum period. If there is a delay in diagnoising or managing an obstetric haemorrhage, it can lead to the death of the mother or in some cases the baby.

There are various reasons why obstetric haemorrhage might occur including:

• Uterine Atony:  This is when the uterus fails to contract after childbirth, leading to continuous bleeding.

• Placental Problems:  Such as placental abruption (early separation of the placenta from the uterus) or placenta previa (placenta partially or completely covering the cervix.
• Tears or Lacerations: Tears or lacerations in the birth canal or perineum can lead to bleeding.
• Uterine Rupture:  In rare cases, the uterus can tear during labour, causing severe bleeding.
• Coagulation Disorders:  Conditions such as HELLP syndrome or disseminated intravascular coagulation (DIC) can affect the body's ability to form blood clots. This can result in excessive bleeding.

It is vitally important that these complications are promptly picked up and managed appropriately. Prompt management is critical to prevent complications.

A delay in recognising and management an obstetric haemorrhage may be negligent and if this can be established, there may grounds for a clinical negligence claim.

Prompt management is critical to prevent complications.

Some examples of negligent causes of obstetric haemorrhage include:

• Failing to identify and manage risk factors. This can include inadequate pre-natal care.
• Improper management of labour and delivery, including poor management of prolonged labour.
• Delayed recognition and response to a haemorrhage, and inadequate intervention. This can include failing to monitor bleeding.
• Inadequate surgical technique, such as improper c-section technique or poor management of uterine incisions.
• Failing to identify and treat complications, such as uterine atony.

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