Wednesday, July 25, 2012

Author Question: Bleeding to Death

S.W. asks: This is the scenario: A woman has given birth attended only by her partner. After an exhausting long labor, the birth goes reasonably well, but a couple of hours later, she hemorrhages. My question is, would it be possible for her to bleed to death while sleeping?

My plot needs her partner to be in the same room, under the influence of alcohol or drugs which he takes to 'celebrate' after the birth. I need him to not realize what's happening until it's too late to save her.

Jordyn Says:

I do think this scenario is plausible on a couple of levels.

When a woman has bleeding complications related to delivery-- she's obviously losing blood. Simply, blood carries oxygen to each of your organs.

When there has been significant blood loss-- the woman will lose consciousness because of two aspects: not enough blood to carry the oxygen to her brain and/or low blood pressure. You have to have a certain blood pressure to perfuse your brain-- and therefore stay conscious.

She would go unconscious and could appear just to be sleeping to the one who's under the influence of all those meds/alcohol.

The pregnant woman would continue to bleed and never regain consciousness. She would die from exsanguination.


  1. A question for writing purposes only ;). Of course...

    Is it possible for this to still happen in a hospital setting? Despite best efforts? Would a hysterectomy be performed to try to stop it?



  2. This is excellent info. What a good question! Thank you for answering it on your blog.

  3. Carol: Yes, bleeding complications still do happen during delivery. I think everything is attempted before a hysterectomy but it is necessary in some cases.

    Thanks for your comment, Mart!

  4. Sorry to post a day late. Yes, postpartum hemorrhage can occur in the hospital. Nurses and docs are trained to respond to this serious complication. Number one reason is uterine atony (a boggy uterus). Normally after birth the uterus contracts, squeezing the blood vessels in the uterus to slow the bleeding. Predisposing factors to bleeding are an overdistended uterus (ie twins+, polyhydramnios (excess amniotic fluid), rapid labor, long induced labor, an infected uterus, grand multiparity (having many babies), retained placenta(uterus can't contract around it) placenta accreeta (buried into muscle of uterus. Lacerations of vagina or cervix can also result in excess blood loss. Treatment is aimed at cause. Agents to help uterus contract are given for uterine atony (pitocin, methergine, hemobate. The uterus can be packed. Uterine artery ligation, a surgical procedure can be attempted. Hysterectomy is last ditch effort. If placenta retained, then manual removal or surgical scraping can be done. Placenta accreeta usually results in hysterectomy. If bleeding is due to lacerations, then those are repaired. Blood transfusion may be necessary.

  5. Thanks so much for adding your insights, Tanya!