Postpartum Hemorrhage: The Silent Killer Affecting Black Mothers

Every year, thousands of women across the U.S. face life-threatening complications during and after childbirth. At the forefront of this alarming trend are Black women, who are over three times more likely to die from pregnancy-related complications than women of other racial and ethnic groups. One of the most critical complications these women face is postpartum hemorrhage (PPH).

What is Postpartum Hemorrhage?

According to the Cleveland Clinic, PPH is defined as severe bleeding after giving birth. It’s a serious and dangerous complication that requires immediate treatment. PPH usually occurs within 24 hours of childbirth, but it can happen up to 12 weeks after delivery (postpartum).

In addition to excessive vaginal bleeding the symptoms of PPH include:

Symptoms of a drop in blood pressure like dizziness, blurred vision or feeling faint
Increased heart rate (tachycardia)
Decreased red blood cell count (hematocrit levels)
Pale or clammy skin
Pain and swelling in your vaginal or perineal area (when blood collects outside of a blood vessel)

“There are multiple factors that increase someone’s risk of postpartum hemorrhage. Some of these are certainly related to access to healthcare, particularly equitable prenatal care, and their healthcare before delivery. In the Black community, disparities in healthcare access are significant, making it less convenient to receive care and often resulting in a lack of access to the specific resources needed to manage their health conditions effectively. Therefore, it’s not solely a pregnancy issue; pre-existing conditions that are not well-managed can contribute to the overall risk of postpartum hemorrhage,” says Dr. Yvette Miller, Executive Medical Officer at the American Red Cross.

An often overlooked, but crucial lifeline in these moments is blood donation, which ensures that mothers are experiencing life-saving treatment during a moment of crisis. In fact, blood donation can mean the difference between life and death for mothers experiencing postpartum complications.

“Our best estimate for postpartum bleeding is that every two seconds, someone needs a blood transfusion. So, we constantly need and invite people from every community, but specifically, the Black community, to donate blood to ensure that there is blood available for everyone, but especially for mothers that are postpartum,” Dr. Miller adds.

Postpartum hemorrhage is not always predictable. Even healthy pregnancies can result in unexpected, rapid blood loss after delivery. According to the Cleveland Clinic, there are two kinds of PPH:

Primary postpartum hemorrhage occurs within the first 24 hours after delivery.
Secondary or late postpartum hemorrhage occurs 24 hours to 12 weeks after delivery.

“It’s certainly not a typical occurrence; it’s usually a medical emergency. While some bleeding is normal during delivery, it’s not always identifiable who will experience excessive bleeding. The situation arises when the mother starts bleeding so briskly and quickly that the outcome can be fatal if we can’t infuse blood quickly enough to compensate for the amount of blood lost. It can take around 30 to 40 units of blood to try to save a mother experiencing postpartum hemorrhage and prevent death due to severe blood loss,” Dr. Miller notes.

As noted by Dr. Miller, many Black women enter labor and delivery already at a disadvantage. Conditions like fibroids, hypertension, and diabetes—which are more prevalent in Black populations—can increase the risk of postpartum hemorrhage.

To combat this, the American Red Cross is working to empower patients—especially Black mothers—with the tools and knowledge to advocate for their health.

“We want people to walk into delivery rooms informed—not afraid—and walk out safe,” Dr. Miller shares.

One way the American Red Cross is working to empower patients is by educating people about the power of blood donation.

Rare blood types are more common in people of African descent and are often needed for treating conditions like sickle cell disease—a genetic blood disorder that affects over 100,000 Americans and affects mostly the Black community.

One treatment for sickle cell, known as red blood cell exchange, requires multiple units of blood—sometimes more than 10 at a time. Without racially matched blood donors, these lifesaving procedures become harder to perform, according to Dr. Miller adding that Black Americans are the second largest population of individuals with group O blood– the universal blood type.

Blood donation can also offer donors a look into their overall health through free health screenings, including blood pressure, hemoglobin levels, and in some cases, A1C tests for diabetes risk. These metrics can alert you to potential health concerns long before symptoms appear, making blood donation not only a gift to others but also an act of self-care.

“Sometimes people see a doctor less than once a year. Our screenings may be the only time they get critical health information,” The American Red Cross shares.

This Black Maternal Health Week and throughout National Minority Health Month, the call is clear: donate blood, raise awareness, and advocate for equitable healthcare access.

“Supporting the health of Black mothers is supporting the health of our communities,” Dr. Miller concludes. “Whether it’s rolling up your sleeve to donate blood or empowering someone with information—they’re both acts of love.”

Tips for Black Mothers

Advocating for Yourself During Pregnancy and Postpartum:

Listen to your body: Pay attention to any changes or concerns you may have.
Don’t be afraid to have conversations with your medical team: Ask questions, voice your concerns, and seek clarification on anything you don’t understand.
Arm yourself with information: Learn about your health, including blood pressure, hemoglobin levels, and sickle cell trait status (if applicable). This knowledge can empower you to have more informed discussions with your healthcare providers.
Utilize available resources: Programs like the Red Cross’ blood donation screenings can provide valuable health information.
Be empowered to advocate for yourself: Use the information you have to actively participate in decisions about your care.

Tips for Expectant Mothers:

Focus on taking care of yourself: Prioritize your health and well-being during pregnancy and postpartum.
Understand your health conditions: Be aware of any pre-existing conditions you have and how they might impact your pregnancy and postpartum period.
Prepare to ensure your health is taken care of: Work with your healthcare providers to manage any existing conditions and plan for a healthy pregnancy and delivery.
Seek and advocate for equal access to healthcare: Ensure you have access to timely and quality prenatal, delivery, and postpartum care.
Understand potential complications: Be aware of conditions like postpartum hemorrhage and know the importance of prompt intervention.
Continue to prioritize your health even after leaving the hospital: Postpartum complications can arise even after discharge, so remain vigilant and seek help if needed.

The Red Cross encourages all who are eligible to make an appointment to donate blood or platelets at RedCrossBlood.org, on the Red Cross Blood Donor App, or by calling 1-800-RED CROSS.