The maternal health crisis in the United States continues to make headlines, with alarming statistics placing the country as having the highest maternal mortality rates among high-income nations. A leading cause of this crisis is postpartum hemorrhage (PPH), a condition that disproportionately affects Black women. BlackDoctor.org spoke with Organon Health Partner and board-certified Obstetrician/Gynecologist, Dr. Kameelah Phillips to discuss why understanding PPH’s dangers, risk factors, and impact is vital for empowering Black mothers to advocate for their health and well-being.
What Is Postpartum Hemorrhage and Why Is It So Dangerous?
PPH refers to excessive blood loss following childbirth, typically more than 500 mL after a vaginal birth or 1,000 mL after a cesarean delivery. For context, this is equivalent to losing nearly three 12 oz. cans of soda—a volume that is five times more than what the American Red Cross deems as life-threatening.
“PPH is dangerous for mothers because its impact can be long-lasting. I’ve seen firsthand that it can have severe short- and long-term physical, mental, and financial implications. And, unfortunately, in some cases, PPH can be life-threatening,” Dr. Phillips shares.
Why PPH Is Dangerous
1. Immediate Impacts
PPH can lead to life-threatening complications such as low blood pressure, anemia, and organ failure.
2. Long-Term Effects
Mothers may face chronic fatigue, chest pain, and difficulties with breastfeeding due to lactation problems.
3. Emotional Toll
Many women experience post-traumatic stress disorder (PTSD) after PPH, which can strain bonding with their newborn and affect mental health for years.
“Unfortunately, a poor birthing experience, such as PPH, may hinder immediate bonding between a mother and her baby, a crucial time for emotional connection that supports long-term positive developmental and health outcomes for the baby. I’ve seen firsthand that some mothers who experience PPH—and even their partners—have symptoms of post-traumatic stress disorder (PTSD) and associated fears of the birthing experience, even years after a PPH episode,” Dr. Phillips adds.
4. Financial Strain
PPH can increase delivery costs by 45 percent, adding significant stress to families already navigating the challenges of new parenthood.
Recognizing the Risks of PPH
While about 40 percent of PPH cases occur in women with no prior risk factors, some conditions can increase the likelihood of PPH, including:
- A history of PPH
- Anemia or high blood pressure
- Older maternal age or long labor
- Large babies or multiple births
“That said, PPH can happen to anyone,” Dr. Phillips notes. “Signs of PPH that I look out for include soaking more than two pads with blood in two hours, blood clots the size of or larger than the palm of a hand, and light-headedness.”
If you are experiencing any of these symptoms, it is important to seek medical attention.
“If severe, continued blood loss persists from PPH and early interventions do not work, in rare cases, more invasive interventions such as a hysterectomy may be needed, impacting women’s fertility for the future,” Dr. Phillips shares.
The Role of Maternity Care Deserts
More than two million women in the U.S. live in maternity care deserts, areas where access to obstetric care is limited or nonexistent.
“These women may lack access to important screenings before, during, and after pregnancy, which put them at higher risk of complications, like preterm birth, hemorrhage, and other causes of severe maternal morbidity,” Dr. Phillips shares.
For Black women, who are more likely to live in these underserved areas, the danger is compounded by systemic inequities and biases in healthcare delivery.
“Specific to PPH, timely medical intervention and fast control of abnormal bleeding is critical in order to minimize the risk of complications. Unfortunately, there are disproportionately more PPH episodes in low-resource settings, where access to needed health services and treatments to minimize these risks are more limited,” Dr. Phillips adds.
Why Black Women Are Disproportionately Affected
Black women face maternal mortality rates more than three times higher than white women. Key factors include:
- Limited Access to Care: Many Black women live in areas with fewer healthcare facilities equipped to manage maternal complications.
- Healthcare Bias: Even with similar socioeconomic status and medical histories, Black women report experiencing discrimination in healthcare settings, leading to delays in care or misdiagnoses.
- Systemic Inequities: Social determinants of health—like housing, education, and access to nutritious food—disproportionately affect Black women, exacerbating health disparities.
“The CDC found that during 2011-2015, Black women died of pregnancy-related deaths at rates 3.3 times greater than white women. While there are pre-existing higher risks that Black mothers face, this comes down to access to care and social determinants of health, which is critical in minimizing the impact among Black mothers. For example, Black women disproportionately live in areas where access to health services and treatments are more limited; Black mothers – even those with high socioeconomic status and similar diagnoses – experience discrimination during maternity care,” Dr. Phillips notes.
One promising tool in managing PPH is the JADA® System, an FDA-cleared device that uses low-level vacuum pressure to help the uterus contract and stop bleeding quickly.
Clinical studies show that JADA can control bleeding in as little as three minutes, significantly improving mothers’ outcomes.
“In the PEARLE clinical study, JADA was proven fast and effective in managing abnormal postpartum bleeding and hemorrhage in 94 percent of study participants in a patient population consisting of both vaginal and cesarean deliveries and reinforced by the RUBY real-world observational registry study. In the PEARLE study, there were no adverse events deemed definitely related to the device or the procedure and there was a low rate of possibly device-related adverse events,” Dr. Phillips who has been prescribing JADA for the past three years shares.
“Because a mother’s total circulating blood volume can flow through the uterus in just 8-11 minutes at term, blood loss can escalate quickly to PPH. This makes timely medical intervention and fast control so critical to minimize progression of complications. If hospitals in these communities have JADA stocked and doctors are educated on how to use it, the device may help control abnormal postpartum uterine bleeding and PPH, which was shown in the PEARLE study to be controlled in a median time of three minutes,” Dr. Phillips adds.
The JADA® System is intended to provide control and treatment of abnormal postpartum uterine bleeding or hemorrhage when conservative management is warranted. For more information, click here or consult with your healthcare provider.
Advocating for Safer Birth Experiences
Dr. Phillips encourages all women — “especially women with potential risk factors for complications, or those in underserved communities — to set themselves up for the best delivery possible by advocating for a healthy pregnancy with their healthcare professional.”
“Having open and honest conversations about potential birth complications prior to delivery with your health care provider is a great first step,” she notes.
Here are some other ways you can advocate for yourself:
- Educate Yourself: Learn about potential complications like PPH and discuss them with your healthcare provider early in pregnancy.
- Know the Signs: Recognize symptoms of PPH and understand when to seek emergency care.
- Demand Transparency: Ask about the resources available at your hospital, including advanced technologies like the JADA System.
- Build a Support Network: Surround yourself with trusted advocates who can speak up on your behalf during delivery and postpartum care.
“As a Black OB/GYN, but also as a mother of three kids, I understand how bias can cause distrust in the healthcare system. However, I believe it is critically important that health care providers rally around Black women to educate and advocate for their safety during their maternity and postpartum care. As their advocates, health care providers can help patients understand any potential complication they may be at risk for. I always make sure to discuss potential birth complications, such as PPH and abnormal postpartum uterine bleeding, and how our team is prepared to address them, should they occur. I’ve found that having these conversations early and frequently during maternity care allows my patients the time to process potential complications and feel safe if a postpartum emergency happens,” Dr. Phillips concludes.
