How do I know if I'm losing too much blood?
If you hired a midwife, she is trained to estimate blood loss and will help you ensure you are staying healthy after your baby is born. If you are alone when the birth happens, there are a few things to pay attention to. First, be sure to stimulate your uterus to contract as quickly as possible after the baby is born to help close off the bleeding. You can easily do this by breastfeeding, or using manual breast stimulation. Check your uterus to ensure it is getting hard and smaller (if you had a hospital birth prior to this labor you are probably familiar with the deep abdominal pressure the nurses use to stimulate the uterus to contract. Don't forget to check the placenta to make sure it is complete, since leaving a piece inside the uterus can cause excessive bleeding. You can expect that changing position may cause a "sudden gush" of fluids from your vagina. This happens because some positions allow blood to pool in the back of the vagina, and when you sit up the vagina tilts to a different position releasing the collected blood. But you should not be feeling continual gushing of blood. Some bleeding is expected, but remember it should not be a lot. You have hemorrhaged, by definition, when you have lost about 2 cups of blood. If you want to know what this looks like, try coloring some whole milk red and see how a half cup of fluid looks on your towels or on a pad. If you have a steady flow of bleeding that is gushing out, you can be sure you are in need of assistance right away. It is also possible to have a hemorrhage that is a steady flow that seems to trickle out. This would seem more like a heavy lochia. Stay hydrated in the early hours after your baby is born. Also, pay attention to the way your body feels. If you think something is wrong, make sure your midwife checks you as quickly as she can, or if she is unavailable seek other medical help.
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