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Aust N Z J Obstet Gynaecol. 2011 Aug;51(4):365-71. doi: 10.1111/j.1479-828X.2011.01317.x. Epub 2011 Jun 9.

Emotional and physical health outcomes after significant primary post-partum haemorrhage (PPH): a multicentre cohort study.

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  • 1Women's Hospitals Australasia, School of Clinical Medicine and Department of Obstetrics and Gynaecology, Australian National University Medical School, Canberra, Australian Capital Territory, Australia.



Post-partum haemorrhage (PPH) rates are rising; however, data on the health impact on women are lacking.


To describe the emotional and physical health outcomes for women following PPH.


A cohort of 206 women with primary PPH of 1500 mL or more, and/or peripartum fall in haemoglobin concentration to 7 g/dL or less, and/or of 4 g/dL or less, was recruited from 17 Australian/New Zealand hospitals. Women completed questionnaires in the first week, and at two and four months post-partum. Obstetric details came from hospital records. Outcomes were anxiety; post-natal depression (PND); fatigue; post-traumatic stress disorder (PTSD); general health (SF-36); physical health problems; post-natal bleeding duration; hospital readmission.


Eighty-three percent completed the two-month and 81% the four-month questionnaires; 28% reported bleeding continuously for more than six weeks; 10% required hospital readmission within two months. Anxiety scores were in the medium range; 11 and 13% were at risk of PND at two and four months, respectively; median total fatigue scores were 17 at two and 15 at four months; 5% showed evidence of PTSD at two and 3% at four months; women scored highly in most SF-36 categories and showed improvements over time in all but general and mental health. Physical health concerns were comparable to those reported for general post-natal populations, with the exception of uterine infection (6% at two months).


In a cohort of women experiencing PPH, emotional and physical health outcomes were similar to those reported in general post-natal populations, with the exception of post-natal bleeding duration, uterine infection and hospital readmission.

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