“They Had to Take My Uterus”: Emergency Hysterectomy After Birth

After a postpartum haemorrhage · Part 11 of 11 · 16 min read · Published 1 November 2026 · Reviewed 1 November 2026 · Next review May 2027

By Dr Rosemary Listing, PhD (Law) · Medical negligence lawyer since 2013 · Of Counsel, Peter Evans & Associates

If this is your story, I am so sorry. An emergency hysterectomy after birth is one of the most profound losses a woman can experience, and it often happens without warning, while you are unconscious, in a few hours that change the rest of your life. You may be grateful, grieving, angry and numb all at once. All of that is normal.

This is the final article in a series that starts with “I thought I was going to die”: postpartum haemorrhage, what happened and what you can do.

Why I can write this

I have been a medical negligence lawyer since 2013 and have worked on many hundreds of claims, many involving birth. Hysterectomy cases are among the ones I think about most. My doctorate studied patterns of failure in medical negligence. I am not medically qualified. The clinical information here comes from the NSW Health PPH guideline, Australian hospital and government sources, and research linked below.

Start with your question

• “Why did they have to do it?” Why it happens
• “Could they have tried something else first?” The steps before hysterectomy
• “Will I go into menopause?” Your body and hormones
• “Why do I feel so much grief when I’m alive?” The grief
• “Can I still have another child?” Growing your family
• “Should it have been seen coming?” What to look for in the records
• “Do I have a claim?” How the law looks at it

Why an emergency hysterectomy happens

A peripartum hysterectomy is the removal of the uterus around the time of birth, usually to stop a haemorrhage that hasn’t responded to other treatment. It is uncommon. An Australian Institute of Health and Welfare working paper found it happened in about 0.79 per 1,000 women giving birth in Australia between 2003 and 2014. Numbers rose over that time, while the rate stayed fairly stable. Older mothers and women having twins or more were over-represented, and the procedure is closely linked to caesarean birth.

Common reasons include:

• Placenta accreta spectrum, where the placenta grows too deeply into the wall of the uterus, often into a previous caesarean scar, and can’t come away.
• Uterine atony, where the uterus won’t contract despite medication and other measures.
• Uterine rupture, a tear in the wall of the uterus, sometimes along a previous scar.
• Placenta praevia, where the placenta lies low over the cervix.

“Nobody ever told me why” explains the causes of PPH in more detail.

The steps before hysterectomy

NSW Health’s guideline describes a sequence for managing a haemorrhage. Medication and uterine massage come first, then measures such as bimanual compression and a balloon placed inside the uterus (intrauterine tamponade), which the guideline says should be considered before more invasive surgery and controls bleeding in about 85% of cases. Surgical options include tying off the uterine arteries or placing compression sutures. What happens during a PPH walks through these steps.

When those measures fail, the guideline says surgery is needed, and it recommends early recourse to hysterectomy, particularly where bleeding is linked to placenta accreta or uterine rupture. The decision must be made by an experienced consultant obstetrician, ideally with a second.

That last point matters. Sometimes the problem is not that a hysterectomy was done, but that it was done too late, after too much blood loss. Sometimes it is that earlier steps were missed, so a hysterectomy became the only option. And very often, a hysterectomy was the right decision made quickly by skilled people under enormous pressure.

Your body after a hysterectomy

You are recovering from two things at once: a major haemorrhage and major abdominal surgery. Many women also had a caesarean, intensive care, blood transfusions or a breathing tube.

Drawn from the WA Women and Newborn Health Service placenta accreta booklet, healthdirect and Better Health Channel. Your own situation may differ: ask your surgeon.

The WA Women and Newborn Health Service booklet on placenta accreta explains that in a hysterectomy for accreta, the ovaries are left behind so you won’t go into menopause immediately, that monthly periods stop, and that you can’t have more pregnancies. If your ovaries were removed, you would go into menopause and your doctor may talk to you about hormone therapy, as healthdirect explains.

The Better Health Channel says recovery from an abdominal hysterectomy may take up to six weeks. After a haemorrhage, anaemia and exhaustion can make it much longer. Recovery after a PPH covers anaemia, milk supply and the physical aftermath.

Based on healthdirect’s hysterectomy guidance and NSW Health GL2025_013, section 7.1.

The grief

Women often tell me they feel they aren’t allowed to grieve. They survived. Their baby survived. Everyone is relieved. But a hysterectomy can mean the loss of a planned family, of a sense of womanhood, of choice. For some women, it means the baby they just had is their only biological child carried by them. For others, it means a sibling who will never exist.

The WA booklet acknowledges that an unwanted hysterectomy can cause grief, sadness and a sense of loss, and recommends involving a psychologist, sometimes long term. Grief may come in waves: at a friend’s pregnancy announcement, a baby shower, your child’s first birthday, a medical form that asks how many pregnancies you’ve had.

Many women also have symptoms of trauma: flashbacks of waking in intensive care, panic around hospitals, gaps in memory. “I still wake up back in that room” covers PTSD after a PPH. And partners often carry their own trauma from watching. This article is written for them.

There is no correct way to feel. You can be glad to be alive and devastated by what it cost. Both are true.

Growing your family

If you want more children, there are still paths, though none of them replaces what was lost.

• Surrogacy. If your ovaries were kept, it may be possible to use your own eggs through IVF, with another woman carrying the pregnancy. In NSW, only altruistic surrogacy is legal: the surrogate can be reimbursed reasonable costs but not paid. Legal Aid NSW explains the rules, including counselling, independent legal advice and parentage orders from the Supreme Court under the Surrogacy Act 2010 (NSW).
• Adoption and foster care. Some families choose these paths. They have their own processes and waiting times.
• Not having more children. This is a valid choice too, and it still deserves to be grieved if it wasn’t the one you would have made.

Talk to a fertility specialist before making decisions, and give yourself time. Many women find they need months or years before they are ready to think about it.

What to look for in the records

Many women want to know whether the hysterectomy could have been avoided. The records can help answer that. My guide to getting and reading your birth records explains how to request them. Ask for the complete file, including theatre, anaesthetic, intensive care and pathology records, and your antenatal scans.

Questions to ask

• Why did I need a hysterectomy?
• What was tried first, and why didn’t it work?
• Were my ovaries kept? Was my cervix removed?
• Was there anything on my scans that suggested a problem with the placenta?
• Should I have given birth in a different hospital?
• What does the pathology report show?
• Do I need cervical screening in future?

You can ask these at a debrief. NSW Health says debriefing should happen at the earliest opportunity and may need to be repeated, including after discharge. See how to ask for a birth debrief.

How the law looks at it

A hysterectomy after birth is not, by itself, evidence of negligence. It is often the right decision, made quickly, that saves a woman’s life. The legal questions are about what happened before it.

Was the care below standard?

Under section 5O of the Civil Liability Act 2002 (NSW), a health professional is not negligent if they acted in a way widely accepted in Australia by peers as competent professional practice. Independent experts compare what happened against that standard and against guidelines. In hysterectomy cases, experts often look at:

• whether a placenta problem should have been identified antenatally, for example after a previous caesarean, where NSW Health requires the placental site to be confirmed by ultrasound
• whether a woman at high risk was booked to give birth at a hospital able to manage it
• whether bleeding was recognised, measured and escalated in time
• whether appropriate steps were taken in the right order, and whether a hysterectomy was done too late

Did it cause the harm?

The law asks whether better care would, on the balance of probabilities, have avoided the hysterectomy or reduced the harm. In Tabet v Gett [2010] HCA 12, the High Court confirmed that losing only a chance of a better outcome is not enough. In some cases, even with a perfect antenatal diagnosis of placenta accreta, a planned hysterectomy may still have been needed. The difference may then be in how much blood was lost, whether the surgery was planned or chaotic, and the trauma that followed. Those differences can matter too.

Information and consent

Under Rogers v Whitaker [1992] HCA 58, doctors must warn of material risks. If you had known risk factors for accreta or haemorrhage, the possibility of hysterectomy may have been something you should have been told about before birth. In a true emergency, NSW Health’s consent manual allows treatment needed to save life without consent, so the question is usually about what you were told earlier.

What a claim can cover

Damages may include pain and suffering, loss of enjoyment of life, past and future medical and psychological treatment, lost earnings and care. The loss of the ability to carry another pregnancy is a significant part of how the injury is assessed. Psychological injury, such as PTSD or depression, is assessed alongside the physical injury. The Civil Liability Act sets thresholds and caps. “Is it too late?” explains what a claim can cover.

Who can claim, and when

The woman can claim. A partner who witnessed the emergency may have a separate claim for their own psychiatric injury, subject to strict conditions. In NSW, claims generally must start within three years of when they became discoverable, with a twelve-year outer limit. See medical negligence time limits in NSW.

In my practice

In hysterectomy cases, the chain of small failures often starts months before the birth. A scan report recommends a follow-up that never happens. A previous caesarean is noted but not linked to the placental position. A woman at high risk is booked into a small hospital. On the day, blood loss is estimated by eye, and the escalation comes a little late. None of these alone may look dramatic. Together they can turn a manageable, planned situation into an emergency that ends in the loss of a uterus. Sometimes, when I read the records, the care was excellent and the hysterectomy was unavoidable. Telling a woman that honestly is part of the work too.

Holding two truths

The people who removed your uterus may have saved your life. And something may still have gone wrong before they had to. You can be grateful to the surgeon and still want to know why no one rescanned your placenta. You can love the child you have and grieve the ones you won’t carry.

The bigger picture

As caesarean rates rise, so does the number of women with placenta accreta, and with it the risk of hysterectomy. Australian researchers and the AIHW have linked peripartum hysterectomy to caesarean birth. NSW Health’s 2025 guideline now requires placental site confirmation for every woman with a previous caesarean, and a multidisciplinary plan where accreta is suspected. Safer Care Victoria’s PPH program works on earlier recognition and escalation. Good antenatal detection can turn an emergency into a planned operation, with blood ready and the right specialists in the room.

Support

• PANDA National Helpline: 1300 726 306. For new and expecting parents, including after birth trauma.
• Gidget Foundation Australia: 1300 851 758. Free psychological sessions for new parents.
• Birth Trauma Australia: peer support for women and partners.
• Pregnancy, Birth and Baby: 1800 882 436. Free advice from maternal child health nurses.
• MensLine Australia: 1300 78 99 78. For partners, 24/7.
• Lifeline: 13 11 14, 24 hours. In an emergency, call 000.

More options are in finding support after birth trauma in Australia. If people keep saying “at least you’re alive”, this article may help.

The woman at the kitchen table still has the page with the line about the rescan. She keeps it in the same folder as her daughter’s hospital bracelet. She says one is the thing she lost, and the other is the thing she got to keep, and she is learning to hold the folder without opening it every day.

With care, Rosemary