Birth injury & birth trauma
"I Kept Telling Them Something Was Wrong": Postpartum Haemorrhage and When Care Falls Short
In this article
If you bled heavily after giving birth, and especially if you felt unheard while it was happening, this is for you. I'll explain what a postpartum haemorrhage is, what hospitals are expected to do to prevent and treat it, and how a lawyer works out whether care fell short. I'll also talk about partners, who often carry this too.
You knew something was wrong.
Your baby was finally here.
You should have been holding them. Instead you were getting colder. Shakier. Further away.
You remember the blood. You remember saying you didn't feel right, and someone telling you that you were "just tired", or that "a bit of bleeding is normal".
Then everything happened at once. The emergency bell. Too many people. Theatre lights. Maybe you woke up in intensive care. Maybe someone sat by your bed and told you, gently, that they'd had to remove your uterus.
Or maybe it was days later. You were home, bleeding heavily, passing clots, burning with fever. You rang the hospital and were told it sounded normal.
You survived. People keep reminding you of that, as if it should close the conversation.
But surviving something and being okay with how it happened are two very different things.
If you've been carrying a quiet sense that it didn't need to go this far, I want you to know that's a reasonable thing to wonder. It deserves a proper answer, not reassurance.
What a postpartum haemorrhage is
Postpartum haemorrhage (PPH)
Heavier bleeding than usual after giving birth. A primary PPH happens within the first 24 hours. A secondary PPH happens in the days or weeks afterwards.
In plain terms: you lost more blood than your body could safely afford. Pregnancy, Birth and Baby has a helpful overview of postpartum haemorrhage.
The usual causes are the uterus not contracting properly after birth, tears to the birth canal or cervix (including severe perineal tears), pieces of placenta or membrane left behind, or problems with blood clotting.
A serious haemorrhage can mean transfusions, surgery, intensive care and emergency hysterectomy. It can leave you with long-term exhaustion and anaemia, loss of fertility, and post-traumatic stress. And in the most heartbreaking cases, mothers die.
Here's what I most want you to understand. PPH is common, but common doesn't mean unmanageable. It's one of the best-understood emergencies in maternity care.
What should have happened
In NSW, maternity services work under a statewide NSW Health Postpartum Haemorrhage guideline. Internationally, the World Health Organization has published recommendations on assessing blood loss and treating PPH. You don't need to read them. But it helps to know that clear expectations exist.
Your risk should have been recognised.
Some women go into birth at higher risk: a previous PPH, twins, a large baby, anaemia, a long labour, or an induction. Women who've had caesareans before and have a low-lying placenta should be checked for placenta accreta, where the placenta grows too deeply into the wall of the uterus. That needs careful planning, often with specialist teams and blood ready.
Let's say you'd had two caesareans and were told your placenta was "a bit low". Did anyone mention accreta? Was there a plan? Or did the bleeding take everyone by surprise?
Bleeding should have been measured, not guessed.
This one surprises people. Blood loss is often estimated by eye, and visual guesses tend to be too low. The NSW guideline expects clinicians to keep a running total of blood loss, watch closely for signs you're deteriorating, and escalate concerns quickly.
Observations and escalation
After birth, staff should regularly check your pulse, blood pressure, breathing and other signs. Certain changes are meant to trigger a call for senior help.
In plain terms: your body was likely showing warning signs before you collapsed. The question is whether anyone was watching, and whether they acted.
Help should have come quickly.
Once a haemorrhage is recognised, there's a well-known sequence: call senior staff, give medications to help the uterus contract, replace fluids and blood, and get to theatre if needed. Delays at any step can turn a manageable bleed into a life-threatening one. Sometimes they're the reason a hysterectomy becomes necessary.
And you should have been listened to.
If you went home and then rang with heavy bleeding, clots, pain or fever, you should have been brought in and examined, not reassured over the phone. Retained placenta and infection are treatable when they're found.
If this is landing for you, and you're realising the gaps in your story were never filled in, I'm happy to listen. There's no pressure to decide anything.
How a lawyer looks at this
"Negligence" is a heavy word, and it gets used loosely. When I look at a haemorrhage, I'm asking two specific questions.
Standard of care
Did the care fall below what a competent clinician should have provided at the time? Independent medical experts review your records to answer this.
In plain terms: did they do what a careful team should have done?
Causation
If it did fall short, did that make a difference to what happened to you?
In plain terms: would you still have lost your uterus, or ended up in ICU, if things had been done properly and on time?
Both matter. A haemorrhage on its own doesn't mean anyone was negligent. A haemorrhage that was missed, underestimated or treated too slowly might.
As you think back, you might notice whether any of this feels familiar. Did you tell someone you felt faint, cold or wrong, and get brushed off? Do your notes describe less bleeding than you saw, or were later told about? Did you wait a long time for a doctor, or for theatre? Did you come back days later and learn there was placenta left inside?
If something in you tightened reading that, it's worth exploring.
Your partner was there too.
I want to say something about the people standing beside the bed.
Partners often watch a haemorrhage unfold with nowhere to go. They're holding a newborn, being moved out of the way, not knowing whether they're about to become a single parent. Many tell no one how much it shook them.
The NSW Parliament's 2024 Birth Trauma report heard from partners as well as mothers. In some circumstances, a partner who develops a recognised psychiatric injury after witnessing a traumatic birth may have a claim of their own.
And if a mother doesn't survive, her family may be able to claim under the Compensation to Relatives Act 1897 (NSW). I hope that's not your story. But if it is, I'm so sorry, and I'd be honoured to help.
What a claim can and can't do
A claim can't give you back the birth you hoped for, or your fertility, or the weeks you lost to recovery.
What it can do is get independent experts to tell you honestly whether your care met the standard it should have. If it didn't, a claim can compensate you for your physical injuries, for the loss of future pregnancies, and for psychological harm. It can also cover lost income, treatment, and the help you've needed at home.
There are other ways to get answers too. NSW public hospitals have an open disclosure process for honest conversations after something goes wrong. You can complain to the Health Care Complaints Commission, which explains what you can complain about, or raise a concern about a practitioner with Ahpra.
Looking after yourself.
Recovering from a haemorrhage is physical and emotional work, and it often takes far longer than anyone tells you. Birth Trauma Australia offers peer support. PANDA runs a national helpline on 1300 726 306. The Gidget Foundation offers free counselling for new parents, partners included.
Frequently asked questions
PPH is common. Doesn't that mean it can't be anyone's fault?
No. A common complication still has to be properly anticipated, monitored and treated. The question isn't whether you bled. It's whether the bleeding was managed the way it should have been.
I lost my ability to have more children. Can a claim recognise that?
Yes. Loss of fertility is a profound harm, and it can form part of a claim.
Is there a time limit?
Yes. In NSW, time limits are set by the Limitation Act 1969 and they're strict. It's best to get advice early, even if you're not ready to act.
I don't have my medical records. Do I need them first?
No. Getting the records is part of what I do.
A closing thought
So many women tell me they've stopped talking about their birth because people keep saying, "But you're okay now."
You're allowed to be okay and still need to understand what happened to you.
So here's a question to sit with: if someone finally listened to the whole story, from the moment you said you didn't feel right, what would you most want them to hear?
Keep reading: Birth injury and birth trauma · "They said it was just a headache": missed pre-eclampsia · Shoulder dystocia and Erb's palsy · When a stillbirth may have been preventable
This article is general information only. It is not legal or medical advice, and reading it does not create a lawyer–client relationship. Every situation is different. If you are in crisis, please call Lifeline on 13 11 14 or 000 in an emergency.
