Vicki Rackner had an uncomplicated delivery. It was afterwards that her problems began. During one of the nurses' routine post-delivery checks, the nurse remarked, "Hmm ... your uterus feels big."

Too bad she didn't check in an hour or two. "Many hours later, my first time out of bed, I fainted in the bathroom," says Rackner, from Mercer Island, Wash. "The blood vessels in my uterus had not clamped down as they should. As my uterus filled up with blood and clot, it made it even easier to bleed. I was carried back to the bed, given Pitocin and 'delivered' the contents of my full uterus. They even weighed the specimen."

Rackner experienced postpartum hemorrhage (PPH), which is estimated to occur in about 5 percent of deliveries, according to Dr. Barbara Assel, an OB/GYN in Maternal-Fetal Medicine at Aurora's Women's Health Pavilion in SE Wisconsin.

Generally, postpartum hemorrhage "is considered to be a loss of more than 500 ml of blood after delivery, but it is really any bleeding after a vaginal delivery or a C-section that leads to hemodynamic compromise (unsafe drop in blood pressure) or could lead to it if left untreated," says Dr. Hannah Phillips, a board-certified physician in Ashburn, Va., who specializes in women's health issues.

In some cases, PPH is caused by problems with the uterus, such as over-distention of the uterus from a large infant or multiple gestation, which prevents the normal contraction of the uterus after delivery, Dr. Phillips says, or by retained placental products or abnormal growth of the placenta into the uterus. "It can also be caused by trauma during delivery such as from an episiotomy or use of instrumentation or damage to surrounding blood vessels during a C-section," she says. "Rarely, it can be due to a maternal clotting problem that can occur in conditions like preeclampsia."

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