I Never Knew About Postpartum Hematomas Until My Third Baby

Nothing traumatic or technically out of the ordinary, but definitely different than what I had previously experienced.

Labor started in the morning unlike my other two births, it lasted longer than my second, I was GBS+, so I had antibiotics administered during labor, and it snowed. I also birthed my son on all fours, a surprisingly effective pushing position.

It was my postpartum experience that brought about the biggest surprise though: a postpartum vulvar hematoma.

Although very new to me – I had never heard of a hematoma after delivery – my midwife had thankfully seen, and successfully treated, them more than once. We suspected it happened when I was pushing and slightly tore. My son was born with his hand up near his face which created a unique (and painful) presentation and thus the perfect environment for a hematoma to develop.

Simply put, it’s a collection of blood outside the blood vessels. When it comes to a postpartum hematoma, they’re not even considered rare — just something that is rarely spoken about. Hematomas usually resolve themselves with rest, but sometimes they need extra support. Regardless of where you might experience a hematoma, it’s always good to be under the care of a healthcare professional as sometimes there are complications.

Thankfully, I didn’t have any complications. I did need to approach my postpartum recovery a little differently, though.

We didn’t actually know about my hematoma until an hour after birth. I was settled in bed with my newborn and my midwife began her postpartum assessment. Everything checked out beautifully with my baby. I was in that perfect, post-birth state of bliss. Some pesky post-birth contractions had begun, but other than that, I felt pretty good for having endured 12 hours of labor. My midwife donned her headlamp and peered under the sheets…

“Kind of. Maybe. I mean, it’s sore.”

She called over the other midwife who attended my birth, and together they explained to me what they were seeing. They offered a mirror too, but I passed on that. I had a small tear, nothing alarming, but a substantial hematoma was developing in the vicinity.

We had two courses of action to consider – repair the tear with a few stitches, or leave it alone. Typically with a tear, they said, they’d pop in a few stitches and call it good. But in my case, with the hematoma, they worried that stitches could constrict the area and cause the hematoma to worsen instead of resolve on its own.

This decision came with strict instructions, though. I was to stay in bed for three full days. No stairs. Only walking to the bathroom. And, when I did, I needed to get out of bed keeping my knees together. Basically, no movement that might compromise my healing. With rest and cold compresses we hoped my hematoma would absorb and get smaller within a few days.

My midwife scheduled a few extra postpartum visits to keep an eye on it, home visits so I wouldn’t go down the stairs at all. Within 24 hours, my hematoma was shrinking, and within 48 we were confident that not stitching my tear was definitely the right course of action. By my one-week appointment, it was completely gone and I was cleared to visit the couch downstairs. Hallelujah!

It’s hard to go slow postpartum. And in the case of my hematoma, I had to go extra slow. But I’m so glad I did. Our bodies need time to heal after birthing a human and nothing replaces that. So, hematoma or not, remember to rest. Rest equals healing.