Postpartum hemorrhage is rare in physiological birth, but it remains a concern for many planning to birth at home. But, it’s not just about having the right tinctures after birth. In this part of the series, you’ll get a comprehensive list of natural ways to maximally reduce your risks while still pregnant.
Contents
Postpartum Hemorrhage: Three-part Series
This free three-part guide unpacks what postpartum hemorrhage actually is (hint: it’s not just about how many ounces of blood you may lose) and how to help prevent and reduce it in a truly holistic way. It goes over nutrition, herbal support, homeopathics, birth physiology, and birth environment—so, dive in!
- Part 1: Postpartum Hemorrhage: a Holistic Take on Causes & Risks
- Part 2: How to Prevent Postpartum Hemorrhage Naturally
- Part 3: 13 Pregnancy Tips for Postpartum Hemorrhage Prevention (nutrition, herbs & mental prep)
The tips in this article include herbs, diet, lifestyle, and psychological prep based on both wise-woman ways and scientific studies.
Let’s break it down one segment at a time…
Pregnancy Nutrition for Postpartum Hemorrhage Prevention
1) Get Enough Iron and Vitamin K from Food
Good nutrition during pregnancy ensures that you get all the nutrients you need for a healthy birth.
When it comes to bleeding after birth, the two big nutrients are vitamin K and iron.
Iron helps prevent iron-deficiency anemia, which is a major risk factor for postpartum hemorrhage.
According to the latest research, iron-deficiency anemia was independently associated with atonic postpartum hemorrhage. That’s when the uterine muscles don’t contract back after birth but instead remain weakened and atonic, causing uncontrollable bleeding (Tao et al., 2022).
If you plan on testing your iron levels, have in mind that iron blood levels are not respective of your iron status. Instead, you should check your iron stores (ferritin), aside from your red blood cell count, hemoglobin, and hematocrit.
Vitamin K is the vitamin that coagulates your blood. In fact, that’s how it got its name—from German koagulation. Low vitamin K levels can cause anemia and hemorrhage.
Healthy vitamin K levels, on the other hand, help optimize your body’s ability to stop bleeding when needed. Maintaining optimal levels also ensures some vitamin K passes to your baby via the placenta during pregnancy and via breastmilk afterward.
You can get plenty of vitamin K and iron from both animal- and plant-based sources. In general, animal foods contain vitamin K2, while plants contain vitamin K1. You need both for healthy blood circulation.
Animal sources include grass-fed red meat, organ meat, butter, egg yolk, and wild caught fish. Grass-fed meat has the added benefit of providing vitamin K2, which helps with immune function (Moustarah & Mohiuddin, 2022; Simes et al., 2020).
Plant-based sources include wild leafy greens, dark green leafy vegetables, seaweed, beets, wild blueberries, legumes, nuts and seeds, and even cocoa. Good options include spinach, parsley, dandelion, kale, collard greens, comfrey, turnip greens, sesame, and lentils. By combining leafy greens with vitamin C (citruses, black currants), you’ll also boost iron absorption (Suttie, 2011; Moustarah & Mohiuddin, 2022).
A note about blood labs in pregnancy
Labs that are commonly used to assess blood clotting status are hemoglobin, hematocrit, and platelet count. If you choose to do these labs, make sure the reference ranges are adapted to pregnant women. You may also choose not to do any labs.
Many women are told that their hemoglobin level is low in the second trimester and that they need to take iron supplements when that isn’t the case. Hemoglobin levels go through physiological drop in the second trimester, as blood becomes thinner to enable more effective placental transfer of nutrients to the baby. In the third trimester, levels usually rise a bit again, close to the normal for the first trimester.
2) Mind Your Copper-Calcium-Magnesium Balance
If you haven’t been tuning into the whole minerals discussion, be sure to follow the Mineral Shaman and dive into the amazing information at the Root Cause Protocol (RCP). Also, give this Mythic Medicine podcast episode a listen.
The bottom line is that your body needs copper to use and store iron properly. Copper is deficient in the modern diet since our soil has been depleted of it. We’re getting far less copper than our ancestors did just a few generations ago, even if we’re eating ancestral foods.
Copper deficiency has been linked to anemia, heart problems, metabolic disease, poor immunity disruptions, and many more. Symptoms of copper deficiency include low energy, anemia, low neutrophils (neutropenia), immune dysfunction, and increased LDL/HDL cholesterol ratio (Burkhead & Collins, 2022).
However, the solution is not just to supplement with copper but to increase food sources that are naturally high in this mineral.
Foods high in copper include organ meats, grass-fed beef, shell fish, seeds and nuts, legumes, and pee pollen.
Copper balance in the body is part of the bigger mineral matrix. Your mineral matrix is made up of all the key minerals that go into your bones, teeth, hair and nails, and those that circulate in your blood. In pregnancy, this mineral matrix is directly handed over to your baby. This continues to happen postpartum if you’re breastfeeding.
Holding all your minerals, the strength of this matrix also affects your blood clotting and how your body can handle blood loss. It also influences your muscles, as muscles need plenty of minerals to contract and replenish. Your uterus is a muscle, and it can’t effectively contract during labor or after if your body is not providing it with the minerals it needs.
Two other key minerals to pay attention to are calcium and magnesium. Muscles need calcium to contract, so it’s absolutely vital. However, most of us get enough calcium on a daily basis. Paying special attention to sources of calcium is a good idea toward the end of pregnancy and during labor.
Calcium is abundant in dairy, fish, sesame seeds, almonds, leafy greens, and blackstrap molasses.
The second but most important mineral is magnesium. The body needs to maintain a balance between magnesium and calcium. Magnesium is involved in over 200 reactions in the body and it plays roles in everything from muscle health to brain activity to antioxidant status and heart health. Whereas calcium helps muscles contract, magnesium helps relax them. One can’t do without the other.
Low magnesium has even been linked with preterm labor, and it’s also a likely underlying factor in restless leg syndrome and muscle numbness in pregnancy (Kamal et al., 2003).
As with copper, soils worldwide have become depleted of magnesium due to aggressive agricultural practices. A recent ecological study found a link between low magnesium content in soil and rates of preterm birth across the United States (Zhang et al., 2021).
Great sources of magnesium include leafy greens, cashews, whole grains, pumpkin seeds, beans, legumes, and dairy (Vorman, 2016).
3) Up B Vitamins through Natural Sources
Your body needs B vitamins to make red blood cells, especially B12 and folate.
Here are some good and diverse food and herbal sources (Kennedy, 2016):
- Brewer’s yeast
- Wheatgrass
- Nutritional yeast
- Kvass
- Boza
- Bee pollen
- Eggs
- Organ meats
- Whole grains
- Coriander leaf
- Parsley leaf
- Basil
- Burdock root
- Fennel
4) Go for Healthy Fats & Reduce Inflammation
A balanced lipid status also helps regulate inflammation in the body and support normal levels of chemicals involved in blood flow and blood clotting.
High cholesterol levels have been implicated in poor uterine contractions in some studies on muscle tissues, but this hasn’t been confirmed in live humans. One study also suggested that obesity may impair the ability of the uterus to contract in labor (Zhang et al., 2007; Bricker et al., 2007).
Cholesterol is also not bad on its own. In fact, the body needs cholesterol to build cells and sex hormones. Most negative effects have been linked with trans fats and industrial oils.
Healthy fats also soothe the inflammatory response and nourish nerves and brain cells.
Therefore, getting wholesome sources of natural fats seems to be the best way to go. This includes both saturated and unsaturated fats, ranging from animal fats to butter/ghee to coconut oil, extra virgin olive oil, and wild-caught fatty fish.
Our response to fats is highly individual, so it may take some experimentation to see which fats work best for you.
Maintaining a healthy weight is important, though, as obesity can impair calcium signaling and ramp up inflammation in the body.
Pregnancy Herbs for Postpartum Hemorrhage Prevention
5) Incorporate Nutrient-rich Herbs
Herbs packed with nutrients, including iron and many others, include:
- Nettles—high in iron and other blood-building nutrients
- Red raspberry leaf—high in minerals and toning
- Yellow dock—great source of minerals and antioxidants
- Alfalfa—green superfood that packs iron and other nutrients
- Moringa—another mineral-rich superfood from India
- Chlorella—an algae packed with iron and omega-3s
- Spirulina—another great algae high in iron and B vitamins
- Oatstraw—rich in nutrients and wonderful for the nervous system and heart
- Dandelion leaf—nutrient-dense and detoxing
- Bee products—pollen and honey are nourishing and complement the herbs
- Comfrey leaf (Caution!)—generally not recommended*
*Although some herblists recommend comfrey leaf infusions as a rich source of tissue-building nutrients (helping to possibly also reduce the risk of tearing), I tend to be cautious with this herb. On the one hand, it has been traditionally used as an occasional infusion without safety issues. On the other hand, comfrey contains pyrrolizidine alkaloids, compounds that may be toxic to the liver. Animal studies suggest that comfrey can damage the liver in high doses. It may be better to avoid this herb since many safer, nutrient-rich alternatives exist or to use it at lower doses. As always, check how you respond (Stickel & Seitz, 2000).
You can make these herbs into an infusion or take them as a dried powder.
Spirulina, chlorella, moringa powder, and liquid chlorophyll are fantastic to add to smoothies!
Liquid chlorophyll is a concentrated plant-based source of plant-based iron and vitamin K. Chlorophyll is what gives herbs their green color.
Raw dock may be high in oxalic acid. Pouring boiling water over the dried herb helps reduce oxalate content, which is especially important in pregnancy. High oxalate levels can be harmful in excess as they bind to other nutrients and can damage the kidneys.
Red raspberry leaf is also commonly recommended by midwives, but I have some precautions with taking it on a regular basis throughout pregnancy depending on how you respond. Some women are sensitive to its uterine-toning effects, me included. We all respond differently and have unique constitutions. Tune in to how you feel while taking it and stay posted for a detailed monograph on this herb.
6) Know Which Herbs to Avoid/Use with Caution
Theoretically, high doses of certain herbs and supplements may increase the chance of hemorrhage (including subconjunctival hemorrhage, subdural hematomas, potentiation of bleeding effects of aspirin, and postsurgical bleeding complications based on case reports). These include:
- Ginkgo (Ginkgo biloba)
- Garlic (Allium sativum)
- Dong quai (Angelica sinensis)
- Red clover
- Bromelain
- Some digestive enzymes
- Cod liver oil
- Fish oil
Unwanted effects on bleeding are highly unlikely if these herbs/supplements are taken at standard doses or for a short time.
For example, you don’t have to worry about avoiding garlic in food during pregnancy—on the contrary! Garlic is a great source of nutrients like sulfur and antivirals. But if you decide to take high-dose, concentrated garlic extracts, do so with some precaution.
Cod liver oil is a curious case. It’s often recommended during pregnancy and postpartum because it’s such a rich natural source of fat-soluble vitamins, including retinol (at least that’s the case with high-quality cod liver oil like the ones from Green Pasture and Radiant Life—check out the full list here at WP).
Cod liver oil and fish oil might hypothetically increase the risk of bleeding because they contain anti-inflammatory polyunsaturated fatty acids (PUFAs) that improve blood flow. It’s for this reason that they’re considered heart-healthy. However, ultra-high doses are more likely to cause side effects, so have this in mind if you’re taking either!
Pregnancy Lifestyle & Mindset for Postpartum Hemorrhage Prevention
7) Walk Daily & Get Natural Sunlight
Aside from nutrition, tending to your mineral matrix also involves staying active, getting natural sunlight, and avoiding mineral-depleting foods and drinks (like coffee, alcohol, and processed foods). All this keeps your circulation active and helps your body mobilize and reassemble all the minerals it’s getting.
Gloria Lemay mentions in one of her blog posts that a multip she worked with bled very little after birth in the pregnancies during which she took daily brisk walks.
On that note, one study looking at birth data from a teaching hospital discovered a link between low blood vitamin D and postpartum hemorrhage. There’s certainly more to the equation, as all mentioned factors play in! (Li et al., 2022)
8) Balance Your Circadian Rhythm (& avoid light at night)
Having a healthy circadian rhythm prevents disturbances of the melatonin cycle during pregnancy, and shift work. It’s a good idea to avoid bright light exposure at night, especially during the last trimester of pregnancy (Reiter et al., 2014).
Our circadian rhythm is our body’s cue for the day and night cycles. As the sun sets and everything gets dark, our body starts secreting melatonin, helping us relax and ease into sleep. Melatonin also affects reproduction, boosts our antioxidant status, and protects our cells and tissues. It plays these roles during pregnancy as well, when its protective benefits also extend to the baby.
Melatonin is produced in the brain of both sexes. Fascinatingly enough, it’s also produced in ovaries and in the placenta in women! There it protects against molecular mutations and cellular damage (Reiter et al., 2014).
Keeping a healthy circadian rhythm during pregnancy helps keep your body in a state of optimal hormonal balance entering the birth portal.
During birth, melatonin synchronizes with oxytocin. An intimate, dark environment supports both oxytocin and melatonin production. These hormones work together to make uterine contractions efficient, helping move along labor and reduce bleeding after birth (Sharkey et al., 2009).
To add, studies show that circadian disruption during pregnancy can increase the risk of chronic health problems in the newborn (Mendez et al., 2016).
9) Face Your Fears & Prepare for Undisturbed Birth
This is actually the single most important factor. I go into much more detail about what circumstances make for an ideal, undisturbed, physiological birth in part 2 of this series.
The founder of Herbal Doula.
Home-birthing mama, independent scientist, natural pharmacist, doula, birthkeeper, and holistic health and birthrights advocate. Endlessly passionate about creating and sharing empowering health information and birth support. Ana has written 150+ and edited 800+ articles, some of which reached over 1 million people
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