Patients may experience bleeding during the natural cycle of childbirth. Significant bleeding after the baby has delivered can have several different causes. In EMS, you will never pack anything into the vagina in an attempt to control bleeding. Sterile dressings placed over the vaginal opening is the most EMTs are able to do to control vaginal bleeding. In the setting of childbirth, fundal massage seeks to stimulate uterine contraction and slow or stop bleeding. As an EMT, if your patient presents with hemorrhage post-childbirth, place several sterile, absorbent dressings over the vaginal opening and perform fundal massage if necessary. Transport the patient. Paramedics may have the option of giving pitocin to stimulate uterine contraction or other medications to control bleeding.
Occasionally the perineum (the area between the vagina and the anus) will tear during childbirth. Care for this as with any other hemorrhage but again, do not insert anything into the vagina. An episiotomy may be used in hospital if there is the potential for a perineal tear during delivery to minimize perineal injury recovery times.
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