Kameelah Phillips, M.D.: Raising Awareness About Postpartum Hemorrhage

Kameelah Phillips, M.D.

Credit: Calla Women’s Health

Postpartum hemorrhage (PPH) is a critical bleeding emergency that can happen after childbirth and is the leading cause of maternal mortality in the U.S. At term, a mother's entire blood volume can pass through the uterus in just eight to 11 minutes, making rapid blood loss a serious risk.

In an interview with The Educated Patient, Kameelah Phillips, M.D., Organon Health partner, board-certified OB-GYN and mother of three, discusses how despite PPH being a common birth complication, progress in effective treatment has been slow, with inconsistent protocols and challenges in measuring blood loss. However, newer interventions, such as the JADA System, show promise in controlling bleeding quickly.

Why is PPH such a significant contributor to the maternal health crisis in the U.S.?

Kameelah Phillips, M.D.: Unfortunately, severe maternal morbidity rates are on the rise in the U.S., with PPH as the leading cause. Despite being one of the most common birth complications, there has been little progress in minimizing the impact of PPH.

For example:

• For decades, there has been limited progress in PPH treatment and conflicting PPH treatment protocols for professionals to follow.
• PPH is determined by the amount of blood a woman is losing, but there’s not an easy way to measure the amount of blood loss.
• There are disproportionately more PPH episodes in low-resource settings, where access to health services and treatments is more limited.

What are the main causes of PPH, and are there any warning signs expectant mothers should be aware of?

KP: While about 40% of PPH cases occur in women with no known risk factors, there are some factors that may increase a mother’s risk of PPH, including a previous occurrence of PPH, anemia, hypertension, increased maternal age, a long labor, prior cesarean section, the size of the baby or having multiples. That said, PPH can happen to anyone.

If women are concerned about having PPH or other birth complications, I suggest they have an open conversation with their healthcare professional to formulate the right plan to optimize their pregnancy and birth experience, and should complications like PPH arise, to ensure they plan to act fast with the appropriate treatment solutions.

What are the immediate and long-term impacts of PPH on a mother’s health and well-being?

KP: PPH can have several emotional and physical short- and long-term impacts on women, including the following:

• The level of blood loss that occurs during PPH — which is comparable to nearly three 12-ounce cans of soda (five times more than what the American Red Cross deems as life-threatening!) — can lead to problems like low blood pressure and anemia. These conditions can cause extreme fatigue, chest pain, and even lactation problems — making breastfeeding more challenging.
• I’ve seen firsthand that some mothers who experience PPH have symptoms of post-traumatic stress disorder (PTSD) and associated fears of the birthing experience, even years after a PPH episode.
• If severe, continued blood loss persists from PPH and early interventions do not work, in rare cases, more invasive interventions such as a hysterectomy may be needed, impacting women’s fertility for the future.

Which groups of women are most at risk of developing PPH, and are there any factors that increase vulnerability?

KP: While PPH can happen to anyone, unfortunately, there are disproportionately more PPH episodes in low-resource settings, where access to needed health services and treatments to minimize risks of maternal complications are more limited.

Additionally, the rate of pregnancy-related deaths for Black mothers exceeds all other racial and ethnic groups. While there are preexisting higher risks that Black mothers face — including hypertensive disorders, peripartum cardiomyopathy, preterm birth and postpartum readmissions — this comes down to access to care and social determinants of health, which is critical in minimizing the impact among Black mothers.

Can you explain how the JADA System works in controlling postpartum bleeding and why it has shown such promising results?

KP: The JADA System works differently than some of the existing tools used to manage PPH and abnormal postpartum uterine bleeding by using low-level vacuum to encourage the uterus to contract as it naturally should after birth, to provide effective, fast control of bleeding. In a clinical study, the median time to control bleeding with JADA was just three minutes.

My confidence in JADA is rooted in my own experience using it as well as evidence-based results. In the PEARLE clinical study, JADA was proven fast and effective in managing abnormal postpartum bleeding and hemorrhage in 94% of study participants, in a patient population consisting of both vaginal and cesarean deliveries and reinforced by the RUBY real-world observational registry study.

What advice would you give to families who want to be better informed about maternal health risks before childbirth?

KP: As an OB-GYN, preparation for birthing complications begins long before I see my patients in the delivery room. I always make sure to discuss potential birth complications, such as PPH and abnormal postpartum uterine bleeding, and how our team is prepared to address them should they occur. I’ve found that having this conversation with mothers and their loved ones prior to delivery allows them the time to process and feel safe if and when a postpartum emergency happens.

With this in mind, I encourage all women and their family members — especially for women with potential maternal health risk factors for complications, or those in underserved communities — to set themselves up for the best delivery possible by advocating for a healthy pregnancy with their healthcare professional. Having open and honest conversations about potential birth complications prior to delivery with your healthcare professional is a great first step.

Is there anything else you would like our audience to know?

KP: Delivering a baby is such a special time in families’ lives. Conversations like these are not intended to scare expecting mothers and their loved ones but instead empower them with knowledge.

Since many parents-to-be are already seeing these types of birthing complication stories online, I encourage them to use it as a segue to discuss any concerns with their healthcare professional and have an informative conversation to help ease any anxiety and fear.