In May of 2021, Sunni Riley was excited to grow her family and was preparing to give birth to her twin daughters, Reese and Wren. Wren was born first with no issue, but Reese had flipped, causing Riley’s team of doctors to switch gears and perform a C-section.
While Reese was born healthily, Riley experienced a severe hemorrhage and needed emergency blood transfusions to survive. Over the next two days, she needed about 17 pints of blood — far more than the average 10.5 pints typically circulating in the human body.
"They could not stop my bleeding," Riley said. "I lost a lot of blood and woke up on a ventilator in ICU."
MORE: Sunni Riley's Story of Survival
Stories like Riley's are all too common. Unfortunately they're becoming even more familiar in America, as the United States has seen a significant rise in the number of blood transfusions during childbirth for decades. From 2006-2015, the rate of blood transfusions during childbirth went up 54% to a rate of one out of every 83 deliveries, according to the Agency for Healthcare Research and Quality.
Why Are Blood Transfusions During Childbirth Becoming More Common in the U.S.?
Postpartum hemorrhage, or PPH, is the loss of more than 500 mLs and is the leading cause of severe maternal morbidity. Defined by the CDC as the inclusion of "unexpected outcomes of labor and delivery that can result in significant short- or long-term health consequences," severe maternal morbidity — and blood transfusions along with it — is on the rise. But why?
Rising Maternal Age
Over the past 50 years, the number of women having babies after 35 — an age considered “high risk”— has jumped by 900%. Women over 35 are more likely to have health issues like gestational diabetes and preeclampsia. These conditions can lead to severe hemorrhaging during delivery, making blood transfusions a crucial part of maternal care.
Increase in Cesarean Sections (C-sections)
While the average amount of blood loss after the birth of a single baby in vaginal delivery is about 500 mLs, the average amount of blood loss for a cesarean birth is approximately 1,000 mLs. Additionally, the rate of C-sections has been steadily increasing in the United States, which means more mothers may require blood transfusions to recover safely.
Rising Incidence of Placenta Accreta
Placenta accreta, a serious pregnancy condition in which the placenta attaches too deeply into the uterine wall, is becoming more common, especially in women with a history of C-sections. This condition often leads to significant blood loss during delivery, making transfusions essential to saving lives.
A Higher Prevalance of Obesity
With obesity rates climbing, more pregnant women are at risk for complications that can lead to excessive bleeding during childbirth. Obesity increases the likelihood of conditions like gestational diabetes and hypertension, both of which can contribute to severe hemorrhaging.
Increased Multiple Pregnancies
Advances in fertility treatments have led to a rise in multiple pregnancies, which are associated with higher risks of complications during delivery. These complications can often result in the need for blood transfusions.
Improved Medical Practices
Advances in medical care have led to more proactive management of maternal hemorrhage. Health care providers are more vigilant and may be quicker to administer blood transfusions to prevent severe outcomes, which can also contribute to the rise in transfusion rates.
