Alaskans giving birth are experiencing obstetric hemorrhage, or excessive bleeding during or after pregnancy and birth, at increasing rates. The rate in Alaska has climbed from 7.4% to 9.4% between 2016 and 2023, according to data released in a recent health department bulletin.
Rebekah Porter, a nurse consultant with the Alaska Department of Health, said any mother can experience OB hemorrhage.
“There's certain things that can make somebody more likely to have a hemorrhage, but hemorrhage can happen without any risk factors as well,” Porter said. “So, every facility should be prepared to at least identify and know what to do in the case of how much blood is lost and where to send a person if need be.”
Porter said it’s not clear from the data whether these increased rates are because more people are hemorrhaging during pregnancy and birth, or because providers are documenting it better. But, Alaska’s rate of hemorrhage is about double the national rate, and obstetric hemorrhage is one of the leading causes of death during pregnancy or childbirth.
Porter said the state is working on implementing a plan to help healthcare facilities reduce rates of OB hemorrhage, through the multidisciplinary Alaska Perinatal Quality Collaborative, and she said there are many different strategies that could help.
“Early identification of patients who have anemia, for example, throughout their pregnancy, making sure that their anemia is taken care of before labor and delivery,” Porter said. “Certainly, education for providers on recognition of hemorrhage, mass transfusion protocols, policies and procedures in place, [and] debriefing afterwards.”
She said the collaborative may also help facilities adopt techniques to more accurately measure blood loss during and after birth.
The study found certain demographic groups in Alaska are at a higher risk for hemorrhage. That includes mothers in Northern and Southwest Alaska, Indigenous Alaskans, Pacific Islanders and mothers on Medicaid. Porter said the state will recruit patients who’ve given birth to put together an advisory council, and they especially hope to include mothers in those higher-risk groups. And she said they’re hoping more healthcare facilities will join the initiative to reduce OB hemorrhage in Alaska.
