Categories of causes of heavy bleeding Perceived causes of heavy bleeding Suggested actions for the problem
Physical causes -weakness of body -use of iron supplements and/or treatment with other medicines are recommended
-weak uterus - follow advice of physician
-heavy work during pregnancy -avoid heavy work or strenuous activity during pregnancy
-lack of vitamins or quality nutrition -consume nutritious foods
-lack of rest -take rest during pregnancy
-mental stress or anxiety -avoid stressors or anxiety
-disrespect or negligence on the part of the husband -husband should take care
too much blood in the body -nothing can be done
-early marriage -avoid early marriage
-pregnancy at early age -avoid early pregnancy
Delivery related causes -prolonged delivery
-‘fhul pore na’ (retained placenta)
-dai (birth attendant) inserted hand inside and caused harm to uterus and vagina
- torn placenta, cord, or uterus caused by dai during the delivery process
-‘fhul shukna’ (“dry placenta”): meaning the woman’s water breaks early and placenta becomes dry
-placenta had a shikor (root) like a plant
-delivery should be assisted by doctors
-consult doctors at time of delivery if any complication -delivery should take place at hospital -‘dai’ should not pull the cord or placenta -consult doctor -go to hospital
Personalistic causes -‘kharap batas’ (bad or evil wind)
-‘kaler dosh’(explained in text)
-attack by something ‘zeen’ or ‘shaitan’ (evil)
- the woman had disobeyed rules that are to be followed during pregnancy
-‘kabiraj’* should be consulted
-‘kabiraj’ should be consulted
-amulet can be used to ward off spirit -women should follow the rules during pregnancy ‘beche chola’
Table 4: Perceived causes and suggested actions to prevent excessive postpartum blood loss.