What Kellie Gerardi’s Health Scare Reveals About Postpartum Hemorrhage—And Why Self Advocacy Matters.
I almost died after giving birth, twice. Here’s what I learned.
Reported by Women's Health Magazine.
When research astronaut and mother of two Kellie Gerardi posted from what should have been the golden haze of new-baby bliss, she was instead disclosing something far more frightening: a postpartum hemorrhage that cost her over a liter of blood. According to Women's Health Magazine, PPH — defined as excessive blood loss after childbirth — affects 3% to 5% of all deliveries and is the leading cause of maternal death worldwide. The World Health Organization estimates roughly 70,000 women die from it every year. And yet most pregnant people have never heard of it until they're living it.
The condition is categorized by what clinicians call the "4 T's" — Tone, Trauma, Tissue, and Thrombin — covering everything from uterine atony to retained placental fragments to clotting disorders. Primary PPH typically strikes within the first 24 hours postpartum; secondary PPH can ambush you anytime in the 12 weeks that follow. Risk factors include IVF treatment, fibroids, anemia, multiple C-sections, twin pregnancies, and a history of bleeding complications — but here's the alarming reality: an estimated 40% of cases occur in women with zero known risk factors. In the U.S., PPH is underdiagnosed by 78%, and Black women face disproportionately higher risk due to systemic racial inequities in maternal care.
What You Can Actually Do Before, During, and After Delivery
Dr. Dena Goffman, Professor of Women's Health in Obstetrics and Gynecology and Vice Chair for Quality and Patient Safety at Columbia University Medical Center, says preparation starts with a formal risk assessment — something she confirms every patient at her hospital receives before delivery. Early warning signs to flag immediately include significant bleeding during labor, intensifying post-delivery pain, rapid heart rate, sudden dizziness, pallor, and a sharp drop in blood pressure. Fever and chills may not surface until bleeding is already underway, which is why Goffman's advice is unambiguous: speak up at the first sign, not the second. Preventative protocols like oxytocin administration and uterine massage during the third stage of labor have demonstrated real efficacy, and it's worth asking your provider whether they use JADA, an FDA-cleared vacuum device that helps the uterus contract and curb hemorrhage. On the policy front, the American Hospital Association recently launched its Safer Births Postpartum Collaborative — a national initiative aimed at helping care teams detect and respond to PPH more effectively.
Whether you're low-risk or high, there are questions worth raising at your next prenatal appointment: Do you conduct PPH risk assessments? What's the protocol if I bleed heavily during delivery? Is a PPH emergency cart stocked in the delivery room? For higher-risk patients, it's also worth asking directly whether your provider is concerned about retained placenta. The instinct to defer to medical authority — to quiet the inner alarm — is understandable. It is also, in the context of PPH, potentially fatal. Gerardi trusted her care team and survived. The women who don't are often the ones whose warning signs went unspoken.
Your body will tell you when something is wrong postpartum — the only question is whether you'll let yourself listen.
Read the original at Women's Health Magazine.
