Redheads, Postpartum Hemorrhage, and Bruising

How many of you female redheads have visited the gynecologist and were told that you bleed more easily, have more fragile or less elastic tissue, or are at risk for postpartum hemorrhage? I have been told all of these by my gynecologist and my physical therapist. But when you ask where they have heard this information, they are unlikely able to cite a source or a scientific study.

Like anesthesiologists who observed for many years (until it was scientifically proven) that redheads have a lower pain threshold, the redheads and postpartum hemorrhage observation is only anecdotal at this point. Currently, there are no scientific studies conducted to prove that female redheads are at risk for postpartum hemorrhage; however, it is common in practice for gynecologists, obstetricians, obstetric nurses and midwives to warn redheads that they are predisposed to postpartum hemorrhage. Often OBGYN manuals at birthing centers inform medical staff to take special precautions for natural redheads who are in labor. An article in the Journal of Midwifery and Women’s Health mentions that risk factors for hemorrhage were criteria for intravenous hydration (IVH) during labor and that natural redheads are at risk for hemorrhage. In Peggy Vincent’s Baby Catcher, an appendix entitled “Pearls of Wisdom” simply states “Redheads bleed” with no explanation or source. The scientific accuracy of this topic is often debated on online chat message boards such as Midwifery Today Forums, www.allnurses.com and www.babycenter.com. It should be noted that other risk factors for postpartum hemorrhage include: prolonged third stage of labor, preeclampsia, mediolateral episiotomy, previous postpartum hemorrhage, multiple gestation, arrest of descent, maternal hypotension, coagulation abnormalities (see the Redhead Bruising Phenomenon below), lacerations of the cervix/vagina/perineum, Asian or Hispanic ethnicity, delivery with forceps or vacuum, augmented labor, nulliparity/multiparity, and polyhydramnios.

To be cautious and to prevent postpartum hemorrhage, all women especially redheads, should optimize their nutritional status prior to and during pregnancy by eating well and by taking high quality prenatal supplements, preferably supplements that are research-based and have pharmaceutical grade manufacturing practices. A colleague of mine, Julie Matthews conducts classes on holistic nutrition for pregancy and conception and has some information on her website at Healthful Living. Redheads should also have blood work that checks their blood coagulation (see more info below), and their practitioners should not rush delivery of the placenta.

For more information about painful intercourse, please see Redheads and Pain.

The Redhead Bruising Phenomenon

How many of you have had a boyfriend who told you that you bruise like a banana? Only me? Dr. Edwin Liem, who previously studied redheads and pain, has once again stepped up to the plate for redheads to test whether they bruise more easily.

Dr. Liem’s predecessors, Reid and Trotter, observed that the blood of redheaded males takes slightly longer to coagulate than the blood of dark-haired males, but both groups remained within the normal range. This study was conducted in 1973, and blood coagulation tests have since improved.

Dr. Liem recruited female volunteers aged 18-40 of comparable heights and weights with bright red hair and dark black or brown hair. Each volunteer completed a questionnaire about their bruising history and were given blood coagulation tests. Seven out of 25 redheads reported a history of easy bruising versus only 2 of the 26 dark-haired volunteers. There were no significant differences in the blood coagulation tests between the volunteers. The conclusion was that if red hair is associated with bruising, the abnormalities are subtle and not detected by commonly used blood coagulation tests.

However, it should be noted that the melanocortin 1 receptor (MC1R), whose function may be compromised in redheads, appears on endothelial cells which are a vital part of the lining of the blood vessels. This malfunctioning receptor also appears on immune cells which contribute to anti-inflammatory processes during the blood clotting process. It remains unknown whether the malfunctioning MC1R compromises the structural integrity of the skin or blood vessels or compromises anti-inflammatory response during blood clotting, but it is possible that these theories may help to explain the observed “Redhead Bruising Phenomenon” that 7 out of 25 redheads (and my ex-boyfriend) report.