What Shot Is Given to Stop Bleeding After Birth?

October 5, 2025 •

3 min read

Postpartum hemorrhage (PPH) affects approximately 3% to 5% of obstetric patients and is a leading cause of maternal morbidity and mortality worldwide. To prevent and treat this condition, a specific shot is given to stop bleeding after birth by helping the uterus contract back down to its normal size. The most common injectable medication used for this purpose is oxytocin.

Quick Summary

Following childbirth, a uterotonic shot, most commonly oxytocin, is administered to promote uterine contractions. This action helps to constrict blood vessels at the site where the placenta was attached, which in turn reduces excessive postpartum bleeding.

Key Points

First-line medication is Oxytocin: The most common shot given to stop bleeding after birth is oxytocin (Pitocin), which stimulates the uterus to contract and constrict bleeding vessels.
Uterine Atony is the Main Cause: Excessive bleeding, or postpartum hemorrhage (PPH), is most frequently caused by the uterus failing to contract adequately after delivery.
Secondary medications are used when needed: If oxytocin is not effective, second-line injectable medications like carboprost (Hemabate) or methylergonovine (Methergine) may be used.
Medications have specific contraindications: Care must be taken when selecting a secondary uterotonic, as carboprost is contraindicated in patients with asthma, and methylergonovine is avoided in those with high blood pressure.
Tranexamic acid is an additional therapy: An antifibrinolytic drug, tranexamic acid, can be given intravenously to women with PPH to help reduce mortality, especially if given within three hours of birth.
Administration routes vary: Oxytocin can be administered intramuscularly or via intravenous infusion, each with a different onset of action.
Prompt action is crucial: Timely recognition and a systematic, escalating approach to PPH management, starting with pharmaceuticals, are vital for maternal safety.

The First Line of Defense: Oxytocin (Pitocin)

After the baby is delivered, the most effective drug to prevent and treat postpartum bleeding is oxytocin. Administering oxytocin causes the uterine muscle (myometrium) to contract rhythmically. These contractions help to close off the blood vessels that were connected to the placenta, a process sometimes called the "living ligature" effect. The medication can be given in one of two ways:

Intramuscular (IM) injection: A single, quick injection into the muscle is a common method for preventing PPH and is effective in controlling blood loss.
Intravenous (IV) infusion: A slow infusion into a vein is another option, often used when an IV line is already in place. This route can have a more immediate effect but is generally used for treatment rather than prevention.

How Oxytocin Works

Oxytocin is a synthetic version of a hormone naturally produced by the body. By mimicking this natural hormone, it stimulates the upper segment of the myometrium, causing sustained and robust contractions. This is crucial for controlling blood loss because uterine atony—the failure of the uterus to contract after delivery—is the leading cause of PPH. Timely administration of oxytocin helps reduce the risk of significant blood loss and the need for more invasive interventions.

Secondary Uterotonic Medications

While oxytocin is highly effective, not all cases of uterine atony respond to it alone. In such situations, healthcare providers may turn to other injectable uterotonic medications. The choice of which secondary agent to use depends on patient-specific factors, such as pre-existing health conditions.

Carboprost (Hemabate)

Carboprost is a prostaglandin analogue given by intramuscular injection to enhance uterine contractions and cause vasoconstriction. It is a potent uterotonic but has specific contraindications. Patients with asthma should not receive carboprost due to the risk of bronchospasm. Common side effects include nausea, vomiting, and diarrhea.

Methylergonovine (Methergine)

Methylergonovine is an ergot alkaloid that also stimulates strong, tetanic uterine contractions. It is typically administered via intramuscular injection. A significant contraindication for methylergonovine is high blood pressure, including preeclampsia, as it can cause a sharp increase in blood pressure. Side effects can include nausea, vomiting, and headache.

Tranexamic Acid (Cyklokapron)

While not a uterotonic, tranexamic acid (TXA) is an antifibrinolytic agent that can be administered intravenously to help control bleeding. It works by inhibiting the breakdown of blood clots. The World Health Organization (WHO) recommends its early use, within three hours of birth, in addition to standard care for women with clinically diagnosed PPH. TXA has been shown to reduce mortality from bleeding in PPH cases.

Comparing Injectable Postpartum Bleeding Medications


Medication	Class	Mechanism of Action	Common Administration Route	Contraindications	Common Side Effects
Oxytocin (Pitocin)	Synthetic Hormone	Stimulates rhythmic uterine contractions.	IM or IV.	Hypersensitivity, certain obstetric conditions.	Nausea, vomiting, hypotension.
Carboprost (Hemabate)	Prostaglandin Analogue	Increases uterine contractility and vasoconstriction.	IM or intramyometrial.	Asthma, severe renal/hepatic/cardiac disease.	Nausea, vomiting, diarrhea, hypertension.
Methylergonovine (Methergine)	Ergot Alkaloid	Causes strong, tetanic uterine contractions and vasoconstriction.	IM (IV not recommended for standard use).	Hypertensive disorders of pregnancy, cardiac disease.	Nausea, vomiting, increased blood pressure.

Management of Postpartum Hemorrhage

For healthcare providers, managing PPH is a rapid, multi-stage process that is guided by standardized protocols. This typically begins with immediate interventions such as uterine massage and the first-line medication, oxytocin. If bleeding continues, second-line medications like carboprost or methylergonovine are considered. In severe cases, especially if bleeding persists, adjunctive therapies like tranexamic acid may be used. If all pharmacological measures fail, more invasive procedures like uterine balloon tamponade or surgery are necessary to save the mother's life. The overall goal is quick recognition and a systematic, escalating response to ensure the best possible outcome for the mother.

Conclusion

While a single shot of oxytocin is the most common medication given to stop bleeding after birth, management of postpartum hemorrhage can involve a range of injectable medications depending on the severity of the bleeding and the patient's medical history. Oxytocin is the standard first-line therapy due to its effectiveness and favorable side effect profile. However, secondary agents like carboprost and methylergonovine play a crucial role when initial treatment is unsuccessful. The timely and appropriate use of these pharmaceutical interventions, in conjunction with other clinical management strategies, is essential for controlling PPH and protecting maternal health.

For more detailed information on postpartum hemorrhage prevention and management, consult resources from the American Academy of Family Physicians, such as their article on the subject.

Frequently Asked Questions

The primary medication given as a shot to stop bleeding after birth is oxytocin, commonly known by the brand name Pitocin. It is administered to stimulate uterine contractions and control postpartum hemorrhage.

The medication, a uterotonic agent, causes the uterus to contract forcefully. This action helps to compress the blood vessels that supplied the placenta, acting like a natural clamping mechanism and preventing excessive blood loss.

Common side effects of oxytocin, the most common injection, include nausea and vomiting. Other potential side effects include hypotension (low blood pressure) and a rapid or irregular heartbeat.

Yes. If the initial treatment with oxytocin is not effective, healthcare providers may administer other uterotonic injections, such as carboprost (Hemabate) or methylergonovine (Methergine), depending on the patient's medical history.

Yes. Oxytocin is routinely given as a prophylactic (preventive) measure in the third stage of labor, immediately after the baby is delivered, to reduce the risk of postpartum hemorrhage.

Uterine atony is a condition where the uterus fails to contract adequately after childbirth. It is the most common cause of postpartum hemorrhage, as the contracting uterine muscles are necessary to close off the bleeding vessels from the placental site.

Misoprostol is a medication that can treat PPH, but it is a tablet rather than a shot. It is often used in settings where injectable medications like oxytocin are not available, though oxytocin is generally considered more effective.