A newly admitted postpartum client who delivered vaginally has saturated 6 perineal pads with bright red blood and many small clots during a one-hour period.
The nurse suspects a post-partum hemorrhage.
The nurse knows that a risk factor for post-partum hemorrhage is:

Choice A rationale

A macrosomic baby, or a baby with a high birth weight, can stretch the uterus significantly, increasing the risk of postpartum hemorrhage. The overstretched uterus may not contract effectively after birth, leading to excessive bleeding.

Choice B rationale

Uterine involution refers to the process of the uterus returning to its pre-pregnancy size. Effective uterine involution typically reduces the risk of hemorrhage, rather than increasing it, as the contracting uterus helps compress blood vessels and control bleeding.

Choice C rationale

A first-degree laceration is a minor perineal tear that typically heals without significant intervention. While it can cause some bleeding, it is usually not sufficient to lead to postpartum hemorrhage. More severe lacerations (third or fourth degree) pose higher risks.

Choice D rationale

Endometriosis is a condition where tissue similar to the lining inside the uterus grows outside it. It does not directly increase the risk of postpartum hemorrhage. The condition primarily causes pain and fertility issues rather than acute bleeding post-delivery.