Have you ever heard that redheads are in greater danger of a postpartum hemorrhage than persons with other hair colors? Or how about their tendency to have more perineal tears? Or this: redheads feel more pain? In honor of National Redhead Day, which is coming up on November 5th, we thought we would take a look at the some of the commonly held beliefs about redheads and birth.
First, a little refresher about what makes a redhead a redhead: A mutation in the MC1R gene is what gives 1-2% of the population the combination of fair skin, freckles, pale eyes and red hair. There is a higher percentage of people with red hair in the northern hemisphere, where the UV light is kinder to the redhead’s more sensitive skin. The MC1R gene is part of a family of receptors that include pain receptors to the brain, which is why some research shows that redheads are more sensitive to pain.
Since early in my midwifery education, I have been told and have believed that redheads are at risk for hemorrhage after birth, and for bad tears, because they have decreased tissue integrity. When I began to do some research for the purposes of this post, I discovered that these are, indeed, widely held beliefs in the medical community. I found numerous message boards where nurses and physicians reiterated these beliefs, and I even found the hemorrhage risk casually referenced as accepted fact in this book: Simulation Scenarios for Nursing Educators, Second Edition: Making it Real, by Suzanne Campbell and Karen Daley, PhD, RN, with the following quote:
“Technology Used: The medium-fidelity HPD is a female (red wig – there is an increased risk of hemorrhage in redheads…)”
What I failed to find, however, was any actual evidence that redheads are at an increased risk for hemorrhage. In fact, the research shows that redheads have normal coagulation, and are not at additional risk for bleeding during surgery. Though there are no available studies specific to postpartum hemorrhage that could be found, the data is applicable.
I could find no information whatsoever about the validity of the belief that redheads have more tears, so we’ll have to leave that one as unknown, for now.
And now for some truths: There is data to support the increased sensitivity to pain in redheads. As mentioned above, the mutation of the MC1R gene contributes to a lower tolerance to pain. There is also a low sensitivity to anesthetics, which often require that a redhead is given higher doses of local anesthetics during dental procedures, as well as general anesthetics during surgery. It would make sense that this would also apply to local anesthetics given during perineal repair, though this is not addressed specifically in the research.
It struck me as interesting that the research I found is actually pretty old, and yet, I, and many midwives I know, hold strong beliefs about redheads and hemorrhages. I even have a small body of personal experience as a practitioner that confirms my belief, as I am certain other midwives do, as well. As with all efforts toward the desired goal of evidence-based practice, there should be a merry blending of the data and experiential knowledge – this data is an unexpected and interesting contribution to the body of evidence that we are always reviewing and reviewing again. Growth is good, right?
So, in conclusion: The evidence does not support the belief that redheads bleed more, but it does support the belief that they are sensitive to pain, and that they may need more anesthesia. There is no evidence to report about tissue integrity.
And the evidence definitely supports that redheads are rare and special people – Happy Redheads Day!
References:
https://www.bmj.com/content/341/bmj.c6931
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1351323/
http://healthland.time.com/2010/12/10/why-surgeons-dread-red-heads/
https://well.blogs.nytimes.com/2009/08/06/the-pain-of-being-a-redhead/