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Not allowed C Section with (now born) DD2

(7 Posts)
Madamolive Sun 21-Aug-11 22:36:25

My first born i ended up with PPH and needing 3 blood transfusions. The whole labour was pretty horrific with needing assisted delivery.
This time round i requested a c-section (due to the first delivery) which was denied ("more favourable not to have one"). I was classed as high risk though.
Went into labour- was long, the birth was fine until after... i suffered severe PPH and ended up in theatre this time round, needing alot of iv's and more blood transfusions. Im now on iron tablets and have been feeling pretty shitty in all honesty since.
I think i may be developing PTSD (not sure of the signs/symptons) and wasn't to sure on where to post this.
I feel really let down by the hospital (not the team- they did a fantastic job following the delivery)
Were they wrong in not allowing a csection?
Where do i really go from here?
Anyone been in a similar situation?

Madamolive Sun 21-Aug-11 22:38:27

My second PPH was 3000ml

BagofHolly Sun 21-Aug-11 23:44:46

As I understand it, cs is an additional risk factor for PPH and according to my midwife they are easier to manage after a vb than a cs - you've got access to the uterus quicker for example.
I had a severe PPH last time, over 3l and I felt GHASTLY for months and still don't think I'm right even now, 7 months later.

RueDeWakening Sun 21-Aug-11 23:56:24

CS doesn't mean you won't have PPH sadly, in fact I think it makes it more likely. I've had 2 CS and 2 PPH, 2nd one was approx 2.5l even though it was spotted very quickly. I felt dreadful afterwards but as DC was in NICU I wasn't actually that bothered by how I felt, if that makes sense.

TheDetective Mon 22-Aug-11 00:16:52

Even if you had a caesarean, there was still exactly the same chance of having another PPH, in fact some would argue more so. The placental site is the biggest site for bleeding, as well as the genital tract after vaginal birth. But factor in a caesarean, and you have a huge open wound which includes several layers of tissue, and the uterus itself which now has a huge open wound as well as the placental site.
I think you have been advised very wisely to be quite honest, and the obstetrician and/or midwives who dealt with you prior to delivery have given you good advice, although by the sounds of it, may have not given you enough information for you to feel confident in what they said.
If you feel traumatised by the events, my best advice to you would be to a) contact the hospital involved and ask for an appointment to debrief you on the birth, and explain why and what happened, options for next time, and chances of the same thing happening again and what if anything can be done to reduce risk. And b) speak to your health visitor or GP and explain how you are feeling, they will possibly advise you to follow my earlier advice and contact the hospital you delivered in - however if this isn't satisfactory, may refer you for some councelling to help discuss the birth and any issues you feel need resolving.
Hope that helps a little... I don't want to sound all 'matter of a fact', I'm just doing a quick post, didn't want to read and run IYKWIM. smile
PS Congratulations of the birth of your baby!

idlevice Mon 22-Aug-11 09:30:25

Oh shit, I had a 3000ml PPH last time, now 20wks with DC2 & assuming I will be offered CS as an option - not that I would definitely choose it but want to have it as an option. In fact, one of the drs dealing with me last time said he thought a CS-hysterectomy would be a good option - bit shocking to be told that whilst recovering with a newborn - I now wonder if that's because the risk of another PPH is high with a CS so that it's better to get everything out & just seal it all up. I was seriously considering that for a bit given this is DC2 & I am not enjoying being pregnant but decided against it in case something happens to one of the DC in the future, morbid I know.

I'm pretty sure I had PND with the PPH a contributing factor, but not PTSD as I didn't really have flashbacks. I went through my notes with an independent obstetrician which was helpful to a degree but ultimately the main question of what caused it can't be definitively answered, which is frustrating & scary. If you think you are having any psychological side effects then do look into addressing them & don't expect anyone in RL to have a clue unless they have undergone something similarly traumatic.

Physically I took at least 6mths to get anywhere near back to normal but at the time thought it was just dealing with a baby & that I wasn't coping very well compared to all the others at mothers' group who seemd to breeze around the shops or out to lunch, coffee, whatever with baby in tow. Make sure you are taking an iron supplement that is gentle on the stomach & doesn't cause constipation - ask a a health food type place if you are not sure.

curlywurlycremeegg Mon 22-Aug-11 09:46:30

I agree with the general response that a c/s will not reduce the risk of PPH and in some cases actually increase it, in fact many women who have had a c/s will suffer what is classified as a PPH (in text books it is over 500ml but in reality must units only class loss over 1000ml as a PPH). These women would probably not have had the same amount of blood loss after a vaginal birth, it is simply blood loss associated with surgery. Therefore if you then add blood loss from an atonic uterus to the blood loss associated with "normal" surgery you are increasing the risk further.

To try and reassure idlevice a previous PPH doesn't always mean you will have one with a subsequent birth. I am assuming your team has checked clotting factors, however they may be something that occured in your previous labour that may have been a factor in the PPH, is there a consultant midwife available at your unit to look through your notes with you? Sometimes it takes a midwife to spot the factors as the obstetric team don't always see the implications of certain interventions.

On a positive note I have a massive PPH with DS1 (2500ml) and then went on to have an emergency c/s (DD) with bizzarely tiny blood loss (100ml), so much so that the team were actually trying to find where my blood loss had gone as they thought it must be a concealed bleed or haematoma and then went on to have two more straight forward vaginal births (DS2 and DS3) with a very moderate blood loss (200-400ml) with physiological third stages.

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