Previous PPH-what are my chances of using birthing centre?

[Snowflakes1122]

3 normal births, no problems during labour, and the last was a perfect home birth.

Then last summer I had a missed miscarriage. Unfortunately placenta was retained and caused me to lose lots of blood very fast. Body went into shock and I lost 2 1/2 to 3 litres.

Have to see a consultant next week, but I really don't want or see the need in having to be on a consultant led ward for birth.
I want to be next door (it literally is) in the birthing centre.

What are other people's experiences following previous pph? How can I convince my consultant to take into account 3 fast straight forward births?

[MidMay]

I'm sorry to hear about your missed miscarriage OP.

Some birth centre's protocols can automatically exclude women with previous PPH (though this is not the case for home births). Perhaps speaking to a supervisor of midwives before the consultant appointment might be a good first step.

The risks, without knowing your full history, would be another haemorrhage, parity (number of previous pregnancies may increase the risk of PPH too due to muscles in the uterus being more lax).

You could state that you will opt for an active 3rd stage with timely transfer to the alongside obstetric unit if bleeding risk is a concern at any stage (e.g. long labour). The birth centre midwives will also be trained in managing a PPH.

Good luck!

[Snowflakes1122]

Thanks. Really helpful advice

I will see if I can speak to them. Nothing to lose by trying anyway.

My labours have been very short (4 hours, 2, then 1 hour) and no complications afterwards.

I have accepted home birth as being out of the question, but feel more at ease with a birth centre.

Fingers crossed

[sycamore54321]

I am sorry about your miscarriage and the additional complications.

I do think your preference is foolish though - what is the advantage to you of the midwife unit? In a PPH, you know that minutes or even seconds are vital. It is essentially the equivalent of a severed artery pumping your blood volume out of your body - and it can take just minutes (single figures) to lose fatal amounts of blood. If I were at greater risk of PPH, I would not want to be anywhere other than a consultant led unit. I genuinely cannot think of any advantage that for me would outweigh this. You were desperately unlucky with your previous experience and three litres is a huge blood loss. Maybe think about why the MLU is so imporrant to you and include those reasons in your discussion with the consultant. Perhaps they can ensure that the specific things that are important to you can also be provided in the main hospital, thereby getting the best of both worlds?

[Snowflakes1122]

sycamore54321

I really wanted another birth pool birth. Sadly they don't have them in CLU. Well they have one for the entire unit, but odds on getting to use it are slim.

You're absolutely right though for me to be cautious. The blood loss happened very fast and it shook me up.

I will have a good chat with the consultant next week too. Thanks