Life after postpartum heamorrage - insights please!!!

[NinaManiana]

My second son was born a week ago. The delivery was ok - forceps, which was annoying but not the end of the world, but then afterwards had a huge post-partum haemorrhage, (not related to forceps) nearly died and lost more than 3 litres of blood and had to have several transfusions.

The next day, waking up in intensive care, feeling very battered and bruised but still delighted with our new little boy, he became groggy and unresponsive and started throwing up green bile. He was admitted to intensive care for 4 days with sepsis.

The final part of the story is that whilst the docs were kindly saving my life, something got knocked with the catheter which was in because of the epidural I needed for the forceps. This was discovered about 36 hours later by which time my bladder was overfilled with 1.5 litres of urine. I have been sent home with a catheter for 2 weeks to rest my bladder, after which we will 'test' what happens when I take it out. I gather permanent damage may have been done, and don't really understand the long term prognosis.

Good news is we are all home now, my son is absolutely fine. I am less so.

So - all this has a purpose other than a massive over share. I haven't been a member of mumsnet before, but feel I need to reach out wider than my current network of mum mates to get some insights. I was wondering;

• Has anyone got any experience of major blood loss? I lost 1.5 litres with first son and can say the way I feel now is completely different - several times a day I feel like I am dying, my chest hurts, I can't stand up. I am on iron and things but any ideas how long I will take to feel better? Is it normal that you feel better some days than others In a pretty random pattern?
  

• Breastfeeding after something like this. I have been breastfeeding my son since he came out of intensive care, milk is fine, he is a hungry boy and loving feeding. But I don't know if this is going to hamper my recovery given the pressure breastfeeding puts on the body. I need to think also of my older son who also needs his mum - if breastfeeding is going to slow my recovery, maybe I need to rethink.
  

• the catheter situation. Has anyone out there experienced s similar bladder injury during childbirth? What were your experiences? Has anyone experienced a quick recovery as I can only seem to find horror stories online and am not sure if the docs are being honest. Horror stories are ok too.
  

Thanks so much in advance for any insights xxx

[thenewaveragebear1983]

No advice but wanted to bump for you.

Hope you get well soon. Congratulations on your little baby

[SnowiestMountain]

My goodness, you really have been though it, no insight but just wanted to send

[mineofuselessinformation]

I can't help with the rest of it - sorry, it sounds like you've had a hell of a time...
But, I experienced severe urine retention after a gynae op. I had two litres in my bladder when they finally drained it. It did damage my nerves, but not life-shatteringly so.
I feel like I need a wee far more often than I should, (so I 'go' before I go out, go when I get there etc), but it's ok in the grand scheme of things.
If that side of things is bothering you, for instance incontinence, ask for a referral to urodynamics. It's not elegant, but will give it some answers.

[Miloarmadillo1]

So sorry, Nina, it all sounds horrendous. I had a major PPH ( emergency surgery, transfusion, intensive care etc) after the birth of DS2, but without the bladder complications. Do you know what your PCV/haematocrit is now? I went back into hospital as a day patient about a week later and had another 2 units transfused, which transformed me from a zombie into a relatively functional human. It will take a long time to get there on iron supplements if you had a huge loss. There is some sort of cut off for being eligible for transfusion but worth asking. The other thing is that your experience must have been massively traumatic and it's ok to ask the hospital to arrange a debrief and to arrange some counselling. I never really addressed what had happened until I was pregnant again, but I wish now I'd done it much sooner. Wishing you a good recovery and all the best with your new son.

[Doilooklikeatourist]

I had similar , though nowhere near as bad as you
I had 3 units blood transfusion, iron tablets and a catheter for 36 hours ( I think, it's a long time ago he's about to graduate now )
I breastfed for nearly 4 months , had mastitis and a cracked nipple .. that really hurt , and I felt like death warmed up for about 6 weeks
This was my first baby I did recover ( obviously) it it wasn't easy , I was exhausted, tearful and ached everywhere
I really wanted to breastfeed , and chose to carry on when others thought I should formula feed
The first trip out was to Tesco , and I used the trolley to help me stand up

[CashelGirl]

I have seen a huge increase in women being discharged home with catheters post delivery. The vast majority of those women have recovered with no continence issues. So fingers crossed it will all be ok. I think drs have got a lot better in dealing with bladder care in a timely way rather than a "wait and see how things are in six weeks" attitude that used to exist.

Generally after a pph your milk production is a bit delayed but it sounds like that isn't a problem for you. I don't know if it will slow your recovery. Do you want to carry on breastfeeding?

It is not normal to feel like you are dying several times a day. You really need to see your GP or go back to your hospital of delivery. It sounds terrifying. You have been through a huge trauma, physically and emotionally. There is no need to minimise it and try and shrug it off as nothing. It sounds awful and you are going to need some time and rest and TLC to recover properly. I am delighted your baby is home and well, but so sorry you had such a horrible time.

[ambermacy]

Hi just wanted to say that I went through a very similar series of events to you in particularly the bladder injury. I was left labour far too long without passing urine I was unable to pass naturally and they finally fitted a catheter I passed nearly 2 litres. After delivery this left me incontinent and I was sent home with a catheter for 2 weeks to allow my bladder to rest. I had to go back for a TWOC (trial without catheter) onto the maternity ward which filled me with all sorts of emotions and I failed he initial trial ( my bladder was not emptying) so I returned home for another week and then I passed! I was so relieved. The best thing that happened to me was getting a referral straight away to he physio team so I got to see pretty much after passing the twoc. They gave me great pelvic floor exercises and whilst I'm not back to how I was I'm a lot better xx

I know it's hard but try to enjoy your time with your little one and don't worry too much. Our bodies are amazing at healing they just need time xx

[ambermacy]

Forgot to say my second catheter period I had a tube (no bag) which gave me much more freedom I could empty it every 2/3 hours and seemed to really help my bladder gel. Got to pee into the loo stood up too like a man 😂😂😂

[Birdofathousandvoices]

Hi nina, what a tough time you've had!
I had a pretty big PPH, transfusions and high dependency (added fun of sepsis thrown in!)

Re how you're feeling just now, and I really don't wish to scare you but I felt absolutely awful for 3 weeks after the birth. Turned out I had retained placenta still and that was all linked to the initial issues with placenta delivery/PPH. What's your bleeding been like and do u have a temp?

I started off breastfeeding and managed 5 days. At that point I just fell sooo awful that I decided to switch to formula so that I could tell a bit more on others to care for baby and let me get some rest (i also had a baby that loved feeding constantly and cracked nipples). Don't guilt yourself, just do what suits your situation.

Wishing you a speedy recovery

[owainsmum]

Sorry to hear you're having a hard time. With my first baby I had a really massive PPH of over 7 litres. I was in hospital for 5 days and it was probably about 2 weeks before I could get out of the house. You have been through a lot and it will take a while to recover. I would recommend counselling, the hospital probably offer it post birth. I did it when we were thinking of having another baby and it really helped.
Re breastfeeding, I fed my baby from 2 days old as soon as I was out of intensive care and carried on for 18 months with no problem.
I'm sure you will be fine, it will just take time to recover.

[KeepFuckingGoing]

You have been through a huge traumatic ordeal.

I can't give any info about the catheter but I am concerned by your general feeling of malaise and exhaustion. Did you have a blood transfusion when you were in hospital? You lost a lot of blood and whilst they should have been checking your Hb levels and ferritin, you don't always get the care you need as everyone is so overstretched.

Please go to your GP if they are helpful or maybe your HV if it is faster. You need them to check your ferritin and Hb levels urgently. Iron levels take bloody ages to come up with iron supplements - months. They are also hard on your stomach. They could give you a transfusion of iron which would be far more effective but you would have to push for that. It maybe that a blood transfusion is more appropriate.

I second the concern of a previous poster - stay aware of the risk of retained placenta. If you start feeling fluey, get a temperature, shivery, sick, generally more unwell, please go to casualty. Sepsis (on top of everything else) is very serious as you know and you may need a removal of retained products and IV anti-bs.

You actually sound as though you are doing really well. Your attitude is great and you are being proactive and aware of potential issues. You sound fab. Are you in touch with a continence care nurse specialist? They are so knowledgeable and can help with questions about the catheter. Ask your HV or GP to refer asap.

With regard to the BF. I am possibly biased as I did not produce enough milk. First child was failure to thrive. Second had a serious milk protein allergy so I gave up BF by 6 weeks both times. I had support from bf groups but is just wasn't happening for me and the babies. My inclination would be certainly to mix feed so you can get more sleep and DH can take over night feeds. Also it does out significant stress in your bifurcation which may not be ideal. However if you are enjoying it and it is going smoothly, be guided by that.

This is not a time for pride. Rope in an organised friend to summon troops to offer support. Whether it is looking after baby so you can sleep, taking your eldest out for the day, offering an hour or so to help round the house etc etc. Don't be shy to say you are wrecked and struggling. If I was your friend I'd be more than happy to provide a listening ear, gossip for light relief and laundry/ironing service. I'd even do an overnight if you were mix feeding do you could have a night of unbroken sleep.

You are doing brilliantly but please please do not run yourself into the ground. You sound very positive now but be aware at some point you may crash hard. Your baby was life threateningly ill as you were. Those are huge things to get your head around. If you start feeling very down go to your GP and get help fast. A midwife debrief with an experienced mw may also make sense if everything for you.

The other place for info may be a big continence charity or a maternity support and info charity/group.

What about Home start? They help people needing extra help after having a baby. I am sure you would qualify for their service.

Best of luck. Please get your fatigue and malaise checked asap. Look after yourself. xx

[NinaManiana]

Wow, thanks all so much for responses. I thought i would never find anyone else who had had the same experience! I guess many of you have read between the lines of my question, which was really 'will I get through this' and it sounds like yes!

To respond to some of you:

Mineofuselessinformation - thank you for sharing. I am putting a lot of pressure on my TWOC next week as i am desperate to be more mobile again. It's good to know if i 'fail' that's not the end. Ambermacy - i am going to look into the tube, thank you. Being more mobile if this goes on longer will help me to return to real life a bit more!

Birdofatbousandvoices and keepfuckinggoing - they scanned for retained placenta at the time as they were wondering if that was causing the heamorrage so i think that's been checked for. But i think i will go back to hospital and tell them about chest pain etc - my levels of whatever they check for were just borderline to not need another transfusion (i already had several in theatre) but maybe they could make an exception. I mean, i look like bloody dracula, my lips are the same colour as the rest of my skin!

Finally owainsmum - 7 LITRES?!?! Wow. What a superstar. If you can get through that, i can absolutely make it through my measly 3

[ambermacy]

Absolutely you will get brought this!! I felt under pressure to be up and out but all that little one needs is lots of snuggles with mummy!! Your body will take time to heal. I thought I'd never be able to go out or even walk properly again but I'm getting there now after lots and lots of rest! Which is easier said than done. Take care and if you have anymore questions about the twoc etc please get in touch as happy to lend an ear xx

[QuestionableMouse]

I had chest pains when I was severely anaemic. The didn't improve until I started taking liquid iron.

[Moondancer146]

I had a similar PPH just over 3 years ago. Lost over 3 litres and had 2 transfusions.

I had a difficult pregnancy and on the whole the midwives and doctors were great but they were pretty useless after my haemorrhage. I had blood levels checked once, was discharged with iron tablets but no advice on how long it would take to start feeling better and no follow up appointments.

I was like a zombie for around 6 weeks and didn't leave the house for 8 weeks, didn't have the strength or energy to do anything at all. I also had an infection in my hand from the iv line and an infection in my c section scar which probably contributed to the feeling.

I found that lots of rest and giving myself time to heal rather than worrying about people's expectations were the best thing and I was so lucky to have a great community midwife who called in to visit even after we'd been discharged from her care.

A week is nothing, give yourself time and enjoy lots of cuddles with both your babies.

[RubaDubMum89]

Nina your story sounds a little similar to mine. I had a forceps delivery but for different reasons and they did huge huge damage to me. I'm not fussed about this, it was essential to get DD out then, there was no time to be careful with my bits. I had an episiotomy which tore, had a deep muscle tear and due to the forceps smashing about in there my bladder prolapsed (they told me after the event - obviously - that this meant that my bladder had dropped down into my vaginal canal). Then I hemmoraged quite severely and my placenta wouldn't come out! Thankfully, I'd blacked out in my head so really have no memory of this apart from being in excruciating pain and then wondering where DD was - she was off being resuscitated (perfectly fine afterwards) . Isn't it fun giving birth? Haha.

The blood loss does make you feel really really shit for a while, I think it was around 8/9 days before I started to feel any kind of strength returning and went back to a normal ish colour! Eat lots of good food if you can stomach it, build your strength back up. And get some laxatives! Those iron tablets are killer. I'm not even joking, 14 days I didn't poop after birth, and I can 100% say, I'd rather give birth again than have that poop again. I've never had a poo make me cry, sweat and vomit before!


RE: your bladder, I didn't have a catheter, but as mentioned, severe bladder trauma. For maybe 2-3 weeks I couldn't tell if I needed a wee or not and had no sensation (in came the adult nappies, sat on the sofa weeing away neither knowing or caring I was doing it!), but eventually the sensation did come back. I remember the first time I felt it, I was so happy I proudly announced to everyone "I need a WEE! ", I was so excited! Hopefully it'll be the same for you, however, my HV did say if sensation hadn't returned by X date, she'd put me forward for physiotherapy, so maybe this is something to ask your HV about?


Good luck with your recovery and I'm so so pleased your LO is OK congratulations on your bundle of joy!

[Birdofathousandvoices]

@NinaManiana how are you getting on?

[scoobydoo1971]

I have had a haemorrhage this week and was rushed into hospital. Not baby-related, post-surgery complication of uterus procedure and now bacterial infection. Need more surgery. Feel run over by a bus...big hugs from me, it is awful and I don't have a newborn to contend with. My daughter was borned with sepsis but she is now a bouncing 5 year old chatterbox, little humans bounce back! Enjoy time with your baby, don't allow too many visitors at home unless they are helpful dish-washing variety and sleep where possible. Be kind to yourself.

I have Ehlers Danlos (connective tissue disorder) and it allows my bladder to fill up 3 times the normal capacity, and it has given me interstitial cystitis. Bleeding, incontinence and awful pain ensue when I do not look after it. With kindness and proper care, it can get better....stay away from coffee, citrus fruits and alcohol for a while. Do not pick up heavy loads either.

[NinaManiana]

Hi folks, thanks for your support. As an update, i had my catheter out today and seems no permanent damage and no need for phisio or anything. After 2 weeks of almost total bedrest, a very iron rich diet and a lot of iron supplements i am feeling much more myself, no longer having chest pains and the docs decided i didn't need a further blood transfusion.

The baby is better from the sepsis, gaining weight, and as i was lucky enough to be able to do bedrest i decided to continue with breastfeeding, which is going well.

So... looks like a happy ending over here!

[NinaManiana]

Can't believe a year has gone by since this thread.

For anyone else who experiences a traumatic birth, there is light at the end of the tunnel!

[LostMyBaubles]

Oh wow a year!
I came on to tell you it will get better slowly but surely

I pph after delivery due to uterus not contracting so all3 of deliveries ive bled. A lot. (Most being 2.5l and least 1.5)

Im pregnant with my 4th and baby is in the wrong bloody position.
Section will increase my risk of bleeding but a transverse baby cannot be delivered naturally!

Glad you are ok!