Previous PPH. Consultant appointment now-what to expect?

[Rose138]

Hi all,

I have a consultant appointment in a few weeks that my midwife referred me for. This is due to my first birth- induction and I had a haemorrhage of 1600ml as soon as my son was delivered. I had had a really good pregnancy and thankfully this time too I am having a good pregnancy.

My midwife didn't say much about the consultant appointment and I know it is only a few weeks away but I was just wondering if anyone has any experience? Will they just discuss my previous birth and make a plan for this time due to my previous PPH? I'm just confused as I will discuss my birth plan with my midwife so I am not sure what is different about a consultant appointment?

Thank you all in advance

[Fresh01]

I had a PPH with DC1 - turned out she tore my cervix on the way out. I lost over 1000mls. I have since had 3 more DC and no issues.

However due to first PPH they always made me have a canuala in my hand in the early stages of labour so it was there if needed. I did need something after DC4 to help stop the bleeding through the canuala.

They also cross matched my blood when canuala was put in to make sure they had some on standby if they needed it. They never did.

They wouldn't let me in the bath or shower during labour as they said blood loss is harder to quantify when it is diltuted in water.

I found the consultants meeting was more about them saying what they would be doing to so if it happened again things were in place.

Good luck! Hopefully it will all be fine this time.

[MmmMalbec]

I lost 2.2ltrs and haven't seen a consultant about it. I'm seeing one but it's about previous Pre E and IUGR. I would imagine it will be to discuss potential interventions if necessary?

[fluffywallow]

I had a 2500ml pph with my DD 2.5yrs ago and am due my second DD in 7 weeks. My first consultant appt was to go over the previous birth (briefly) and discuss what I wanted this time around. My preference was a cs and my consultant agreed (the Pph was just one of many problems with my last birth). As a result I got booked in for various other consultant appts and specialist midwife appts in order to get the cs signed off (which is just following NICE guideline protocol).

I suspect if we'd decided to go for a natural birth I'd have had less appts scheduled but I can't be sure.

[Rose138]

Thank you so much for your replies.

That's really interesting Fluffywallow as I had considered a cs but wasn't sure you could request one? I too had other problems during labour and the thought of going through it all again makes me really anxious. I had to stay in for four days too as had a blood transfusion etc and this time I would just hate that even more as I want to be away from my first child for the least time possible.

Can they refuse a cs if you express that you wish to take that route or do they have to honour your decision?

Thank you so much

[snapple21]

You are just as at risk of bleeding with a cs, if not more.

[starlight36]

I would agree that the consultant appointment was more to run through the procedures that the hospital would follow for mothers who had suffered PPH post-birth. I wasn't allowed to use the midwife led birth centre - although hadn't got in there the first time as it was full! I had to have a cannula inserted on arrival - second birth happened so quickly this didn't happen either! Luckily no PPH second time around. I would use this as an opportunity for you to express your preferences and get an extra check up.

[ChristmasAccountant]

I had a PPH with my first which was emcs.
While pregnant with ds2 I saw the consultant and was told what measures they would have in place for my second delivery. I actually requested another section which they were happy with and had blood ready for me during the surgery. I did have another PPH but it wasn't as much - about 1000mls I think.

[ChristmasAccountant]

From what I was told I could request the section but it had to be "approved" by the consultant.

[fluffywallow]

Have a look at the NICE guidelines on cs - they can't turn your request down (and positively encouraged mine - and our experiences sound similar) but your first consultant could refuse the request and then you would have to go to a second consultant. My consultant told me that that is usually for 'maternal request' cs's though where there's no history of traumatic birth.

I've had to have various appts as I mentioned but I've received nothing but support. They have run through all the potential scenarios and discussed at depth how they'd reduce risk this time (as others have said, canulate early, have blood ready and so on). As another poster said, the risk is still there but for me it's better the devil you know than the devil you don't.

Good luck with your appt