To want a C section after haemorrhage during labour?

[Bananaparp]

During my last labour I lost a lot of blood. I was rushed from midwife led care to the consultants in the hospital and needed a drip. I am now pregnant again and concerned about it happening again.

WIBU to push for a C Section? I’ve had 2 previous natural births and this is my last baby.

Ask, my sister had pph and as part of debrief was offered straight away should she have another.

Thanks. I’ve spent a lot of time wishing I wasn’t pregnant because it feels like if I die I’ve taken my children’s mother away for a new sibling. I think a planned c section would also help with my mental health for that reason.

You are not unreasonable but would a c-section make a PPH less likely? My understanding was it was more likely with a C-section? I am no expert unfortunately but I’d discuss it with people who are before making any decisions.

I had a PPH with a csection, its a known risk, one of the questions on the checklist is 'do we have correct blood type available' when they're getting themselves ready before the operation. I don't know if its more or less likely with a csection though.

I had a haemorrhage after one of my births. For the next one, my midwife put a cannula in in case I needed extra medication, had blood on standby and was totally on top of it.

I didn't need any of it, perfect birth.

You wouldn’t be unreasonable to ask about it, whether it would be safer or riskier in light of your history. Make your decision based on that - if it’s safer no brainer, if it’s riskier discuss your options re birth plan (eg consultant led), if it’s no difference decide based on what’s best for you so you aren’t stressing too much.

I’d ask the question of your consultant but my understanding is that the risk of a PPH is increased with a c section. To what level I’m not sure so best to speak to the experts

My 2nd c-section resulted in massive blood loss, it may not be any easier. But as you are clearly worrying about it try and talk to your consultant about risks and mitigation and which option is best for you - you do have/should have the choice of how you deliver so speak to someone with expertise about what is best for you, your baby and your mental health

YANBU, I had a PPH after last birth and it's terrifying. I was already consultant led due to pre eclampsia so not too far from theatre thankfully. However, I wouldn't want a C section of I was to have another child. But you definitely aren't being unreasonable to feel different

Have a chat with your midwife/obstetrician. YANBU to want to do something to prevent the same thing happening again - but a CS may not necessarily be the correct answer, depends a little bit what exactly happened last time. There are things that can be done to prevent or minimise the blood loss this time, and let you feel safe and in control - they should be able to talk you through everything as part of your birth plan. Good luck :)

A haemorrhage is actually more likely with a c section op.

I thought there was even more of a risk with a c section.

Second time round I had a cannula, fluids and whatever drip it was to get my uterus to contract afterwards and a catheter. I explained my worries about it happening again with my midwife and consultant. You can’t prevent it as once it’s happened the risk increases. I’m not having a third as I bled the second time anyway.

I’ve no idea what the risks are for PPH with natural v c-section, but I had PPH with c-section. YANBU for feeling anxious though, I’d definitely talk it through with someone knowledgeable

I had a really bad hemorrhage a section, they couldn't stop the bleeding nearly had to have a hysterectomy but the 'Rouge Balloon (google it) worked in the end. So whilst I don't think having a section stops it, the Consultant did say she was thankful I'd had that level of bleed in theatre where they could act on it straight away rather than in a birthing suite where I might have lost a lot of blood before they reaised.

I would discuss it with a consultant but I think you are 100% right to question it. I think some people are just prone to hemorrhages and there is no way I could consider a vaginal birth now.

It wasn’t a PPH it was an IPH. Don’t know if that makes any difference?

I had a big PPH on the operating table during my first c-section. I had a few transfusions and took iron tablets for a long time after. I wasn't offered a c-section for my second or third children. The consultant didn't think it would be a recurring issue but obviously I had shared care for subsequent births

I had a PPH of 3.5l and was offered an ELCS the next time, no problem. I hardly lost any blood with the c section. Definitely ask.

I had a shoulder dystocia with my first delivery so emergency forceps plus extended episiotomy. I then had a huge PPH after second delivery due to retained placenta, needed two blood transfusions. Had a missed miscarriage so stupidly chose medical management which caused a huge PPH again, needed two transfusions yet again and emergency surgery to save my life.

I understandably asked for a c-section with my next baby and they tried to talk me down at every level. I had to see three different consultants plus a ‘consultant midwife’ who all tried to talk me out of a section. On the actual day of the section a consultant came in to again try talking me out of it, she offered me induction instead. Had the c-section in the end and it was great, no PPH and I recovered better than I did following my vaginal births.

Be prepared to fight for it but yes, I’d have a c-section over a vaginal birth any day of the week.

I had a PPH during my first natural birth and needed a blood transfusion and surgery. Consequently had two c sections after which were fine. Both times talked through with consultants who were happy for me to do either. I preferred the c section as I felt it was a more controlled situation and I felt I might hinder a natural birth being so worried about it. Talk it through with your partner and the consultants and do what you feel most comfortable with.

I had a massive pph with a c section resulting in HELLP syndrome & me ending up in high dependency with some of my major organs failing & needing blood.

I can’t find much about the risk of an IPH instead of a PPH though? I don’t want to die but everything I’m reading says about the risk to maternal mortality, added to that I have a very low BMI so concerned that I have less blood in my body to lose before I die/ go into shock. I’m honestly wishing I had never agreed to having another baby.

Also my midwife seems to really be brushing of my concerns, basically said i didn’t need a blood transfusion so it couldn’t have been that bad. She also said my first pregnancy was straightforward so likely this one will be too.

OP

I think you need to make an appointment to talk it through with an obstetrician. It doesn’t sound (from your description) to have been a major IPH or PPH but it’s impossible to say without seeing your notes- which the obstetrician will be able to. Statistically, Caesarean sections do carry an increased risk of PPH but IPH is very dependent on what the cause was last time. There are other risks with Caesarean section as well as benefits, similarly there are both risks and benefits of vaginal delivery. Your obstetrician really is the only one who can advise you re risks of both options with any accuracy. The risk of IPH or PPH with your next delivery really depends on the exact cause (If known) last time, your current health and your past medical history. All these factors have to be taken together to give you YOUR risk.

Regardless of any of that, you can ask for a Caesarean section if that’s what you want. But I think in your case, as with most people, having the facts on which to base your decision may ease your anxieties.