ELCS after previous PPH?

[piggyboo]

I had quite a traumatic first birth (planned homebirth but transferred in), 24hr latent labour, 19hrs active labour, epidural, syntocinon drip, forceps and to top it of PPH of 1800ml (due to atony) and a blood traansfusion. This birth also left me with small rectal prolapse and mild urinary incontinence.

I am currently 34 weeks pregnant and suffering with spd, i had a quick look at risks and ruled out ELCS as everything i read said it was likely to increase chances of bleeding again. I have however just come across this new study which suggests a c-section may be safer.

www.rcog.org.uk/news/bjog-release-severe-post-partum-haemorrhage-less-likely-planned-caesarean-section-finds-study

so now i am confused as to what to do, i am due to see consultant on monday, just wondered if anyone has any experience of elective caesarian after pph??

No experience of a second baby after pph, but I have done a lot of research about this because I had a severe pph after DS was born (over 7 litres), and would like to have another baby but obviously need to know the risks of another big bleed. I also had a birth debrief with a midwife which was really helpful.

Basically it depends why you had the first pph as to whether it is likely to happen again, although statistically you are still 3 times more likely to have a pph if you had one before. Also remember that all labours are different. Your pph was due to atony, likely because your body was exhausted after such a long labour (fairly similar to me). First labours are usually longer than subsequent labours, so your next labour will probably be quicker, and therefore you won't be so tired. Also the midwives will be aware of your history and will be extra vigilant for any signs that a pph may be possible.
When I went for my birth debrief I was quite surprised that the midwife didn't mention ELCS at all as an option, but that just confirms that there is not much of an increased risk with a VB, because there is a higher risk of pph with CS anyway.

Sorry that was quite a long reply, but I hope it helps! I certainly am not worried about having another baby after discussing it with the midwife, and really feel that there is no reason why I shouldn't have an uncomplicated VB next time around (although not even pregnant yet!)

I had a PPH with DD1 of 1000mls. Noone mentioned having a csection to avoid it happening with any of the next 3 babies.

They were aware of the PPH as I was never allowed to get in the birthing pool for any part of my subsequent labours or deliveries as they can't accurately measure blood loss when it is diluted in water.

The midwives also put a cannula in my hand as soon as I arrived at hospital! This was in case I had another PPH they could get additional fluids on board quickly.

Each labour is different and thankfully I never had a repeat of the PPH.