uterine atony I'm scared

[Yumpopbythesea]

i am upset and frightened. i had consultant yesterday and cried the drive home after. my son was 10 lb and after birth my uterus didn't contract. uterine atony. This meant a had a PPH needing 4 units. I was given a drip and suppository and massage to get my womb to respond and contract.
I thought that this was unlikely to happen again as i had a combination of factors:
presentation was face first and looking up to left,
long ish delivery 19 hours 2 hours were active pushing,
ventouse assisted,
episiotomy,
managed first stage was rushed so umbilical cord broke off,
low lying placenta (only minimum 2cm away from opening)
I retained some placenta ( its been suggested the placenta must have had an extra lobe and nothing appeared missing from placenta despite retained piece being rather large, 2 weeks later I had another pph which needed 3 units and erpc)
So I thought i all this won't happen again. i would probably be ok this time.
But consultant says there is a 33% risk of uterine atony happening again and risk of shoulder getting stuck (I haven't googled this yet :()
She said nothing lowers risk not induction or section, spontaneous labour a vaginal delivery is the safest bet.
When i go into labour not to hang around just to go straight to hospital. I have a choice of 3 all about 40 minutes away.
I am scared which she said was normal as I had previous traumatic delivery.
Also when I MC in November I bled and didn't respond to two injections to stop bleeding and had to have ERPC.
I don't know how not to be petrified. I can't bare the thought of saying bye to my son and going to give birth not knowing how I will be after.
Ultimately I am frightened I will bleed to death. I don't know if i'm being hormonally crazy, but I'm struggling to rationalise and be positive,
Can I do anything to prevent uterine atrophy?
try to have a smaller baby by avoiding sugar?
Do baby spinning?
I am going to ask MW to arrange a birth planning meeting but don't know what else to do/ask?
I don't know how high the risk of death is? I don't want to be ill and go through all that again but I just want to be safe and go home with my baby and get to watch my family grow up.
Can anyone help/advise or reassure me?

[Owk15]

Hello, just wondered how your delivery went?
I experienced the exact same thing and we are wanting another child but I'm 2 scared
Thanks x

[idlevice]

I had similar birth with DS1 & for DS2 had to deliver in a teaching hospital consultant-led unit as I was considered high-risk. Some things I would advise based on my experience:

Try to ensure you are not anaemic before delivery as if there is any significant blood loss the effects will be worse (ask for full blood tests to check if both haemoglobin and ferritin levels are reasonable)

Ask for an ultrasound after delivery to check for retained products (although a bit uncomfortable this gave me peace of mind)

Ask for CS to be considered if baby is not in optimum delivery position/placenta is not in optimum position (although I was advised risk of PPH was actually higher with a CS due to the body's natural defences against potential blood loss not being activated)

Ask for epidural to be ensured if requested so you can remain "with it" in case the situation gets complicated rather than being exhausted and tired coping with pain etc

Ask what the procedure will be should a similar thing happen again, including the procedure for retained placenta

There is a rare blood clotting disorder that causes excessive bleeding - have you ever been checked for this given your experiences? (Can't remember the name of it, sorry). Also presence of fibroids is well-known to cause excessive bleeding but I think you'd know if you had those. Hope it goes well for you.

[3cupsoftea]

**Mass pph

[3cupsoftea]

I had UA the first time around too. I'm now 29 weeks preg. I have decided to give the hospital a miss this time. I had a mass oh but believe it was mostly down to my uterus being so whacked out on syntocin for hours and hours and then the episiotomy where the doc cut thru a large blood vessel. So I decided to skip the drugs and scissors, hired an indie MW and will hope for the best.
Good luck xxx

[Brionius]

The risk of death is very very small. Not none but very small. Ask for a meeting to see what measures will be taken to reduce the risk of it occurring and what will happen if it does occur.

[Londonbased87]

The risk of dying from postpartum haemorrhage in the UK is very, very small (~1/100000) - see www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/Saving%20Lives%20Improving%20Mothers%20Care%20report%202014%20Lay%20Summary.pdf

Scary though it is, every person looking after you will drill for this regularly.

Things that can help with PPH prevention and rapid treatment so blood loss is minimised : anticipation, a cannula already in, injection to deliver the placenta, drip after the placenta is delivered (the last two already ready in the room before baby born).

Good luck. 33% is still a 67% chance of nothing happening this time.