Mears esp - following on from afterpains thread...

[hannahsaunt]

I had dreadful and immediate afterpains after birth of ds1 which accompanied a large pph. No afterpains that I can remember after ds2 and no pph. Now that I am pg with ds3, my iron levels are being monitored and an active management of 3rd stage labour recommended due to increased risk of a pph this time round. Do you have a sense of what the likelihood is of another pph and the consequences? I had to have 2 units transfused first time round as my iron was dropping by over a gram a day (hence trying to get me up to reasonable starting point so the end point of loss of iron doesn't require transfusing). Do have visions of uncontrolled blood loss and emergency hysterectomies...but I do tend to plan for the worst case scenario . Some sense of the actuality would be helpful if anyone knows.

[lulumama]

you can take spatone to boost your iron levels

i may be totally wrong, but i thought an actively managed 3rd stage could make the possibilty of retained placenta and blood loss more likely

[hannahsaunt]

bump for evening

[Klaw]

I've got the AIMS booklet on the 3rd Stage and went through it with fine tooth comb.

It really is a case of weighing up the pros and cons and then listening to your heart.

Ideally, for me, I'd want a physiological 3rd stage after a completely non interventional labour and birth, with the knowledge that, if it was needed, syntometrine/syntocinon is there and that mw is trained to deal with emergencies.

If there has been any intervention in the labour then you must have a managed 3rd stage.

Being aware that pph is possible and educating yourself on the ways to minimise it should give you the best chance of a normal birth and 3rd stage.

Obviously things like being upright, relaxed and feeding baby (or nipple stimulation) should help to ensure that the placenta comes away nicely. Make sure that your bladder is emptied regularly in labour so that it is not full when it comes to the 3rd stage. If it is full the uterus cannot contract properly to cut off the blood supply so the risk of PPH is increased.

HTHs :-)