Big PPH and pregnant again - advice!

[Dalirose]

Hello 👋

I have 3 children and during my last birth I had a big PPH, lost over 3.5L and ended up in theatre with a couple of blood transfusions, too. PPH likely due to how quick the birth was. Was very scary at the time and was very poorly for a while after. That was 2 years ago.

Now we are, unexpectedly expecting again! I am only 8wks, however, really scared about the birth already and how this will be managed given what happened last time. First 2 births went well with no complications.

Has anyone experienced birth after a big PPH before and how was this managed?!

Thank you 😊

I have and was consultant led throughout my pregnancy and had to give birth in hospital rather than a midwife led unit. I was nervous as was dh but actually my second birth was absolutely textbook and i did not have a PPH this time. Mentally I needed to prepare myself and made sure I understood what the plans were if it happened again but I was lucky that it was all ok.

I had a big PPH with my first, currently 8 months pregnant with my second and the main differences have been that I’ve been consultant led this time, I’ll have a cannula fitted at the beginning of my labour so that the access is there should they need it, they’ve kept an eye on my bloods throughout with the expectation to start medication if needed before birth but so far not been needed. X

I never had a PPH however I have 6dc and with my last I was put on a drip straight after birth just in case, it was annoying because I couldn't get up and get cleaned up but apart from that no issues

Thanks ladies!
When you say you are consultant lead, does that mean your usual pregnancy appointments are not with your midwife?

For me it has meant I have all the usual midwife ones plus extras with consultant- mainly in third trimester though after one at 14ish weeks x

No PPH with my second even though I was induced and labour was twice as quick.

I was very nervous though, I asked the poor midwife to double check my bleeding about 5 times while I was waiting to be stitched - I was under a blanket but just lying on one of those absorbent pads, and had no frame of reference for what bleeding might be normal so asked her to have a look every two mins because I was worried and could feel a small amount of bleeding. But it was all fine.

I've had 3 children. I had a 2l PPH with my third (full placental abruption in labour and needed EMCS). I was never given a blood transfusion, just given iron tablets and left to it. I'm 8+1 weeks pregnant and I'm really scared of another abruption/PPH. They've told me I'll be very closely monitored this pregnancy but not really sure what that means yet.

I had a 2.9l PPH and abruption with my first (they are as sure as can be that it was an abruption - I was in theatre already by that point so it was caught very early). I had a transfusion and was in hospital for 5 days afterwards.

I had two children subsequently, both by ELCS. The main difference was that they absolutely did not want me to go into labour naturally (and neither did I!) because having one abruption raises the risk of another vs the usual population. So the sections were at 39 weeks and at 38 weeks; the consultant was more conservative for the last one and would rather go earlier than 39 weeks, which I agreed to. There was crossmatched blood available both times, the team was fully briefed etc. I had minimal bleeding both times - 600ml and 400ml.

really similar experience to you- I labour very quickly and my first labour was precipitous (less than 3 hours). Consequently I had a major PPH afterwards, lost a similar amount of blood, also ended up in theatre and needed 2 blood transfusions.

I had my 2nd DC last year and was also concerned about having another PPH. I was consultant led, I did labour in the midwife led unit but only because it was 2 minutes away from the normal ward should I PPH. I had a cannula fitted during the labour and did a lot of research before and was advised that if I breastfed before birthing the placenta, it’ll help prevent a PPH. I’m not sure why or the exact science, but from memory a midwife explained that with very very quick labours, your body has an increased chance of retained placenta, which can cause a PPH (it stops contracting after labour- mine did), and damage to blood vessels.

In both cases breastfeeding can help encourage your body to contract and prevent this.

i had a really positive experience and didn’t have a PPH for number 2, despite having another very rapid labour (2 hours). I’m not sure if that was down to breastfeeding in the first few minutes but honestly I’m glad I did it, as it helped give me some control back when I’d previously felt powerless.

I felt totally safe though with the cannula fitted, they also ordered my blood ‘just in case’ from the blood bank, and they totally reassured me that if I were to have another PPH I’d have a transfusion available rapidly.

The consultant told me that it’s actually much safer and more controlled when they know to expect it, comparative with your last experience- when they don’t.

Hope that helps!