So scared of pph

[aprilmarcella]

I am due to have my second baby any day now, like with my first I was petrified of having PPH, it turns out I lost 600ml of blood when I had her that’s noted down on my notes which I read through recently but at the time there was no fuss from anyone in the room and I wasn’t aware of anything happening but after reading about, it’s technically classed as a minor PPH with anything above 500ml, I did have a 2nd degree tear too which I’m not sure if that contributed to most of it, I’m so scared of it happening again or worse because I read that if you’ve had one before you’re more likely to have another one and I’ve convinced myself of the worst and it makes me cry and panic whenever I think about not making it home to my first born :( been scared of it since day 1 and I've had my fair few nights of breakdowns over it and it’s quite exhausting I know I can’t control the outcome of birth and if it happens it happens but thinking positive doesn’t last long. Midwife knows about my concerns and she isn’t concerned but I’m wondering why if I had one before it’s not noted down that it was and I need extra monitoring or something…

Hi I had one with my first and lost pretty much all my blood. For my second I was consultant led for a little while and it was agreed I’d have a cannula in when I went in to labour. Reason for this is that first time my veins collapsed so they couldn’t get drugs in to me. Therefore if it happened again they would be prepared. I was told being induced and having an epidural can raise the risk? My pph was due to retained placenta. As it was I went in to labour naturally and only had gas and air…baby was born fine and I had no pph. Sending you lots of love and calming thoughts ❤️

I had a PPH with my first, and a tear, needed blood transfusion and in high dependency for a few days after. Second baby - ended up having accidental home birth, no tear no episiotimy, no PPH.

Good luck.

@Unitedthebest jeez. Nearly all?

So with my first I lost almost 2l. I had a retained placenta and also a tear (not sure what degree but had stitches). Like @Unitedthebest they also struggled to find a vein, probably not as much as united experienced I imagine. Baby had an infection and we were in 7 days.

Second birth was wonderful in comparison. No pain relief - well ok gas and air to begin with but nothing during pushing as I couldn't push and huff gas. Baby happy, no pph, fewer stitches, felt totally in control. When I arrived at hospital they put a cannula in, but it wasn't needed. I worried about a second pph too but it was all fine, once labour started I think I just clicked into a different mentality and was like, ok let's do this. 🙂

Second was much better for me too. I had to have a cannula for a while and stay in a bit to keep an eye on me but it was absolutely fine. They said it's often the case as PPH much more likely with a longer labour which you are more likely to have on your first vaginal delivery.

600ml isn’t much, and they are making an educated guess - it’s not exact measurements.
You sound quite anxious, your worry is disproportionate. Have you spoken to your midwife about this aspect? Do you have any MH support for possible pre-natal anxiety? Your medical team aren’t worried about pph risk, which should be reassuring as if there were indications of increased risk they would be taking steps to mitigate. It is something that is always on their radar anyway. You need support with your feelings about this.
sorry to be blunt, I am saying this with kindness.

Had a third degree tear with my first and while I don’t remember there being any PPH I lost a fair amount as my haemoglobin was very low after. I’ve had three kids since and never haemorrhaged or had any tears so there is hope!

I lost 2.9l with my first (suspected placental abruption). The next two were elective c sections, and even though c sections theoretically increase the risk of haemorrhaging I didn’t. In fact I had minimal blood loss for a section, especially for the second one.
Do make the team aware on the day just in case, but it’s a great sign that they’re not worried.

Yeah I was induced and it was about 12 hours and probably a few hours of pushing too and had to have forceps so maybe that was the case

Yeah I was having talking therapies but was discharged a few weeks ago, it’s just such a strong worry it seems that nothing can take it away I’m also waiting to have a call back from a midwife that works at the ward I’ll be giving birth on to talk to about my worries and hopefully she can reassure me further about actual likeliness of stuff etc

I was induced and was labouring for about 12 hours so maybe that could have been why she wasn’t coming out and pushing was quite a long process so had to have forceps, I know it doesn’t sound like a lot compared I guess it’s just the statement that if you’ve had one before you’re more likely to again x

Yeah my iron levels were already quite low I’ve been on iron tablets since about 3 months pregnant and it hadn’t increased by much by 6 months so wondering how it is now, I guess I’ll be in the right place if anything happens and I’ve asked for an active third stage so they can make sure to focus more of after birth and getting help with the uterus to contract, I guess we just have to see 😅

So long as you are giving birth with medical assistance nearby you will be fine. That sort of level of PPH is quite common an relatively easy to deal with with modern techniques. The midwives will know what to do and will look after you. You would be unwise to opt for home birth, due to being higher than average risk, but in a hospital it wouldn't be a major event to deal with as and when it arises. Try not to worry about worst-case scenarios - that releases unhelpful hormones into your bloodstream. Focus on ensuring that you can be in a place and with people that you trust, and have confidence that all shall be well.

If it helps, induction may be and instrumental birth is a risk factor for PPH. Planning to birth on the labour ward is also a risk factor but if you feel safer on the labour ward or have other risk factors making home birth less safe (like previous PPH) then the labour ward probably makes sense over home/MLU.

Sorry if it’s a silly question, just out of curiosity because I didn’t know this either but how come birthing on labour ward increases the risk? I’ve only asked for this because it’s closer to theatre at my hospital if they need to do anything quickly

I don't think anyone really knows why. For women of similar "risk" planning to birth on a labour ward vs home/MLU is associated with increased rates lots of different interventions. Maybe the environment is more stressful so your labour is more likely to slow down, maybe they are in more of a rush to free up space so they are quicker to do things like breaking waters or giving syntocinon, maybe you're more likely to be monitored on CTG (very little evidence CTG benefits mums or babies but does increase risk of forceps/surgical birth), maybe women who choose to birth on labour ward have a preference for more intervention or believe doing more is safer.

obstetric anaesthetist pov... 600ml is really nothing dramatic. It's important to remember that as part of normal pregnancy you create about an extra litre of blood so that you have some 'spare' to lose at delivery. If there was no fuss or drama in the room I really wouldn't dwell in it too much.

Lost 1.3 litres with my first but nothing with my second ! Nurses and doctors were prepared and I asked for extra checks. I refused induction for my second and he came naturally and I had a very quick labour. I was scared before too especially after such a scary situation first time round but I couldn’t have asked for a better second birth.

Lost nearly 2L with baby 2. Lost consciousness etc. Baby 3… all good! They were nervous, definitely, but nothing. They’re good at stopping these things OP. Tell them you’re worried and you’ll be fine. 600 is only a smidge above normal really.

Yeah I’ve refused induction this time too, I’ve heard over the years it’s more painful and intense. So would like to just have it happen naturally if I can

Thank you, my midwife has heard it throughout my whole pregnancy and previously with my other one so I think she’s noted it all down that I’m scared 😅