PPH - Advice and options

[doodlexyz]

I'm hoping there are some mums here that have experience of PPH's and the options after multiple PPH's.
I'm a mum of 3, pregnant with baby 4, and now worrying. I'll tell my story first...

DD1 - I ended up being induced at 41+5, once I got going, labour was around 8hrs, I had an epidural, so quite relaxed, and pushing of around 30mins I think. All well, no problems. I felt a bit weird for a few days after, which I'm told was most likely from having the epidural.

DS1 - Arrived 40+1. Went into labour at around 4am, very manageable contractions, decided at about 9am to head to hospital, got there at 9.30am. Asked for pain relief, none available as I was 8cm dilated!! 27mins later, with literally 2mins of pushing baby arrived. This is where my problems started, I had a fairly major PPH (600ml loss), and the drs/midwives were running round like loonies trying to get a drip into me, for about an hr is was like an episode of casualty. Very traumatic, and didn't get to hold my baby for all that time. Managed to not have a transfusion, although I felt awful for quite a while, but managed on iron tablets and iron rich food. At the time I just wanted to get home. All well with baby, and no lasting effects on me.

DD2 - This pregnancy I was under the consultant due to the last birth. Had a couple of appointments and growth scans, but no real plan put in place as such. Although my midwife was fantastic and made sure in my notes that I had a venflon put in during labour just in case, and that things were in place in regards to a PPH.
Anyway, I ended up being induced at 41+3. Labour lasted around 5 hrs, again easy time of it really, until last 1/2hr, and once again pushed out in 2minutes, literally! Again I had a PPH (1000ml loss), but it was a lot less traumatic due to my fantastic midwife, and was managed a lot better. Again I got away with no transfusion. But obviously blood loss was more this time.

My concerns are that I am going to have an even more excessive PPH this time. I really don't know what is the best way to go? What options do I have? I've began to think maybe its the quick pushing that causes the bleed, so maybe epidural might help?

Also just to confuse things more... I want to be sterilised, so did think maybe an elective CS might be the way to go, then I could be sterilised at the same time. But from research I've done CS is probably more likely to cause PPH!

Can anyone help? Confused and worried?

smileyhappymummy Thanks, I think your right, getting things straighter in my head will hopefully give me something to focus on and hopefully I'll have less uncertainty

Hello

I hope I am not posting inappropriately (if so many apologies) but I wondered whether posters may be interested in our research project? We have posted a message on the 'Media/non-member requests' board under the heading 'Have you experienced emergency complications during or after childbirth?'. We would really welcome your involvement as there is so much that our study could learn from your experiences.

Thank You

Nick.

hiya just wanting abit of information from the ladies on here, im currently nearly 29 weeks with my 2nd child. my 1st labour was hurrendous, i had a 2000+ml pph, after having ds, but also was bleeding very heavaly alway through labour. and then also had a pph when ds was 4 weeks old due to an infection from babys sac and membranes still been in there. and ive just seen a few people on here mention consultants, should my MW have reffered me to see a consultant about my previous birth? i have tried to disscus with her how scared i am about it happening again and each time she just says they will be prepared this time, but its not making me feel any better

OP - have you been tested for blood clotting disorders? That can be one risk factor for a PPH. It doesn't exactly help practically-speaking but at least you would know. Even with a CS they can have blood ready for you in case there is a PPH. For my first pregnancy I tried to avoid a CS in case they took my womb while they were "in there" as I knew there was a PPH risk (not from clotting disorder). I was told after my birth horror experience that they are more likely to do a hysterectomy during intervention if it is a second or later child & also based on the woman's age - all common sense stuff really but shit if it happens to you.

when the bleeding started they gave me a drug to start clotting my blood but then the next day they gave me drug to thin it back out again. and when i bled when ds was 4 weeks old they said i had to take asprin for 2 weeks cause although i was loosing blood really bad they said my bloods was showing it was also clotting too much so i guess they checked.
think i shall speak to my midwife at my next appointment.
god i know i would hate them to take my womb although this is my 2nd child im only 20 years old

I think it would be very reasonable to ask for consultant appt - might put your mind at rest a bit and that is valuable in itself!
We are just starting to think about trying for baby no 2 and I have been to see my GP to ask for consultant referral even before conceiving to make us both feel better - he perhaps thinks I'm a bit mad but who cares!

NoahandtheWhale, smiling at your husband's comments about buckets at the bottom of the bed. My husband said something similar to me - it was months later, and we were discussing the blood loss (mine was 1200ml) . He asked did I realise how they knew how much blood I had lost, and said it was because they gathered it in a Kenwood Chef bowl (He wasn't smiling though - he very strongly wanted me to have an elective the next time, luckily I had a nicer time all round).

I lost over 3500 mls with my 2nd section, it was a crash section for extreme distress, cord compression). It wasn't at the actual op (I lost just above normal amount at that point) it was while I was in recovery. I was rushed back to theatre as was passing out. They opened me up and there was over 1 litre in there and a ruptured artery. Altogether I lost over 75% of my blood. I had several transfusions and was in high dependency with drains and oxygen for 3 days. The most blood I had lost before that was 600ml with DD2 which was a VBAC.

I was so scared of having my next baby after the PPH and convinced I would bleed to death. I had my 3rd section as an elective. No extra bleeding at all, just the usual 1000 ml for a section. So it doesn't always happen again. The good thing is even if it does they will be ready to act. Amazingly even after a bad PPH I could still have other babies and not repeat the PPH.

Jellybeans - thank you for sharing that, makes me feel a little better! Logically I know that my risk of massive PPH next time around is probably not very big at all, but emotionally it's hard to feel that way.