Prolonged labour and missed PPH (later requiring 2 units of blood)

[helpet]

Hello

I just wondered if anyone knew whether midwives/hospital not noticing a fairly significant postpartum haemorrhage is normal?

I was in hosp for a couple of days after DS was born (because of early rupture of membranes). It was a prolonged labour (OP; 5 days of first stage labour and then 18 hours on syntocinon drip). I kept asking if it was normal to feel so weak and faint after giving birth - how do you know if it's your only experience? Eventually, 48 hours after having my DS, they tested my blood count and had to give me a transfusion of 2 units.

Looking back I remember that when I was being stitched up (for second degree tearing) that the midwife grumpily asked me if I had thrush (I didn't) - she said "there's so much blood I can't see what I'm doing" - thanks for the reassurance!! Nothing like that kind of statement when you've had no sleep for 5 days, just given birth, paralysed from the epidural, and your non-feeling legs are akimbo in those lovely stirrups !!!

I am 31 weeks pregnant with number 2 - and sh!t scared.

Is it normal for busy midwives not to notice blood loss of that quantity? I am so worried about it happening again.

The hospital tell me it's hard to quantify blood loss and they look for physical symptoms as well - in the 7 hours after the birth I was alone in the blood-soaked sheets (DH sent home to rest) in the delivery room and felt in a VERY bad way but no one checked on me - so how would they know?

I understand how busy London hospitals are and how you just have to be grateful that you and your baby are alive. I'd just like to know if I have to prepare myself for what felt like a complete lack of care and respect again ... ?

I would hope to god that's not normal. I haven't ever had a pph, but after my son was born (at home) the midwives asked to give me an injection to deliver the placenta quickly. They said there was a lot of blood so they needed to stitch me up quickly to establish whether it was from the tearing or a pph. They stuck around for a fair while after to keep checking my pad, until they were satisfied it was just the tearing. I would have expected similar in your case - if the midwife noticed a lot of blood, why the hell didn't she keep an eye on you??

I remember with DD too (who was born in hospital) that midwives/healthcare assistants checked me regularly after her birth.

I'm not sure where you go from here though to ensure a better standard of care - sorry.

Are London hospitals really so grim that you just have to be grateful for you and your child getting out alive?! Bloody hell

It sounds like your hospital let you down. I had a minor pph after dd3 (8OOml lost) - I know that's how much because the midwife weighed everything they'd mopped up with and worked it out. It was my understanding that was standard practice. It's disgraceful that she couldn't see what she was doing with the stitches. That implies some active bleeding at least. Did she use a tampon? I've had three lots of stitches and they've always put a huge tampon in to keep the area clear whilst stitching.

I think you would always have felt pretty drained after a labour that long but you shouldn't feel weak. Usual post behaviour is to feel able to leap up and do lots of things - for about 5 minutes till you crash

I think you should talk about your concerns with your community midwife and document in your birthplan that you are concerned about pph, want particular notice to be paid to the amount lost and you want your Hb level checked if it's at all doubtful.

My loss was not checked ONCE after giving birth. I thought that was appalling. But then, lots of mws aren't nurse-trained nowadays.

Thanks everyone - I always felt let down but somehow the hospital seem to suggest that it's no big deal - I suppose they have to really don't they - they never take responsibility if they can help it. Sounds like you were let down too LittleSilver - you'd think it was quite an important and standard observation post-partum!

Hopefully I just got a duff MW that time (she was the third - I liked the other two a lot more!) - it was Christmas time so they didn't have their usual staff - apparently.

My Mum (who was a nurse a VERY long time ago) can't get her head round it all, and a Dorset MW I had to see a couple of months ago was very unimpressed.

Bloody London!!