Bleeding after birth

[Neen99]

When I had my first baby, after the placenta was delivered I suddenly started losing blood at an alarming rate. The midwives thought the baby might have 'torn an artery' on the way out, and called for the Doctor, who eventually, after lots of messing in an already v. painful area! removed a clot, after which the bleeding stopped. Various midwives told me various theories whilst I was in hospital about what had caused the 2 pint blood loss, for which I had to have a blood transfusion. I was eventually told the clot had stopped my womb 'clamping down' and that this was a 'fairly common occurence'. Now I am due to have my second baby in 5 weeks and am dreading the same happening again. Has anyone else been through this sort of thing?

sorry Neen99 - I don?t have any personal experience of this one but have heard of similar scary bleeding episodes after birth. It must have been quite frightening - just when you least need to go through any more. My advice (if you haven?t done it already ) would be to mention your concerns to your midwife and ask her if there is any evidence that if this happens once you increase your risk of reoccurence. One consolation is that if it is fairly common the doctors and midwifes will be used to spotting it quickly and acting on it with experience and ease.... Sorry I can?t be any help Hope the next 5 weeks fly by (I still have 18 weeks to wait )

I had a similar experience with both DS1 and DS2. First time both m/ws got a little worried but a clot was found and as with you it stopped quickly but i didn't need tranfusion. DS2 they had seen on my notes what had happened and had a second shot of syntometrin ready which I did need after delivering placenta. Felt a little giddy after but again no transfusion. Thanx for the reminder as I am due in 7 days and had forgotten and will make sure I mention it so that they keep a close eye. Hope all goes well but do mention it to your M/w at delivery so that they can keep an eye out.

I bled really bably after my first baby too. The MWs blamed it on the fact that I asked for a natural third stage so I agreed to the injection but continued bleeding. They then decided it was a bad tear and spent almost 2 hours fiddling round trying to stitch me up. I was incredibly painful. They told me that the area didn't reespond to anaesthetic so I just had to use the gas and air. Eventually I started going into shock and they got a Dr who did the job in minutes. I was not happy.

With my second though everything was fine but after my last miscarriage I had very heavy loss and it only stopped once they removed the clot. Also stopped the painful cramps too. But a week later I was back in with a foul smell (bleeding had stopped) and it turned out to be another clot which was acting as a plug. Again once removed I was fine.

I would say that occassionally MWs (well anyone really) can get so bogged down in what they think might be the cause of the problem that they don't bother to explore the alternatives. You know about this now so make sure you put it in your birth plan and mention it at delivery. I know if this happened to me again I would be telling them to get a Dr straight away and to look for a clot rather than just assuming they knew best. I don't know if having it once puts you at more risk of recurrence, I can't see why it would but at least forewarned is forarmed. Good Luck. I hope everything goes well this time.

Very odd, I was going to post the same question today. I had a 10 litre blood transfusion after my dd was born (post partum haemmorage) and ended up in intensive care after a 9 hour general anaesthetic, they only just avoided a hysterectomy. I would love to have another and it's coming up to a year, but I'm scared that it'll happen again. My dh had PTSD afterwards and it took us a long time to get over it as they didn't know if I would make it or not.

My dh is a clinical negligence defence lawyer and he went to a talk last week where they basically said that if you have had a PPH and lost more thatn 15000 ml of blood (ie 15 litres) then you have a much higher chance of having another one. If you have lost less than that the chance goes up from 1% to 2%. Obviously I don't think you should take this as advice and you need to talk to the Obs about it but I thought it might give you something to ask them.

I thought that I had got over it but as the time approaches where we are thinking of trying again I keep thinking about it and worrying.

SamboM, I thought what I had gone through was bad enough, but yours sounds horrendous. Could you not opt for an elective c-section next time, or do you think the same problem might arise when they removed the placenta?
I think when you go through a traumatic birth for whatever reason, you and your partner should be offered some sort of counselling as standard procedure. Your head is all over the place when you've just had a baby anyway, and you don't think you'll need any help to get over your experience, but looking back, it really affected me for months after. And when you get pregnant again, it brings it all back.

When you have had a post partum haemorrhage after a previous delivery then your RISK of another haemorrhage is increased. However, that does not mean that it will actually happen. It depends on a lot of factors and cannot be predicted prior to the next delivery. It may be that the causes of the first haemorrhage are not there second time around. Certainly the medical staff and midwives will be alert to detect and treat it early should it reoccur.

SamboM, sorry, didn't realise a caesarean was what you'd had the first time round. Just read your story on another thread about Post Traumatic Stress Disorder and traumatic births. Perhaps not the best thread to have discovered considering I'll be giving birth again shortly!

Don't worry Neen99, it's very rare! Honestly, my dh said that the bloke at his talk said that he gets 2 really bad pph's a year out of 5000 deliverys so I was just unlucky. Oh and I got that figure wrong, apparantly it's 1500 not 15000 ml blood, sorry.

I have been told i will have to have a csection next time. We were offered counselling but turned it down, maybe have some before deciding for sure to get pg again though!

SamboM, why will you have to have another section next time? Is it so they can see what's going on in there better?
I think counselling would be a good idea, sometimes it's better for someone to 'make' you talk about things rather than not thinking about them. And they can really draw feelings out of you that perhaps you didn't consciously know you had.
Not that I'm an expert of course (just read a lot! )

Neen99, I'll have to have another section as they are going to put a prophylactic "bib and braces" stitch in, that is a way of stitching your uterus back in so it contracts! Also they aren't keen in general on vbac at Chelsea & Westminster. To tell you the truth I'd be happier, at least if something goes wrong they are in there already and if it is scheduled they will have the consultant and vascular surgeon there, instead of a rush job at 1am with the Senior Reg and then waiting for the consultant to arrive at 3am.

The reason we haven't gone for counselling is that we don't have a problem talking about it, in fact we do quite a lot, especially now we are thinking about ttc again (though it still make us cry sometimes ) We are going to go and see Prof Steer who is the top obs bloke at C&W to discuss cause and possible recurrance again. We have a few good friends who are doctors (incl a surgeon who has dealt with several pphs in his time) and have talked to them extensively as well.

Did you have counselling?

Quick update, have just spoken to Prof Steer and we are going for "pre-conception counselling" with him in August

Hi Sambo,
No, didn't have counselling - too much going on at the time, including dh getting made redundant on his first day back in work after having 2 weeks hols off with me and ds after the birth. This had immediate effect, as he had only been with company for 6 months, and included his company car having to be returned that day, leaving us car-less as I don't drive!
I shudder just to think of what a sh*t time that was, both of us were a wreck emotionally and couldn't be any form of support for each other at all.

Anyway, it took a while for everything to settle down again, and it feels like it's took this long to get our relationship anywhere near back on track, never mind have counselling for what seemed to be just one small part of everything that was going wrong at the time.

Sorry to waffle, bet you wish you'd never asked now!

So do you think you might go for some prior to giving birth - what did they say about it, are they going to take precautionary measures or just wait and see?

Poor you, sounds like you had a really rough time. All we had to cope with was this pph, though dh was incredibly busy at work for about the first 3 months of dds life which compounded his stress.

Has your dh got a new job?

Neen99, I too had a pph after my first labour due to an atonic uterus and also lost 2 pints (I was totally unaware of it at the time and dh was trying hard not to freak out). I didn't have this again after my second (good job too as dd2 arrived 15 minutes before the midwife) - instead I opted for severe shock one hour later as the postpartum complication of choice.
I don't think the two were related, and when I asked the obstetrician at my 20 week appointment he said that either was very unlikely to happen again.

I don't think I'll go for any before I give birth this time - it'll just worry me a lot a this stage I think. Perhaps I've missed my 'window of opportunity' on that one since it was a while ago now.
Dh got into temporary work for a bit just to bring some pennies in while he looked for something secure and worthwhile. He now works in a bank where he's been since last August, so things are okay there (touch wood! )

Pre-conception counselling sounds like a really good idea - keep chatting to me and let me know how you go on.

2under2, 20 questions now! - what's an atonic uterus? How old are your two now?
How come you were unaware that you had lost all that blood?
I was still doped up from the Pethidine but it would have been hard not to notice the Midwives fretting and the floor looking like the floor of an abbatoir!

Neen99, an atonic uterus is one that won't contract after the birth because the muscles just don't react (I think). And well, I did notice, but only when I looked at the floor and several people came rushing into the room. I didn't notice the blood gushing out at all until someone told me eventually. I don't know - maybe lack of sleep was to blame?
My dds are 2 and 4 and baby no.3 is due in November. Oh, and my last delivery was a planned home birth - my midwife had no problems with me having had a pph after my first labour.
Hope you have a smooth delivery and no problems this time round!

Thanks 2under2 - hope everything goes okay for you too. Did your Midwife at the home birth have to give you something to make your uterus contract?

Sambo, they just said that this time they will put something in the back of my hand that will make it easy for them to give me a quick injection of something if I need it.

Neen99 my midwife was still on her way and stuck in traffic when dd2 was born! I was very scared that I'd start bleeding again and dd2 wouldn't latch on, so I got dd1 who was still breastfeeding at the time to have a good suckle. We had the syntometrin in the fridge at home and dh was getting ready to give me it should the need arise (we were on the phone to my midwife keeping her updated). Ah, all very exciting!

How did you fimd a home birth compared to your previous hospital one?
I don't think I could have been brave enough to risk a Doctor not being around if something went wrong again this time, but hospitals are such horrible places. Other peoples' experiences of home births sound so much more cosy and relaxed afterwards.
Are you having a home birth again this time round?
How quick was your second labour then? I guess it was the speed of it that caused the shock afterwards? I have heard of that happening before. I'd be really interested to hear both your birth stories if you've got the time to post them! , especially to see how your first experience compared to mine.

Neen99, I haven't got a properly written up version of birth no.1, - it was induced (40w 3d), took three days for labour to start and dd was born after six hours of labour, 2.5 hours of which was second stage (I found pushing very hard because I'd had an epidural). She came out fine and immediately went on the breast. I started bleeding about 20 minutes later and was told about it properly once it'd stopped (my midwife warned me that I would start to feel very lightheaded). I spent the rest of the day (dd was born at 4:30am) in high dependency and then a night on the normal ward, discharging myself in the morning.
Birth story no.2 is here I'm not sure whether to have another home birth or not. The shock last time was very frightening and if that happens again I'd rather be in hospital. Also the logistics of childcare this time round make a home birth more difficult - I can get a sitter to come here and look after the kids but haven't got anywhere where we could drop the children off, and I don't particularly want to labour with them around, nevermind a non-family member other than a midwife. On the other hand, I'm no fan of maternity units!

2under2, your website is beautiful, as are both your girls.
I can understand your aversion to hospitals now, but also why you are apprehensive about another home birth.
Have you had to have more antenatal tests this time round? I guess you could go for the hospital just to be on the safe side, but just discharge yourself as soon as you can. I believe you can do it within hours when it's your third baby.

Had a scan yesterday to check if baby was head-down, as they couldn't make up their mind - we saw his little face with his snub, squashed-looking little nose and big pursed-up lips! He looked a lot like my ds1 did on his newborn photos!

Sambo M, my mum has just been diagnosed with 'Von Willebrand's disease', which is hereditary (50% chance) and can cause excessive bleeding and also PPH. The hospital are running tests now on me before I give birth, as there are implications for the baby.
Why they never thought to test for this before I don't know, as apparently it is not uncommon, and when I lost blood after having ds, that was the 3rd blood transfusion I have had as I had to have two after having my tonsils out years ago.
If I do have it, there is something they can give me if I bleed again this time round.
Maybe worth looking into?
There is more info on Von Willebrand's on this website:
click here

Thanks neen99, will ask my Prof about this. When I had my tonsils out I bled profusely, don't think I had a transfusion but do remember vomiting blood in the shower for ages. Maybe this is why

Good luck to you, hope you don't have it.s