Advice please! Abruptions, sensitive cervix and homebirths?

[Lavenderboo]

Any advice or opinions or experiences would be very gratefully received.
Had planned a home birth from the minute I found out I was pregnant - am now 38 wks. MWs very supportive all the way. But had a couple of very minor bleeds. Medical staff and myself were not really concerned, but I went in cause I needed Anti-D (for rhesus negative blood)just in case. Was told little bleeds happen, and looks like it probably comes from the cervix as its a sensitive area during pregnancy.

MW wanted to check with consultant that home birth was ok, did he recommend a hospital birth and what was his opinion on chances of excessive bleeding in labour (given the two small bleeds) and any risk of tearing to cervix. He was very reasonable and said he couldnt say for sure that it was cervical bleeding and MIGHT indicate an abruption (placenta coming away; very dangerous for mum and baby during labour).

I' ve got no other risk factors for an abruption and live v close to hospital. But should I go in or stick to my home birth plans ? have got fear of hospitals and over-intervening/ interfering hospital MWs!

I think its probably my interpretation of what risk is at this point and Im sorry to ramble but any input would be fantastic.

I had a placental abruption with my first son and he was delivered as an emergency caesarian. I was rushed into hospital already bleeding quite heavily. I was also very nervous about having to spend any time in hospital but in actual fact the staff and midwives were fabulous with me and my husband. My son was born a healthy little chap and we left hospital 3 days later, at my request because I can't sleep in hospitals. Hope this helps - Good Luck.

Sounds like the Consultant was quite sensible,. although obviously he needs to cover his backl and cannot say that the bleeding is definetely not indicative of abruption. But if they thought that you were having an abruption they would have whisked you in straight away! Consultants on the whole do prefer births to be in hospital, even low risk ones.
Placental abruption is usually characterised by extreme pain and heavy bleeding.
It seems likely (and as you have been advised) that you have a sensetive cervix.
If you agree to go in to hospital it is quite likely to be the first step on a chain of intervention, which seems excessive as it seems that you do not have serious problems in this pregnancy.
You can always transfer to hospital if you start bleeding heavily in labour.
HTH.
Selina

I had an abruption at home and rushed into hospital but too late to save my DD from long term problems. Personally, I wouldn't take any risk at all by having a home birth. Sorry to be negative but I wouldn't wish what happened to us on anybody else.

I had a abruption which my first in the birthing pool in hopsital. I was very dilated at the time and luckily they managed to pull him out with a ventouse within about 20 minutes of the abrupion occurring - still he was very blue, agpar low.
He wouldn't have survived at home (according the the surgeon.)
Personally I wouldn't risk it x

i wouldn't risk it but it sounds like you obviously want to stay at home

I had an abruption, albeit early in my pregnancy and I would advise you to be in hospital every time. My labour was 2 hours beginning to end and I didn't even notice the first 30 plus minutes I only knew I was in labour because the consultant told me... I live a mile from the hospital but it could have been a problem if I'd been at home which I nearly was as I almost decided not to go to hospital. Baby's agpar was 2 and he needed to be resucitated at birth. If I hadn't been in hospital he would have died.

Incidentally i had no real pain with the abruption and a very painless labour (hence not noticing) the hospital and scanned for possible abruption earlier and said nothing to worry about. I now know there's a 50% false negative rate on the tests.

All I had was bleeding on and off -with the only significant bleed just before labour.

Abruption can of course be catastrophic for mother and/or baby. It's also pretty rare. Non-problematic bleeding in pregnancy is pretty common and is often just a cervical bleed, or just because there's more blood vessels in the vaginal area than normal. There are other risk factors associated with abruption and this should be taken into consideration before you make your decision.

A consultant is likely to always recommend a hospital birth in this situation because statistically eventually they will come across that one person who goes for a HB and it turns out that it was unsafe - therefore stopping everyone means that that person is swept up (thank goodness for that).

But, you are able to evaluate the risk yourself if you want to. By asking questions about whether there are any other problems (eg large amounts of waters, high blood pressure, fibroids to mention just a few) you can get a better idea as to what your actual risk is.

I completely understand people saying that they'd "never risk it" especially if they've been through the trauma themselves (as have many of you on this thread ). But if the risk is really low, you may decide that it's acceptable (considering that risk management is difficult... and it's easier to say better safe than sorry... yet it MAY well be that you're more at risk, statistically, from being in a fatal car crash on the way to the hospital!!!).

FYIW I had a bleed in my last pregnancy and was never told not to consider a HB for THAT reason. I've also had one this time and again it's never been mentioned as a risk for HB. BUT I have no other risk factors so all circumstances are not the same.

I had a very slow abruption, I didn't have severe pain or much bleeding. I didn't have any risk factors either.

It made me go into labour 9 weeks early, so I was in hospital and they were trying to stop my labour, they didn't suspect placental abruption at the time. Being there saved my daughter's life because once I started pushing, after 5 days of labour stopping and starting, the placenta must have fully come away and DD's heart stopped.

They said they had 7 minutes to get her out to prevent brain damage.

I wouldn't risk being at home, but because it happened to me, of course I'd say that!

LunaticFringe, and mintyfresh - so sorry you didn't have a better outcome. I can't offer anything more than my sympathy.

Abruptions are not always characterized by severe pain.

I bled on and off (mostly on) from 8-30 wks, initially was told was cervical but from about 17 wks the consultant felt I may be having small repeated abruptions, biggest bleed was at 26 wks.

I was booked for hb but strongly advised to be consultant led and hospital delivery, was induced at 38+4 and had synto 4hrs post del to minimise bleeding. DS was born healthy with apgars of 9+10, but placenta looked patchy.

DS has cerebral palsy, thought to be as a result of repeated abruptions, most probably strongly related to biggest bleed at 26 wks. I am glad I opted for hosp as our outcome could have been a lot worse.

DS4 was born 6 months ago, trouble free preg (one tiny spotting episode at 9 wks), planned hb but was actually delivered by DP before ambulance arrived as only had 6-7 pushing contractions!

Its a very personal decision, good luck with it.

I had no pain with my abruption either - just a sudden massive bleed 2 days off my due date. Had a perfectly healthy pregnancy too with no risk factors. I guess these things just happen sometimes....

Good luck Lavenderboo - hope all goes well for you

Two minor bleeds is very common and not a risk factor for a major abruption in most cases.

With my first child I actually had two or three small bleeds and decided to deliver in mw led unit within hosp grounds instead of at home as was original plan. All went well, and I could have had her at home. I have since had two trouble free pregnancies and two home births, good luck with your decision