Placental abruption AFTER delivery

[hayleycookie]

I had my DS 3.5 years ago, and am pregnant again now with DS2 in a new area, 100 miles away from the previous hospital I gave birth in.

With DS1 I was induced 12 days overdue, and had a long LONG labour. When it came time to deliver the placenta I had two midwives pulling on it to get it out. It came out in 8 pieces (!) and I was told it tore the lining of my uterus. I vaguely remember someone saying about internal stitches? I also lost a lot of blood (1500ml). As a result I was then anaemic, had to have iron pills and some other medication for a few weeks after birth, and injections every day in my stomach. My husband suffered PTSD and I had PND.

The midwives I'm with now seem to have no record of my previous birth. I had to tell them how big DS was (10lb 5oz!), how I delivered etc.

However, because I didn't tear OUTSIDE, and I delivered with just gas and air, they don't seem at all worried about this birth. I've literally just today remembered about my uterus and placenta problem. It might sound silly, but no-one ever asks about internal problems - just ''did you tear? Did you need any intervention?'' etc, so I never thought about it.

I have an appointment with my consultant this week to discuss birth options, as it looks like this one is going to be big too. But all along they've said they won't intervene or do anything different, because I delivered my DS naturally. I plan to tell them about the placenta/uterus issue I had. Is this likely to change how they treat me? Has anyone had similar issues and gone on to have a natural birth? Am I more likely to be induced or c-sectioned because of the placenta problem problem I had before?

Also: I'm not sure whether this classifies as a Placental Abruption or a Retained Placenta. Anybody help?

Can you ask for a birth debrief? Someone (a midwife in my case) will go through your labour notes with you and would be able to tell you exactly what happened and whether there is any cause for concern for your next birth.

I didn't have this problem but 3 years ago at the birth of my son had other problems, am at a different hospital now as have moved, pregnant again - speak to your previous hospital to find out how you can get a copy of your labour notes which they should have kept and whether the request better from you or your obstetrician and what the process is. I am in the middle of sorting this out myself, in the end it was easier and quicker for my obstetrician via their secretary to request the labour notes rather than me and this process has only taken a couple of weeks. It has been a matter of lots of chasing up and different people telling me different things but it looks like they will be with my obstetrician this week. I'm not sure but I get the impression they prefer to give them to your obstetrician not you, but I an hoping once my obstetrician has them I can then spend some time having a look. Also, if there is a mental health specialist midwife she may be happy to read through the notes with you and answer your questions. I know totally what you mean about them being dismissive about your worries, I guess we just have to stick to our guns and keep asking the questions.

Hi OP, I had the same problem as you with DD1 and was very poorly for a long time after, despite 2 blood transfusions and iron injections.

When I had DD2, I was made consultant led high risk due to two risk factors- previously large baby and large PPH.

Therefore I would assume that you would be the same.

The consultant put a plan in place and I was scanned for estimated weight at 37 weeks, so DD2 didn't get too big, I had to have an assisted placenta delivery and blood was ready should I need it urgently.

Apparantly a PPH puts you at greater risk of subsequent heammorages, so my consultant wanted to make sure they were prepared for it.

As it turned out I was fine with minimal blood loss and was back on my feet straight away Hopefully you will be the same!

Thanks Snozberry and April. I'll contact my previous hospital and chase them up about getting details on exactly what happened. I'm also gonna ask my consultant if there's anything she can find out about it. Maybe she will be able to get them quicker?

Whatthefreakingwhatnow Yes it sounds like we hadid REALLY similar births! I'm on a consultant every other visit but I'm still classed as low risk. I have a growth scan this month to check how big he's likely to be. Were they happy to let you deliver naturally or did they discuss c section or induction with you? How does an assisted placental delivery work?

I was told that I wasn't to go over 40 weeks, as they think my placenta crapped out on me and caused the PPH, it was in really bad condition when I delivered and if I wasn't already being induced it could have been too late

So, I was to be induced at 40 weeks, unless she was massive - in which case it would be moved to 38 weeks and section if over 10 and a half lbs.

Oh and assisted delivery is fine- they give you the injection and gently pull it out - took them about 20 mins and I wasn't in any pain

You can't "tear" the inside of uterus or have it stitched, there's some loss of understanding somewhere along the way. Def try and get hold of your notes from lady time. Also it's not an abrupt ion if it's after the birth. Sounds like it was just difficult to deliver hence why it came in bits, possibly a bit of manual removal. Chances are it won't happen again though so try not to worry about it.

Retained placenta, manual removal. Not sure if having one retained placenta increases your chance of a second (easy Google). They are best removed in the OR not by pulling.

Sounds just like my experience with DD1, retaking placenta and PPH. With DD2 the consultant said they wanted to induce at 40 weeks, I had to delivery on the ward rather than midwife led unit. Also needed to have canulas in and blood on standby just in case.
In the end I delivered naturally at 39+1. There were some issues with the placenta being stubborn but after about 40 mins the consultant thought she had coaxed it out.
Unfortunately I had another PPH at home 4 weeks later and was rushed up hospital by ambulance. Discovered some small pieces of retained placenta had caused it so I needed surgery to remove.

All fine now, DD is 13 weeks. Fight for a birth plan that prepares for the worst, then hope for the best