Birth after previous haemorrhage

KCT93 · 2023-01-24T12:17:25+00:00

Firstly, thank you for reading... My labour and birth with DC1 went exactly how I had hoped, quick and in the pool. However, my placenta would not come away afterwards. I was rushed to a different ward with a million doctors watching while they finally managed to get it out. This lead to me having a haemorrhage, but not significant enough to need a blood transfusion. They told me straight after, that I would have to give birth on this ward next time, and not on the much nicer, relaxed ward. This potentially means no access to a pool for another water birth. My question is, is this something I could appeal/question/fight for? I would love to be on the ward I was with DC1 where there are more pools available. I understand I am now probably classed as higher risk, but it wasn't actually the labour or birth that was the issue, it was my bloody placenta (should be the easy bit!!) The pool helped me SO much and I am so anxious about not having this option again, all being as smooth as last time. TIA.

CristinaNov182 · 24/01/2023 12:19

There is an injection that they can do to make the placenta come out fast.

chances are they have tried it last time, but it’s worth asking.

if they haven’t, maybe you can have your pool birth then the injection to speed things up. Good luck

TooSmallForTheMembrane · 24/01/2023 12:22

Yes, you absolutely can ask to birth in their birthing unit ‘out of criteria’. A sensible plan such as getting out of the water to have the syntometrine injection and deliver the placenta, and having 40 units of oxytocin on standby ‘just in case’ would be a good compromise.

You can ask if the hospital has a consultant midwife or birth choices team who you can speak to to make a plan. Failing that, I find that telling a consultant that you will have a Homebirth if they don’t let you use the birthing unit does the trick 😂

SpringDream · 24/01/2023 12:22

Following with interest as I am in a similar situation although my first birth wasn’t smooth. Long induction, long labour, episiotomy and forceps and very big almost 10 pound baby. 1.7L PPH. Now pregnant with number 2 and a bit scared about a second PPH. I’ve got a consultant appointment to discuss at 22 weeks. I’ve read they prefer delivery on labour ward rather than birthing centre so that if PPH did happen again then everyone is there ready. I’ve also read no showers and no pools as dilutes the blood and makes it harder to quantify.

Original poster

KCT93 · 24/01/2023 12:22

CristinaNov182 · 24/01/2023 12:19

There is an injection that they can do to make the placenta come out fast.

chances are they have tried it last time, but it’s worth asking.

if they haven’t, maybe you can have your pool birth then the injection to speed things up. Good luck

Thank you for your reply! I chose the injection option last time, but this must not have worked. I am not exactly sure how they managed to get it away eventually, I just remember being all wired up to monitor my levels etc.

I am too early for any sort of midwife appointment yet, but I will ask them for more info when I have one 😊

OP posts:

Original poster

KCT93 · 24/01/2023 12:24

TooSmallForTheMembrane · 24/01/2023 12:22

Yes, you absolutely can ask to birth in their birthing unit ‘out of criteria’. A sensible plan such as getting out of the water to have the syntometrine injection and deliver the placenta, and having 40 units of oxytocin on standby ‘just in case’ would be a good compromise.

You can ask if the hospital has a consultant midwife or birth choices team who you can speak to to make a plan. Failing that, I find that telling a consultant that you will have a Homebirth if they don’t let you use the birthing unit does the trick 😂

Thank you so much for this! I really hope it can be an option. I will definitely use that if not 😂

OP posts:

Original poster

KCT93 · 24/01/2023 12:26

SpringDream · 24/01/2023 12:22

Following with interest as I am in a similar situation although my first birth wasn’t smooth. Long induction, long labour, episiotomy and forceps and very big almost 10 pound baby. 1.7L PPH. Now pregnant with number 2 and a bit scared about a second PPH. I’ve got a consultant appointment to discuss at 22 weeks. I’ve read they prefer delivery on labour ward rather than birthing centre so that if PPH did happen again then everyone is there ready. I’ve also read no showers and no pools as dilutes the blood and makes it harder to quantify.

Oh bless you, that sounds like you had a difficult experience! That is basically what they said to me, it is because the labour ward has everyone ready! But all births are different, and I don't think they should be the ones to make that choice for us!

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CristinaNov182 · 24/01/2023 12:29

SpringDream · 24/01/2023 12:22

Following with interest as I am in a similar situation although my first birth wasn’t smooth. Long induction, long labour, episiotomy and forceps and very big almost 10 pound baby. 1.7L PPH. Now pregnant with number 2 and a bit scared about a second PPH. I’ve got a consultant appointment to discuss at 22 weeks. I’ve read they prefer delivery on labour ward rather than birthing centre so that if PPH did happen again then everyone is there ready. I’ve also read no showers and no pools as dilutes the blood and makes it harder to quantify.

Unfortunately you won’t get any home birth or pool birth option. I’m high risk also as well, went through a labour similar to you but without the big baby and only lost 0.5l. it’s not just that the loss of the blood will be hard to quantify, it’s also that you will probably need a monitor for baby’s heart if not throughout at least at some point. In my case they picked up both my heart and baby’s heart dipping low after the epidural, and were able to help us asap.

You could ask for a CS though. I’m going to go for another induction, if it comes to that, hoping this time will be better.

CristinaNov182 · 24/01/2023 12:31

KCT93 · 24/01/2023 12:22

Thank you for your reply! I chose the injection option last time, but this must not have worked. I am not exactly sure how they managed to get it away eventually, I just remember being all wired up to monitor my levels etc.

I am too early for any sort of midwife appointment yet, but I will ask them for more info when I have one 😊

Show quote history

You can ask and have a review of what happened, step by step. This way you can see if there is a similar plan you can make this time, that will allow you your pool birth plus everything else made ready for after.

If you had the injection, what dosage was it? I don’t know how it works, but maybe they can give you a higher dosage, considering your body didn’t respond to the (I assume) standard dose?

SpringDream · 24/01/2023 12:35

CristinaNov182 · 24/01/2023 12:29

Unfortunately you won’t get any home birth or pool birth option. I’m high risk also as well, went through a labour similar to you but without the big baby and only lost 0.5l. it’s not just that the loss of the blood will be hard to quantify, it’s also that you will probably need a monitor for baby’s heart if not throughout at least at some point. In my case they picked up both my heart and baby’s heart dipping low after the epidural, and were able to help us asap.

You could ask for a CS though. I’m going to go for another induction, if it comes to that, hoping this time will be better.

Show quote history

Ah I see, I think I would probably need the extra monitoring actually as I remember now my little girl’s heart rate dipped twice at the start of the labour. I don’t mind giving birth on labour ward. For me I really don’t want an induction. It took 4/5 days and all ended with her heart rate dipping, them removing the pessary and the registrar somehow managing to break my waters even though I was only 1cm. I think my PPH was because of the long induction/big baby so if I can avoid the induction part that would be great

crabette · 24/01/2023 12:43

@SpringDream if it helps, I had a part-induction... I was about 4-5 days in early labour so didn't need a pessary, but the hospital put me on an induction drip and broke my waters. It was fairly quick at that point, but I think because I was already well through early labour and about 3-4cm. Wouldn't have any issues doing that again, I have heard it's pessary which is the worst bit. Sent you a DM to avoid de-railing this thread!

OP, sending hugs. I think as a PP suggested, a full debrief would be good, in order that you could hopefully see if you could use the pool even in the early stages? I would say - I also wanted to use the pool for DC1, and couldn't because I ended up being induced - so I wouldn't pin all your hopes on having the same experience anyway? But I understand you don't want to have the option removed before you even start!

Original poster

KCT93 · 24/01/2023 15:34

CristinaNov182 · 24/01/2023 12:31

You can ask and have a review of what happened, step by step. This way you can see if there is a similar plan you can make this time, that will allow you your pool birth plus everything else made ready for after.

If you had the injection, what dosage was it? I don’t know how it works, but maybe they can give you a higher dosage, considering your body didn’t respond to the (I assume) standard dose?

Show quote history

I was going to contact birth afterthoughts to get as much info as possible about what happened. I am guessing it was the standard amount, so requesting a higher amount on standby could be an option - didn't even think of that, thank you!

OP posts:

Original poster

KCT93 · 24/01/2023 15:37

crabette · 24/01/2023 12:43

@SpringDream if it helps, I had a part-induction... I was about 4-5 days in early labour so didn't need a pessary, but the hospital put me on an induction drip and broke my waters. It was fairly quick at that point, but I think because I was already well through early labour and about 3-4cm. Wouldn't have any issues doing that again, I have heard it's pessary which is the worst bit. Sent you a DM to avoid de-railing this thread!

OP, sending hugs. I think as a PP suggested, a full debrief would be good, in order that you could hopefully see if you could use the pool even in the early stages? I would say - I also wanted to use the pool for DC1, and couldn't because I ended up being induced - so I wouldn't pin all your hopes on having the same experience anyway? But I understand you don't want to have the option removed before you even start!

Thank you! I agree, I need to know more about what happened etc.

It is wishful thinking that it will go as smoothly as last time, but like you said, it would be nice to have that option if I can 😊

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Novemberhater · 24/01/2023 15:40

I had a 1litre PPH with my first. It didn't happen with my subsequent births. I hope that helps.

mumonthehill · 24/01/2023 15:43

I haemorrhaged after first ds and had a transfusion. I was consultant led for second ds and was not able to have him in a midwife led unit. I must admit i was ok with this as wanted to ensure i had help if i needed it. But if you feel that you want to try a water birth i would keep asking for it. I did not haemorrhage second time around, had much more straight forward birth.

Original poster

KCT93 · 24/01/2023 15:46

mumonthehill · 24/01/2023 15:43

I haemorrhaged after first ds and had a transfusion. I was consultant led for second ds and was not able to have him in a midwife led unit. I must admit i was ok with this as wanted to ensure i had help if i needed it. But if you feel that you want to try a water birth i would keep asking for it. I did not haemorrhage second time around, had much more straight forward birth.

Thank you! I am definitely going to ask for it and do all I can to have this option. I am glad your second birth was much more straight forward for you! It is reassuring to hear you didn't haemorrhage again.

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wishuponastar1988 · 24/01/2023 15:53

I had a debrief with the consultant regarding my Labour in august. I retained the placenta after a 'text book' vaginal delivery at the midwife led unit and ended up losing 2l of bloody in a PPH and was put to sleep in theatre. Consultant said that the risk of PPH again is 1 in 3 but that I could still Labour at the midwife led unit - they would just be on alert for it happening again and I could be transferred if needed. I also had 2 lots of the injection to help with the placenta but it didn't work.

keepaweatheredeye · 24/01/2023 15:54

I had a 1.75pph with my 9 pound DS - induced, 4 day Labour with 3 epidurals, 2 spinal blocks, forceps and an episiotomy. Currently 13 weeks with no2, my midwife has already said not to be hopeful about anything other than a Labour ward birth, and a probable induction (which I have pushed back on as I believe my induction led to my tricky birth). I also lost all kidney function and ended up in hospital for a week, with 2 blood transfusions and 8 bags of fluids to fix my dodgy kidneys!

CristinaNov182 · 24/01/2023 16:51

@keepaweatheredeye You went through a horrendous labour. remember you always have the option of an elective CS. You can tell them if you get to the point where they think you need induction that you want a CS.

Keha · 24/01/2023 19:20

I had a retained placenta and quite a lot of bleeding with first baby. After seeing consultant and everything low risk they were happy for me to use the birth centre second time. I had a retained placenta again but no significant bleeding. Where I am it is an alongside birth centre so the doctors were right there if needed.

keepaweatheredeye · 24/01/2023 19:22

@CristinaNov182 I really want to avoid a CS; I'm such a wimp with pain but I'm going to speak to my consultant about it - just so worried about being immobile for a while, my DH is only able to take 1-1.5 weeks off max due to starting a new job and not being entitled to pat leave!

CristinaNov182 · 25/01/2023 11:46

@keepaweatheredeye I’m the same, really low pain threshold, but I know after I’ll be up and back to normal immediately, so don’t want a CS. My DH is also not entitled to paternity leave and I have a little one too. I keep telling myself the pain is going to be limited to labour, I don’t have to start suffering now! And keep pushing it out of my mind. I’ll practice some breathing before labour, apparently it helps, but that’s it.