Hemorrhage?

[acemama]

Hi, All! I am very newly pregnant and really want to have a homebirth this time. My first concern is that it's rather "underground" in my state. I don't like that we will have to tip toe around, but we can get past that. My real concern is that of a pp hemorrhage. I admit I have this fear (probably irrational fear) that I am going to bleed out. I am a bleeder. I remember being scared after my last birth because I could feel blood just pouring out like a water faucet. I got really dizzy, about to pass out but I stayed awake. It really did freak me out. I tend to have fast labors and worry about the MW not getting there on time and not have Pit available to stop a bleed. Am I just creating something to worry about? Is there a way ease my mind or learn more to get over this fear? I guess I just want someone to reassure me that all will be well. Thanks for all input. I really appreciate it.

[mom2sol]

Hmmmmm... I don't know what to tell you. I wonder if there's a way you can have pitocin on hand in case midwife doesn't make in time. I would just discuss my fears with her.

[hennaLisa]

Plan Ahead

I would discuss my concerns with my midwife, and I would also make sure to have a clear backup plan for if you need to transfer to the hospital. Figure out how close the nearest hospital is. Drive the route with your partner. Figure out where you would need to enter and go. Also, see if you can find a doctor in your area that will be a backup for you. Talk with your midwife about what she would do in that case. Would she be able to accompany you to the hospital?

I have heard that nursing your baby right away stimulates your body to produce natural hormones that encourage the release of the placenta. You could have that as part of your plan. Also, you might try visualizing your birth going just how you want it. I know it sounds a little weird, but I think it is possible to alter the course of your body's inner workings by visualization. I took Hypnobirthing classes for my home birth, and I am generally a rather scientific, skeptical person when it comes to this kind of thing. It definitely worked for me. You might take a class or read a book on hypnobirthing because the technique could help you to stay calm and collected so that you are better able to deal with whatever comes up (bleeding or not).

Happy Birthing!

[Mainstream Hippie]

I did pass out from a PP hemorrhage after my first birth. It was due to OB incompetence, but remained a concern with my home birth.

I discussed it with my midwife. We talked about things she does differently, so I won't be in the same situation. We discussed how she carries pitocin, in case it is indicated.

I personally wouldn't birth with a midwife who was unable to carry pitocin and oxygen because of legality issues, though there are herbal and nnaturopathic remedies that are probably as effective as pitocin. It is my own personal comfort level. Discuss it in detail with your midwife, and research it thoroughly online.

Best of luck with your decisions. It completely sucks that some states take rights away from women by refusing to license/certifiy/regulate midwifery, and instead outlaw it like it is some sort of criminal activity.

[sarahloughmiller]

Discussing it with the mw is probably what will ease your mind the most. MW's can handle it just fine in most cases and most do carry pit but that is something you will have to discuss with the mw. Do you know how far away from you the mw lives? If she lives close I am sure that will ease your mind. Since you do birth fast maybe you can have a plan in place in case she does not get there. I had my twins pretty fast (1.5 hrs start to both out) and I did hemorrhage after but my mw was here (thankfully she was still here since it happened 6 hrs after the birth) and she handled it fine. I did also pass out when I tried to get up to have the bedding changed after it and it took some time to recover but overall it was fine. It does take a while for you to actually bleed to death, I forget how long but it is not like you will hemorrhage and die in minutes. How far away is the closest hospital? Like someone else said, nursing does help too. Nursing causes your uterus to contract thus helping to prevent/stop hemorrhaging.

[sdejje]

I am a "bleeder" too, and it was that fear that caused me to deliver my first five children in the hospital. I had wonderful, natural deliveries with my first four babies, but with my fifth, my midwife most definitely became a "medwife." I did end up hemorrhaging with that one, and I truly believe that the hemorrhage was caused by all of my midwife's interventions. The one good thing that came out of that experience is that I learned that if I start to hemorrhage at home I will have plenty of time to get to the hospital. So I am finally going for a homebirth! Also, my midwife is aware that I may hemorrhage again and already has plans and precautions in place.

[acemama]

Thanks everyone! The closest hospital to me is less than 10 minutes, but there are NO dr's at that hospital that could be my back-up. I can get a back-up at a hospital about an hour from me. I guess in the even of an emergency it wouldn't matter what dr. I had I am going to interview a couple of midwives and see what they have to say. They are both about an hour and a half away, I think? But I don't birth quite that quickly.

[Mainstream Hippie]

You don't technically NEED an assigned back-up OB, as long as you have regular prenatal appointments with your provider, and keep a copy of your records in case of transfer.

If you arrive at a hospital without an OB or where your OB or midwife doesn't have privileges, they just have the hospital's on-call OB handle your birth. You would be responsible for those fees and costs, whatever your health insurance doesn't cover.

[the_lissa]

I had a bad pph after my first birth that was unresponsive to meds and required a d&c.

Do you know why you bled?

My pph was most likely from uterine atony from a long labour, so that was something I looked out for the second time around. My midwives have every drug they have in the hospital so I was not worried because if I started to bleed, they would be able to help me until an ambulance got me to a hospital. Anyways, I had a very successful, uneventful home birth.

[holly6737]

I live in an "underground" state, and my midwife carries oxygen and pitocin to stop bleeding. In all likelihood, yours will as well.

[ursusarctos]

Susun Weed recommends several herbs to stop bleeding in her book Wise Woman Herbal for the Childbearing Year, which is a great book otherwise too if you haven't already come across it (I wouldn't be surprised if your midwife has). She recommends angelica tincture to get the placenta out and shepherd's purse tincture to stop hemmorhage, among others. I have read several birth stories where the mother used shepherd's purse to very effectively stop postpartum hemmorhage.
Also I have read numerous accounts of women taking a bite or two (or more...) of their placenta (which is full of oxytocic hormones) to successfully stop excessive bleeding, and seen it recommended in many places.
I would think holly6737 is right about your midwife probably having pitocin though...

[sarahloughmiller]

10 min is close so that should make you feel better about it. Here docs can not be back ups so it is just whoever is on call that you end with. Really in a true emergency I think you will be happy to take what you get as far as docs are concerned. Good luck with your mw interviews!