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post #21 of 31
5/27/10 at 7:26pm
ETA: talked to the midwife today and this is what I was told:
Mom's normal blood pressure is around 120/80.
She was still in the birth pool when the placenta came out (easily according to midwife), and after that she started bleeding. When midwife noticed water was getting dark she had her get out. Midwife estimated she lost 2 cups of blood after getting out of water, and of course no way of knowing how much she lost before then. Blood pressure got down to 60/40 and after a while mom was dizzy and seeing stars (midwife's terms). Did not say specifically what she did to control bleeding (but nothing herbal or homeopathic from mom & doula's accounts). Bleeding did stop on its own after a while but midwife wanted mom to use the bathroom and when she got up she felt like she was going to faint, so laid back down. Midwife then gave her a shot of pitocin to get her BP back up (midwife's words). Midwife did say she was quite concerned (midwife, not mom), and that she knew she lost a lot of blood because her hemoglobin afterwards was 8 (I don't know what it was before). She mentioned that mom was very weak still a week later and quite shaky after standing up holding baby for 5 minutes for a PKU. She did also say that she had never transferred for PPH (has attended 800+ births).
I know mom did not request no pitocin or herbs or homeopathics first. She would have relied on midwife's judgment as far as transferring, but she (mom) wasn't overly concerned about the whole thing. She can be kind of laissez faire (is that the right term? I've probably butchered the spelling if it is) about things in general.
I find this fairly concerning....I mean, sounds like a pretty normal situation at first--but once the bleeding occurred, why not use herbs/homeopathics in this situation? Do you know if baby was nursing, or if fundal massage or nipple stim was done?
And if pitocin is used to bring up b/p, I've never heard that before. Pit is an artificial form of the hormone oxytocin--it stimulates uterine contrax to cause uterus to shrink down and stop bleeding.
I don't know--it's hard to tell from here. I'm left with more questions than answers--and wondering if this mw really knows enough about pp bleeds, how to stop them and how to promote mom's fast recovery afterwards. Again, I don't know--but I'm concerned.
I will say that I've seen a few bleeds that were definitely 'borderline' as far as considering transport goes--we stayed home. And I knew that recovery would likely take more time than usual pp recovery--told the family as much, gave them a specific list of do's and don'ts, with the general admonition, oft repeated in the first days/weeks "REST! Pay attention to how you feel, don't push yourself at all." Here is an incomplete list:
Do: drink drink drink plenty of clear fluids, get plenty of calories including high protein, double your multivitamin (maybe), rest rest rest as much as needed and stay mostly in bed for at least a few days. Resume life only very slowly after that. Do listen to your body very attentively
Don't: get out of bed or even sit up for more than few minutes in the first couple days (so--crawl to the bathroom or pee in a bucket at the side of the bed, use a bedpan--whatever is easiest), don't do ANY chores or be in charge of other kids, don't let visitors stay in your company more than a few minutes at a time (visitors should be helping out, not tiring you out)....
Anyway, if mom was still getting dizzy after only 5min of standing, one week later, I'd say she either didn't know how to promote her fastest recovery, or wasn't compliant. Yes, it would take more than a week to fully recover from such a bleed-but at 1wk pp, for families who know what to do/not do, and have pretty much complied with that, standing for 5min has never been a problem in my practice.
Again, though, this is about more questions, no real answers for you.
(not being comfortable with her won't be a good reason in his book).
IMNSHO, this is an especially important reason if you are going for a homebirth. You really, really, need to be comfortable with your HB MW.
If switching isn't an option, then talking to the MW and expressing your concerns *until you feel your concerns have been addressed* is vital.
YES. The details you provide don't concern me, but if I was your midwife I would be very, very concerned about our relationship. The trust between you and your midwife is a two way street, and you've run into a road block. It doesn't matter which way the block is facing.