2nd time round will I PPH again?

[kimdylan2010]

Hi all was wondering how likely it was that i will have another PPH as 5 months pregnant again and it is playing on my mind, I had a vaginal delivery 3 years ago went into labour spontaneously at 35 weeks 4 days I had shoulder dystocia episiotomy 3rd degree tear uterus did not contract had PPH then had to have a blood transfusion and rush balloon? I think I will be offered a C-section this time but what are the chances of it going wrong again?

[HappyHappyMommy]

Hi; welcome to MDC and congratulations on your pregnancy.. I'm bumping up your post for attention. Anyone have experiences with PPH and subsequent pregnancies to share?
 

[dayiscoming2006]

I've never had really bad PPH, but I have "mild" PPH that needed to be treated in one way or another with each birth. But, I wouldn't go straight with a C-Section as they have some serious risks too and I've heard of PPH with those too. I'd simply get on a some supplements to minimize bleeding. Iron (ferrocel), red raspberry leaf tea (2 cups a day in 2nd tri and 3 cups a day in 3rd trimester) to strengthen your uterus, vitamin K to help with blood clotting. Avoid fish oil and other blood thinning supplements or medications at the end of your pregnancy. If you do home birth, wombstringe (herbal PPH remedy) worked on me with birth number 3. It's to be used after the placenta has been delivered. I don't know if there was any mismanagement on the part of a doctor or midwife, but make sure they don't yank on the cord and try to get the placenta out before it detaches. That can cause a lot of problems and is why I think I had a bit more severe PPH case with my second. They didn't let me deliver my placenta and manually extracted it immediately after the birth. They then gave me an INCREDIBLY painful D and C because of retained pieces(Romania)   With my third the placenta came out about 5 minutes after my baby was born. 

I don't know if it was a "true" dystocia. Were you able to try different positions? One of the best positions if I remember right, in that case, would be hands and knees. I had one baby on my back and ended up with an episiotomy. I delivered 2 larger babies after that with hands and knees and no tears or episiotomy.

I hope some of that was helpful to you.

[Ms Rabbit]

I had PPH with DS1, but not with DS2. When I was pregnant with DS2 and asked them if I would hemorrhage again, they weren't concerned. They said maybe, maybe not, but just because I did the first time didn't set me up for it again.

[ilovejeff]

I had pph and a retained placenta with DD (first birth). My MW gave me a shot of pitocin after DS was born to ensure that I didn't stop contracting, and no pph!

[mercii]

I'm wondering the same thing! I had a severe PPH on my most recent delivery (2nd child). I am currently nearly due with my 3rd.. I will let you know how it goes. This will be a birth center birth, and my midwife plans to give me pitocin immediately after birth. She is also prepared to transfer immediately if that doesn't make a noticeable difference.

I have read that c-sections increase your risk of hemorrhage, (which makes complete sense if you consider that they cut it open, then sew it back shut and expect it to contract as strongly as an intact uterus!) so I would avoid that route if at all possible.

Also, have hope about the tearing! I tore badly with my 1st but had zero for my 2nd! I'm optimistic for my 3rd, even though we suspect she's quite a bit larger.

[sky_and_lavender]

I had a pretty bad PPH after a normal birth. It was a homebirth and I did avoid transfer and transfusion but just barely. Anyway, I asked my mw how likely it was that I'd have it again, and she said it wasn't necessarily more likely. In my case, I was very exhausted before I even went into labor and feeling very dead as I gave birth--it felt like my body just completely ran out of energy. It was circumstantial and doesn't have to be the same in every birth. Wishing you a healthy and beautiful birth!
 

[Katie8681]

http://www.obgynnews.com/news/obstetrics/single-article/prior-postpartum-hemorrhage-raises-risk-of-another/c9535c4e63a647ba04d432201761b8af.html

Some research on the subject. In this study, they looked at about 1million births, looked at how many first time moms had PPH, and compared the rate of PPH in the second and third deliveries of both no PPH and PPH ladies. Of women who had hemorrhaged in their first births, 12.8% hemorrhaged in their second, while of women who had not hemorrhaged, 3.8% did. This was in Sweden. These results are pretty consistent with other studies on PPH risk factors. 

At your first birth, the fact that you spontaneously went into labor at 35+4 makes me wonder if you had a uterine infection, which sometimes causes PTL, and is also known to be associated with PPH. Does that sound like a possibility?

[heatherfd]

To the OP , you certainly had a lot of reasons to have a PPH, a difficult delivery and episiotomy . 

Women who have had a PPH are at more risk of a PPH again  and of course theres the possibility  of shoulder dystocia again. 

As someone who had a 3 litre PPH with my first delivery it can be very frightening both for you & your partner .

Its worthwhile talking to your care giver about what measures you can put in place to reassure you both about your PPH and dystocia , should they arise again.

My choice was to  have 2 large gauge cannulas in situ & a Syntocinon ( pitocin) infusion set up & ready to be plugged in.

As luck would have it , they weren't needed but to know we have a plan in place & could act immediately was immensely helpful to me.

Would love to hear how you go as you certainly have been through the mill, hopefully will have a nice uncomplicated delivery next time.

Best wishes . 

[HawaiianBlesing]

Alfalfa supplements or added to your RRL tea will help as well.  

 

[heatherfd]

Can you explain how that would prevent or treat a PPH ?
 

[IdentityCrisisMama]

I had a PPH with transfusion with DC #1 and heavy bleeding with DC #2 homebirth. I did take an anti-PPH drug that started with an "M" just for good measure. 

[mercii]

Well, my 3rd delivery went well. All normal bleeding, and my bleeding is slowing down much faster than the past 2 in the postpartum stage, too.

I did take alfalfa and red raspberry leaf tea, so I wonder how much that helped! Alfalfa is high in vitamin K, which helps with blood clotting, and red raspberry leaf tea is known for toning the uterus, enabling it to contract better.