Should I do another homebirth???

[candiland]

My first birth went off without a hitch... after three/three and a half hours of pushing, my daughter was born. However, after the birth of my son, I hemmorhaged pretty badly. Granted, I wasn't taking great care of myself during that pregnancy. But now I am very concerned that if and when I give birth again, I may hemmorhage. Would you still recommend a homebirth? Would a shot of Pit immediately after the birth help curb a potential hemmorhage? Or would you not recommend this?
It's funny, because I haven't gotten a really straightforward answer to my question... the more mainstream people, including Sheila Kitzinger in her latest book, say that a previous hemmorhage should rule out homebirth. Other more radical birthers say that it can - and should - still take place at home. What is your personal opinion? Do you know any stats. about this? I mean, what do you think my chances are w/ the p.p. hemmorhage at my next birth?

[Cathi]

I think there are several things to consider. For me, I'd look at how close I was to the delivering hospital, how my midwife felt about her competency regarding postpartum bleeding, and how I honestly felt about being at home. If I weren't completely comfortable being at home then I would choose the hospital. But if my midwife felt confident in her abilities to handle the situation, and if I trusted her opinions, I would still have to say that home is the best place to birth.

Every labor and delivery is different!

[Peppamint]

Well, your level of comfort is the important thing.

My friend bled badly after the birth of her first baby. Her second baby was born at home and she didn't bleed near as badly. Granted, she had no episiotomy and she took better care of herself that time around. Our midwife had her start taking supplements (I can't remember what off-hand). I think Vitamin K is a good thing to take the last couple weeks of pregnancy if you're concerned about heavy bleeding.

Since you've had two homebirths, you also have to consider how you'd labor in a hospital. Would you be comfortable in the hospital or do you think labor might stall because you're used to laboring/delivering at home?

How does your midwife feel about it?

[Mallory]

I hemmoraged at my second birth in a birth center, but I am farily certain my next birth will be at home.

I was very comfortable with how my midwife handled it, even though right at that moment when I was seeing tunnel vision and my ears were ringing, I kept telling her to leave me alone while she was trying to start the i.v.

If you were in the hospital and hemmoraged, what do they do? I don't really know but I would guess give you pitocin and an iv, swipe out your uterus (OUCH!) some more of those lovely uterine massages and watch you. Of course they could give you a blood tranfusion-which no homebirth midwife would be prepared for- but I think that the rest of that could be just as easy at home and is proabably almost always enough for a woman who has labored and delivered with no drugs (I don't have any stats just what I believe).

I think I probably would want a shot of pitocin, but I haven't really studied anything about this either way(I am not currently pregnant or TTC). I do think it would make me feel a little better about it. I would for sure ask any attendant to really make sure my uterus is clamping down.


Why do you think you hemmoraged?
My kids were 19 months apart witch is not soo close, but my mom also hemmoraged with my little brother (we are 11 1/2 months apart), and I think that the spacing had some effect. But I really think that the biggest problem was that she was in such a hurry to get my placenta out, I would definatly want to have plenty of time for my placenta to be passed by itself next time.

[Peppamint]

Originally posted by CarrieBeary77
For me, I would do a hb again. I will never birth another child of mine in a hospital for as long as I live. End of story.

But that's me and my comfort level.

You need to weigh your options and decide for yourself.

That's exactly what I was trying to say!

Couldn't have said it better!

Good luck on your decision Candiland!

[moonglowmama]

It's worth having an honest discussion with your midwiife about. For most midwives, a hemorrage is a scary thing and you'd want to take every precaution during your pregnancy to be healthy. One thing my mw recommends is taking Chlorophyll supplements (for the vit. K) and iron the last trimester is you're at risk.

I bled a lot after the birth of my son, due to a clot that wasn't getting out of there. My midwife gave me a shot of methergine, after which I went to the toilet and out came the cloth and all was fine.

I agree that most of what they'd do at a hospital, your midwife is able to do at home, and she is likely more experienced.

By the way, your post reminds me that I need to get on the stick with the red raspberry leaf and nettle teas (good for building up vit K among other things). I too haven't been doing as well this pregnancy as I did with my son. Thanks!

[crazy_eights]

Originally posted by moonglowmama
I bled a lot after the birth of my son, due to a clot that wasn't getting out of there. My midwife gave me a shot of methergine, after which I went to the toilet and out came the cloth and all was fine.

I had the exact same experience after my first homebirth - almost to the letter (man, doesn't that uterus trying to contract against a retained clot hurt like the dickens?). It was my fourth birth, first at home, first hemhorhage. I think my midwife was a bit "green" as far as homebirths were concerned (CNM who had recently left hospital practice), my pregnancies were closely spaced and I was a bit strung out and not taking as good care of myself as I should have. Honestly, I think she wasn't watching for a later problem - I contracted nicely after the birth and only developed a problem after an hour or so. A little fundal massage probably would have gone a long way in terms of preventing the problem in the first place.

I have since moved and had 2 more homebirths (babies #5 and #6) with a different midwife who has me take chlorophyll or alfalfa in the last trimester, red raspberry leaf tea, and is much more proactive in terms of nutrition and herbs. No hemorhages with either one - a grand-ol' multip like me with my "flabby" uterus!

[georgia]

you might ask about filling a methergine Rx to have on-hand in case of emergency. i'm not big on pharmaceuticals---but if i had started bleeding, and it was questionable---i was going to do all in my power to stay home!

[candiland]

Thanks for the replies, guys.
My midwife is so laid back... she's like, whatever, I'm not concerned, it's totally up to you.
I hemmorhaged after my placenta came out. It sounded like a rushing river, or a faucet turned on all the way. She felt for my uterus, and it was up under my breastbone! She started with Angelica tabs under my tongue, and kept gauging my level of consciousness by talking to me. She massaged, she swept out clots, and kept dumping Methargine down my throat, gave me a shot of Pitocin, continued massaging... and I kept right on bleeding. I did not have one cramp, even after the Pitocin. Oh, and my boy nursed right away, while all this was happening.
In retrospect, I drank lots of Gatorade during transition/pushing, and my bladder was kinda paralyzed after the birth. I felt like I had to pee, but couldn't. This could have been a contributing factor, as well.

[mamallama]

So, do homebirth midwives do bladder caths? One of mine did one when I hemmoraghed (at home), but she was a CNM.

The last thing I heard before I passed out was my other midwife (not the CNM) saying from across the room "is that audible blood loss?"

The DEM wanted me to eat some placenta, but the thought made me queasy on top of being on the verge of passing out again. The blood loss was ultimately controlled with pitocin in an iv & methergine tabs.

I should add that I was borderline anemic, but I was well within the practice's risk allotment. I took chlorophyll prenatally, as well as rrl tea. And iron supps.

In the future, the practice I was seeing will not be attending out of hospital births at all, for anyone(according to the 'ole reliable rumour mill). Even if they were, I don't know if they'd take me. My only option for a homebirth most likely be...less than legal. I will choose a mw who carries drugs, but that brings up the potential transport issue. Frieda Miller practices in my state, and she's currently sitting in jail because she used drugs to save a mother's life....

For me, I have made peace with eating placenta. I will have tinctures on hand. For me, I feel that the risks of staying home, even with my history, are more favorable than the risks of birthing in a hospital.

In addition, I reserve the right to change my mind at any point! Intuition is a powerful sense, and if mine tells me that I'm in for trouble, I am getting in the car!

[JesseMomme]

I have been meaning to answer for days, but everyone's replies were great - all I can say is YES!!!!

[BirthTender]

Mamallama/RE:bladder caths

HI, Mamallama, I carry urinary caths & am trained in the insertion of them, as I am a RN. However, there are midwives out there who are not nurses who also have been trained in the insertion of urianry caths. In 22 years, i've only had to insert a cath at home twice & only due to the woman not being able to pee, even after the peppermint oil drops in the toilet trick, hearing running water, etc. & one time it was for a postaprtum mom who just could not urinate & was bleeding too much & the other one was a lady at 6cms. who had tried to pee for the past few hours after drinking adequte fluids & jsut could not pee. Relieving the bladder brought on final dilation quickly & in the other one it stopped the heavy postpartum bleed. Karen of BirthTender in the foothills of the NC Mtns.

[bhdavison]

I am with you candiland!

I also hemmorhaged after the homebirth of our son. Our midwife thinks I lost over 8 cups of blood right away. She gave me a shot of pit in each leg, accupuncture on some places on my feet and some other things orally. I also chanted as I tried to stop my own bleeding. I could feel the gush and there was nothing I could do. Yet I was already so out of it and exhausted I don't remember being too scared. However, my DH was terrified. This was his big fear about homebirth...alas, it is what happened, after a 24 hour labor, 3 hours of pushing and a 10 lb baby boy!

Anyhow, now we are TTC and thinking about homebirth. We have since moved and the hospital with the OB ward is moving as well. Before we were 3 minutes from the hospital (oh, and we did ultimately transport after bleeding for 20 minutes. As the paramedics walked up the stairs, I stabilized. But we went anyways for safety sake)Now we are about 10 minutes from the hospital. I feel a bit nervous about a repeat hemmorhage, our midwife does not. I feel nervous about a another big baby, our midwife says it will be so much easier. Anyhow, I am there with you, candiland, wondering what makes the most sense.

After reading this thread and hearing all the helpful tricks for third trimester, I feel pretty confident that we will have another homebirth, as birthing a large baby at our hospital vaginally is probably pretty slim given all the interventions the local docs love to push. Yet, I will have to do some work to get over my fears and get back into my headspace of trusting and believing.

Good luck!

BRooke

[MaWhit]

To echo everything the others have said, go with your gut and do what feels right. Here are some things you can do to prevent/treat hemorrage:

~raspberry leaf tea throughout PG
~fundal/uterine massage after delivery
~nurse immediately or otherwise stimulate nipples if hemmorrage occurs
~bite, chew, or swallow a small piece of placenta
~visualize blood flow slowing and ceasing
~take the herbal tincture Shepherd's Purse. It has an awesome reputation. I got mine form www.iherb.com

There are other herbal and homeopathic teatments as well, but I am not on my own computer so don't have access to that info right now. If you're interested I'll share it later though. LMK.

[Katana]

I can echo what the other mamas have said.

I say, do what feels comfortable to you. I don't know if I'm going to have anymore, but personally I will always try a hb first. I'd have to be dragged to a hospital kicking and screaming to ever go there again.

My births were complete opposites.

I was two tablespoons away from hemoraghing after hb-ing ds. I drank some orange juice, ate some pb and j and felt better. He was my first, came out at 10lbs 8 oz and 23.5 inches long. My midwife was very laid back and calm, and it helped me stay calm.

Dd came a little early so I went to the hospital. The only blood with her was right as she came out, and it was about two tablespoons.

I go at it from, you never know what is going to happen, so hope for the best.

Good luck.