Hemorrhaged after giving birth & placenta didn't detach itself - Mothering Forums

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#1 of 14 Old 05-23-2010, 05:01 PM - Thread Starter
 
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Nearly 4 months ago I gave birth at home to a beautiful and healthy baby boy. The placenta didn't detach itself and I hemorrhaged, requiring hospital transfer via ambulance. I lost 4 pints of blood and needed a blood transfusion. I spent a few days in the hospital because of all that, but my son and husband were both able to be in the room with me. I'm physically healed from that experience, but emotionally I'm frightened about how "next time" will be. My husband and I plan to have a couple more children together. I'd like to have home births again or at least a birthing center birth. Realistically, I know the things that happened to me are not uncommon. I've also been told that just because something happened one time does not mean it will happen again, that every pregnancy and every birth is different. And though I know these things, I'm *afraid* still.

Has anyone been there? I'd especially like to hear from someone who had these experiences and went on to have uncomplicated deliveries ... or another complicated one. I came close this time and I'm so afraid I might actually die next time. Yet, I know that I want more biological children and don't feel "done" yet.
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#2 of 14 Old 05-23-2010, 05:55 PM
 
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First of all, a big hug to you. I understand.
My second birth(homebirth) was a super long insane labor that I feel was sorta mismanaged by my midwife at the time. After my daughter was born I bled a lot and kept on-two huge clots were blocking the cervix...the midwife jammed down on my belly and they came out...shot of pitocin and methergine pills and the bleeding was under control. Looking back I probably should have been transferred-I lost a lot of blood and was completely out of it.
The birth after that (2 years later) was an unassisted homebirth-and it was perfect-no heavy bleeding, in fact, didn't bleed much at all!
The homebirth after that was midwife assisted (never felt right about going it alone and was right-there was heavy meconium staining, but baby was fine).
Birth after that-perfectly fine!
I admit I had a lot of healing to do after that bleeding episode with our second birth-ptsd type stuff. It profoundly affected me. What helped with subsequent births was to be prepared, KNOW how to spot and treat hemmorhaging, have herbs/homeopathics onhand and know that I can always transfer. What also helped was the understand that the bleeding situation was a fluke, freak situation and most certainly NOT the norm, nor the rule.
I hope you feel better about it all!

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#3 of 14 Old 05-24-2010, 12:00 PM - Thread Starter
 
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Thanks, sapientia. It's good to hear the hemorrhaging is not likely to happen again. I wonder if it is normal to be so emotionally affected by it months after the birth.

How about the placenta not detaching? Does anyone have experience with that?
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#4 of 14 Old 05-25-2010, 11:13 AM - Thread Starter
 
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Anyone else have experience with either of these things?
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#5 of 14 Old 05-25-2010, 12:20 PM
 
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I've had several hemorrhages due to very very large placentas and the uterine distention from very large babies. To be honest, it can happen again. You can do everything "right" and still have a bad bleed.

That said, after having had 1250 and 1300cc blood losses my previous two births, this last birth was less than half of that in terms of total blood loss. We practiced active management of third stage and I felt *much* better. I'd also make sure that you're on a really really good iron supplement leading up to the birth. I use Hematinic by Solgar, and it keeps my iron levels generally in the upper 12s to mid 13s.


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#6 of 14 Old 05-25-2010, 02:00 PM - Thread Starter
 
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Originally Posted by loveneverfails View Post
I've had several hemorrhages due to very very large placentas and the uterine distention from very large babies. To be honest, it can happen again. You can do everything "right" and still have a bad bleed.

That said, after having had 1250 and 1300cc blood losses my previous two births, this last birth was less than half of that in terms of total blood loss. We practiced active management of third stage and I felt *much* better. I'd also make sure that you're on a really really good iron supplement leading up to the birth. I use Hematinic by Solgar, and it keeps my iron levels generally in the upper 12s to mid 13s.

My son was 9 pounds 14.5 ounces and I hear his placenta was really large. Do you think that had something to do with it not detaching?

Also, do you have home, birthing center or hospital births and in your opinion, which is best in this instance?

What is "active management" of third stage?

Sorry for so many questions.
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#7 of 14 Old 05-25-2010, 07:42 PM
 
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By any chance did you follow the Brewer Diet or other high protein diet, particularly in the first trimester? The reason I'm asking is that my 10 and 11 lb infants with giant placentas were pregnancies where I had very high protein intake during the placental attachment period in the 1st trimester. This last pregnancy I put an emphasis on healthy carbs and restricted protein intake and had a very proportionate, not macrosomic infant with a normal sized placenta. I can't promise those same results for you, but I can tell you that I will continue to follow that kind of diet because I think my body may overgrow placentas which in turn can result in babies who are bigger than they might otherwise be.

I am not a medical professional and this is not medical advice. That said, I do think that it intuitively makes sense that a larger placenta may take longer to fully detach, which increases the risk of a partially detached placenta where you're bleeding but the placenta isn't fully out yet.

A birth center is not going to be distinguishable from a home birth unless one is closer to the hospital than the other. My comfort level in choosing a home birth for subsequent births would depend on how close you are to the hospital. However, in the next birth, I'm not sure I'd be willing to risk it unless you literally are within 10 minutes of a hospital, preferably 5.

But there are a lot of things you can do in between full on hospital birth with all the cool tools and home birth with no medical intervention. You may be able to get a heplock at home so that if you did bleed, they could start running fluids ASAP already having venous access. I don't know about the particulars of your case, but I know that the evidence is very good for active management meaning less blood loss for mom and fewer moms who meet the threshold for PPH. Active management means controlled cord traction and a shot of pitocin as soon as the baby is born.

Blood loss is serious. It don't know the conversion off the top of my head and blood loss is generally stated in ccs or mls, but it looks like you had almost 2 liters of blood loss. That's a heck of a lot of blood. It is something that can kill, and quickly. If it were me personally, I would search for a hospital based midwife and ask for your pediatrician to write orders for a 6-12 hour discharge. I'd feel better with a birth *without* hemorrhage under your belt before deciding that this one was a fluke and feeling comfortable staying home for future babies. However, I think you should also talk to your midwife about what her thoughts are about if you are a safe home birth candidate or if you would be best served in a hospital birth for your next birth. And if you are best served by a hospital environment, it's still possible that your midwife could be there as a doula for you and still be there to support your family.

I've had two hospital births and three home births. I do tend to like my home births with more intervention to try to head problems off at the pass, so keep that in mind when thinking about what I'm saying.

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#8 of 14 Old 06-28-2010, 10:58 AM - Thread Starter
 
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Thanks, loveneverfails. No, I didn't follow a high protein diet. I'm a vegetarian, and while I consumed a healthy amounts of protein, I didn't consume an amount that was too high. Also, big babies run in my family. My sister had 3 nearly 10 pounders, the first born naturally in the hospital and the last 2 born at home naturally. She didn't have a problem with her placentas not detaching and she never hemorrhaged. Another of my sisters had a near 10 pounder, born naturally in the hospital without complications. On the other hand, another sister had a more average sized baby, and although she had no problems with the placenta detaching, she hemorrhaged 2 weeks after giving birth.

Does anyone have any positive, reassuring stories?
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#9 of 14 Old 06-28-2010, 01:33 PM
 
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I had retained placenta which was manually removed with my first son. It was a hospital birth so it was done within 20 minutes of giving birth. I don't think I needed any blood that time.

My second birth was a home birth (best experience ever!) with a transfer to hospital due to retained placenta. The ^%#%$ %$%$ &^%$^&% doctor twisted the cord around his hand, put one foot up on the end of the bed, and proceeded to try pulling the placenta out. I lost most off my blood and ended up having fluids and blood pushed into me after I was rushed into surgery by a different doctor.

(These two births were 13 months apart so after this I spent a year in deep depression)

Five years later I had a birth center birth and finally found out what it feels like to deliver a placenta.

Don't let the thought of it happening again stop you from having another child. Educate yourself on what your options are if it does happen again so you and your partner know how to deal with it.
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#10 of 14 Old 09-18-2010, 02:26 PM - Thread Starter
 
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Originally Posted by loveneverfails View Post
I've had several hemorrhages due to very very large placentas and the uterine distention from very large babies. To be honest, it can happen again. You can do everything "right" and still have a bad bleed.

That said, after having had 1250 and 1300cc blood losses my previous two births, this last birth was less than half of that in terms of total blood loss. We practiced active management of third stage and I felt *much* better. I'd also make sure that you're on a really really good iron supplement leading up to the birth. I use Hematinic by Solgar, and it keeps my iron levels generally in the upper 12s to mid 13s.

Thanks for listing your iron supplement. I agree that iron is extremely important, especially when it comes to hemorrhaging.
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#11 of 14 Old 09-18-2010, 02:29 PM - Thread Starter
 
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Originally Posted by hillymum View Post
I had retained placenta which was manually removed with my first son. It was a hospital birth so it was done within 20 minutes of giving birth. I don't think I needed any blood that time.

My second birth was a home birth (best experience ever!) with a transfer to hospital due to retained placenta. The ^%#%$ %$%$ &^%$^&% doctor twisted the cord around his hand, put one foot up on the end of the bed, and proceeded to try pulling the placenta out. I lost most off my blood and ended up having fluids and blood pushed into me after I was rushed into surgery by a different doctor.

(These two births were 13 months apart so after this I spent a year in deep depression)

Five years later I had a birth center birth and finally found out what it feels like to deliver a placenta.

Don't let the thought of it happening again stop you from having another child. Educate yourself on what your options are if it does happen again so you and your partner know how to deal with it.
Thanks for your thoughtful post.
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#12 of 14 Old 09-19-2010, 01:50 AM
 
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We are two of a kind. I, too had a homebirth followed by retained placenta, hemmorage, and transfer to hospital via ambulance. I had a transfusion too, 2 units concentrated cells. They estimate I lost around three liters of blood.

Although my experience was recent, I can tell you that my baby was average size, 8 lbs, 1 oz, and my placenta was also average size. I had a homebirth with my older daughter, and although it took about 45 minutes for the placenta to detach, I didn't bleed much with her at all. So i don't feel like I'm prone to hemmorage or anything like that. I would homebirth again if I got pregnant again, but I would go with a very experienced MW and i might do the pictocin shot as soon as the cord stopped pulsing. I also ink I would transfer earlier, meaning within a few minutes if I started bleeding and passing clots, rather than trying to get it out at home. I think that would be better for all involved, as I think I was too close to the line this last time.

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#13 of 14 Old 09-19-2010, 02:20 AM
 
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I had a very complicated, intervention-laden, and traumatic labor & delivery with my first. It ended in a hemorrhage. My baby had been rushed from the room and I was incredibly out of it, so I didn't really understand what was going on at the time. My mom was more traumatized by it than me. I had other things to worry about, KWIM? Anyway, I just kind of lumped it in with the whole horrible experience.

My next labor and delivery was way different. It was fast and unmedicated. I gave birth at a free-standing birthing center and things went pretty well. But after my daughter came out, I was trying to let her cord pulse out. She was on the bed beneath me, and I was still in the hands & knees position that I'd delivered in. I could see some blood on the bed, and I could hear it pouring on the ground. I asked if that was normal... and the midwife and nurses kind of avoided the question. Turns out that I was hemorrhaging.

I was given a shot of pitocen and all the normal measures to stop the bleeding were taken. (Nursing, etc.) I was weak and loopy. The after-pains were horrid. Eventually the midwife had to go back in after some of my placenta, or a blood clot, or something. She wasn't the most clinical-speaking midwife in the practice (honestly, she was kind of a bubble-head ), but she did save my life... so I didn't bother asking too many questions. All in all, things were fine. I had to stay a total of 12 hours after the birth (6 hours more than normal, I think) because they wanted to observe me and let me rest. I was very, very weak... and I was supposed to take it easy for several weeks after the delivery. When the nurse came out to do our home visit at around 3 days PP, she *flipped out* over my blood counts or something. There was some talk about a blood transfusion, but I was given the option to just skip it since I was doing pretty well, all things considered. They said that what helped was the fact that my iron count (or something) had been really, really good prior to delivery.

Anyway, after all that, I was told that it is common for women to hemorrhage in subsequent pregnancies after they've done it once. This makes me kind of nervous. I mean, things were taken care of with both of mine... and thankfully I managed to avoid blood transfusions. But I do distinctly remember the midwife asking me not to go toward any lights. I also remember asking my DH not to look at me as the midwife was frantically trying to pull the pieces of whatever out my uterus, because I didn't want him to "remember me" like that. (Apparently this REALLY haunted him for quite a while.)

In your position, I wouldn't worry so much about delivering in a birthing center. They are prepared to handle these types of things. Personally, though, I am afraid to deliver at home because of the risk. I realize that the same care could be provided at home as could be provided at our birthing center... but we are located slightly farther away from the hospital than the Center is. Plus, the sheer amount of blood that I'd passed all over their concrete floor makes the idea of delivering in my own bedroom unappealing. LOL. Anywho, all that considered, I don't think I would ever feel comfortable delivering unassisted because of the likelihood of hemorrhaging. I know that I wouldn't be able to handle the issues myself, as I wasn't even able to hold my child to my breast after my last delivery.

So... that's my story. Thank you for sharing yours. I hope you are able to move past this fear, and that you go on to have as many healthy and uneventful deliveries as you desire.
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#14 of 14 Old 07-24-2012, 09:22 PM
 
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I know its a few years later, BUT, I have had this happpen TWICE! In 2009 I had my son, and hemeraged, along with my placenta not detatching (my doc had to manually remove it)! This past April 2012, I gave birth and the SAME thing...only after 15 minutes doc was able to get me into the OR where he did a d&c as well. I needed blood transfusions after both those deliveries. My first daughter in 2008 had no complications,

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