[JamieB]

I have a friend who had a pph with her dd, her first and only child. She thinks it was pretty severe and they may have given her a transfusion but she doesn't accept them because of her religious beliefs. Her NP told her afterwards that she lost one unit of blood. I asked her about cord traction and she definitely remembers them pulling on the cord. They told her she had a lazy uterus that wasn't contracting properly.

She was told never to have more kids but I advised her to get a second opinion so she went to see another ob/gyn who told her to wait until her dd was 18 months old to TTC again so that her iron has a chance to buld back up. Her DD is a year old now and my friend thinks she may be pregnant.

All of this to ask if anyone can give opinions on whether or not she HAS to be in the care of an ob/gyn or can she go with a midwife? What are the chances that she will hemorhage (sp?) again? She had a really bad experience with her doctor and I feel like a midwife would be great for her but I obviouslt don't want her to be in any danger.

Thanks for any input!

 

[MsBlack]

Well personally, I'd rather be in the care of a homebirth mw than anyone else, in her situation. First, hb mws are way more likely to be able to help her use nutrition and supplements to rebuild her blood fairly quickly--and to get as healthy as possible in general. 2nd, and this varies so I'd want to ask to be sure (during initial interviews), a hb mw is less likely to fiddle with her placenta/cord--more likely to support a naturally occurring birth of the placenta instead of using force (force/traction so often leads to pph).

And, pardon me---Lazy Uterus????? Sheesh. The phrases these docs come up with! Always trying to blame women's inadequacy for problems that arise that are MOST OFTEN (according to the evidence, mind you) caused either by providers needlessly hurrying, or needlessly using drugs/procedures that end up causing or contributing to problems.

How about instead: Pushy Doctor Syndrome-- as in "oh, I suffered a pph last time, caused by P.D. syndrome; I've been told that this is likely to repeat each time I give birth, since standard of care dictates that I receive cord traction and only 5minutes to get my placenta out."

Or maybe: Impatient, Overworked Staff Syndrome--as in "yes, I had to deal with IOS Syndrome last time. I'm told this is likely to repeat at my next birth, so I'll need xyz drug/procedure to prevent damage....."

trying to be funny here, but seriously.

If I were her I'd get my birth records and get them to someone who can help me figure out what exactly happened and why. And then I would avoid allowing the same 'syndromes' to affect my next birth!

 

[Lit Chick]

Seriously, only 5 mins to deliver the placenta? I took nearly 30!!!! And I was perfectly healthy and had a normal HB. Mine was very much lazy mommy syndrome - I did not want to push anymore. When they told me I had to, I did and it was no big deal.

My BF had 2 hb and she had pph with both. Both times her MW handled it beautifully. She did need pit and massage, but she and her (huge - #2 was 12 lbs!) babies were healthy.

If your friend wants a MW, she should talk to some. They would be able to honestly tell her the risks of pph given her situation, and also if they would be able to assist or if she should have an ob.

Good luck, and I hope your friend has a healing birth this time!

 

[rainashine]

1 unit of blood? I thought that was a pretty normal amount to lose during birth and I'm quite sure they would not have given her a transfusion for only that much. I would bet her hcps screwed something up and scared her to protect their [email protected]$#

 

[AlexisT]

It shouldn't risk her out of midwifery care. It may risk her out of home birth with some providers depending on their guidelines for PPH, if that was something she was interested in--but not in a hospital. (Assuming there were no other issues of concern.)

1 unit of blood is not a huge PPH, so I think lines are crossed here. Either she lost more (maybe they wanted to give her 1 unit?) or her OB gave her totally wrong information about not having more kids. The only thing I can think of is that they thought it might be worse next time and they wouldn't be able to transfuse.

FWIW I lost 1.2 litres of blood (1 unit = 500ml) and I wasn't near transfusion guidelines. I had low hemoglobin and had to take iron tablets, but I was fine. I was told to wait a year because of the surgery but no one mentioned the risks from the PPH.

I would definitely tell her to get all her records and review them carefully with her OB/MW.

 

[Full Heart]

She should just go ahead and interview some mws. They would be the best person to answer her questions. That said, I had a pph with my 2nd, enough that I passed out. I went on to have 5 more hbs.