If you're pregnant, chances are you have little — if any — fear of a serious postpartum haemorrhage (PPH) that your midwife or doctor would have trouble controlling.
After all, your care provider has access to an array of modern obstetrical technology.
Many care providers use active management of the third stage (the stage where you birth the placenta) to prevent heavy postpartum bleeding.
Active management was a process created by doctors, where interventions are used as a prevention, rather than trusting or waiting to see before acting.
According to a study on active management from the World Health Organization, “Our study suggests that few women are benefiting even from the correct use of uterotonics, and fewer still from the additional components of active management”.
Unfortunately, we live in a time where birth is very medicalised.
Rather than saying, “I birthed/gave birth to my baby”, we use language such as “my doctor delivered my baby.”
The latter is language that implies birth is anything but a natural bodily function.
Certainly, there are times where modern obstetrical technology saves lives. However, with record high c-section rates resulting in one third of babies being born surgically, we are also seeing the downside of overusing medical technology for a natural process.
If birth is a natural process, do we need active management for the majority of labours?
Wouldn't nature provide us with a means to prevent serious complications? Yes, things don't always go as planned, but shouldn't assistance during birth be an exception and not the rule – if birth is a normal bodily process?
Postpartum Haemorrhage – Nature's Prevention
Yes, birth is a natural bodily process. Despite our medicalised culture, most women are able to safely give birth without any intervention.
If we look at other mammals as an example of birth, we see just how much we interfere with the process.
In this article, Jan Tritten, midwife and the founder and editor-in-chief of Midwifery Today, shares how she watched the birth of kittens in awe of the natural experience that it was. As a midwife, she remained available but hands off – present if necessary, but giving no unnecessary aid.
After giving birth to each kitten, the mother cat proceeds to eat each kitten's placenta. As she observed this, Jan Tritten thought about what she'd heard about animals giving birth. She pondered, “As she ate the placentas, I realized that I have never heard of a cat, goat or dog hemorrhaging to death or even suffering too much blood loss.”
Yet, a postpartum haemorrhage is seemingly commonplace for us humans. How could this be?
What Can We Learn From Other Mammals About Preventing Postpartum Haemorrhage?
Not only do other mammals consume their placentas, they also do other things that reduce the risk of birth complications.
Firstly, it's important to understand that birth is a natural hormonal process.
When we interfere with the birth process, we interfere with hormones. We create complications that might not exist in a natural setting.
Many mammals give birth alone in quiet settings. They aren't watched, touched by others or interrupted. We know that oxytocin, melatonin and other hormones work best when a woman feels safe, comfortable and when she doesn't feel observed – all of which can be difficult to achieve in a medicalised setting.
In nature, mammals are not separated from their young. They clean their own babies, they often breastfeed shortly after birth and they have unrestricted contact with each other.
When women give birth in a hospital, they might experience immediate separation as their baby is weighed and tested. They might be given a cleaned and swaddled baby, which has difficulty using its natural feeding instincts. Their babies might be taken to the nursery for exams or to rest.
We know that both skin-to-skin and breastfeeding naturally trigger the release of oxytocin, which helps to prevent postpartum haemorrhage.
Do I Really Need To Eat My Placenta To Avoid Excess Bleeding?
It's easy in our modern society to be taken aback by the idea of consuming our own placentas. After all, we do have access to medicine. When we really think about it though, is it better to use an artificial hormone or a completely natural product?
While some believe placing a quarter sized piece of placenta in your mouth can help stop a postpartum haemorrhage, there are also other things we can do to prevent bleeding.
When we let labour begin spontaneously, we reduce the risk of postpartum haemorrhage.
When we don't try to interfere with labour by speeding it up or inducing unnecessarily, we reduce the risk of PPH.
When we choose not to accept unnecessary c-sections, we reduce the risk of PPH, for future births too. Not only is the risk reduced from having surgery, but retained placenta is a risk factor when a woman has had previous uterine surgery. This too can result in a PPH.
When women are able to follow their natural birthing instincts and give birth in quiet, dimly lit settings, when they are left to nurse and bond with their babies, when they have unrestricted skin-to-skin with their baby, we lower the risk of PPH.
Eating a balanced, nutritious diet during conception and pregnancy is important too. Being mindful of your iron levels during pregnancy and before the birth can be very helpful. It's common to be iron deficient particularly in the later stages of pregnancy. Take a quality iron supplement if you are low – speak to a naturopath so you can locate a practitioner strength and quality supplement, which is readily absorbed and gentle on your tummy.
By doing your research, avoiding an unnecessary induction of labour and enjoying skin to skin contact after the birth, you can help reduce your chances of a postpartum haemorrhage.