Postpartum Haemorrhaging.....

I am pregnant with my 3rd bub and due early October...I just wanted to ask if anyone has had issues with postpartum haemorrhaging, particularly with it recurring in subsequent labours?

Firstly - for background info - with both of my kids so far I have had to be induced, at 41+ weeks, had no pain relief with either, birthed on my back both times (due to being hooked up to IV's and monitors). Just in case these may have been factors.

With #1, I lost about 400mL of blood after having a 7lb 11oz bub, but was generally ok - I didn't suffer ill-effects from the blood loss, just from my care at the hospital afterwards :doh: But I was told that every pregnancy and labour is unique and thus I probably wouldn't experience anything like that again (blood loss-wise)

With #2, he was 9lbs 5oz and after he came out, my placenta refused to budge. The midwife gently tugged it, can't remember if she massaged my stomach, but I don't think so, and then after some more tugging it came away. However, I then lost a little over a litre of blood in about 20 seconds flat...suddenly the room was filled with nurses and midwives and machines and an OB and lots of noise and jabs and someone diving on my stomach and talks of losing me and helicopters and surgery....then they managed to get the bleeding stopped, thank God, and eventually things settled down. Apparently because I had had an extra IV put in towards the end of the labour with more fluid (I think I had 6 or 7 litres?) it stopped my blood pressure from dropping too low and helped to stabalise me.

So my question...now that I have had a long-winded explanation....is is this likely, from your experiences, to happen again this time around? I am being seen as a high-risk patient this time and am far more informed and headstrong about how I want things done and apparently on the outside I seem confident about the whole thing....but I am still absolutely terrified on the inside. I want a vb, although my GP seems to think I should have a C-section to be safe...which I am desperate to avoid. This is in part because from my last scan, it looked like bub might be over the 8lb mark again and he thinks that the size of the bub is going to cause problems. Everything's going to be re-assessed again at my 36 week scan when they see how he is, how he's lying, how big he is etc. I desperately don't want to be induced again either, but have come to accept that that may be unavoidable, tho I still live in hope :pray:

Sorry for the scroller! :redface:

Scary stuff - I was induced with DD1 (sounds similiar to your #2) and it took me ages to recover BUT delivery with DD2 was amazing - complete opposite infact, I went into labour spontaneously, was gently active through most of my labour and arrived at the hospital at 10cm dilated. I had her 40 mins later (she was posterior too). No PPH and easy recovery. To be honest I was petrified of giving birth after DD1 (not sure how I only realised that at 30 weeks pg :rolleyes:). I spent considerable time physically active, so walked (perhaps waddled was a better description) for at least an hour every day and really worked on my own belief in my bodies ability to deliver as I really believe my brain stopped everything last time. Obviously every birth/person is different but believe in yourself and your body. Perhaps it is worth talking to a counseller about your concerns too. I was lucky enough to have an AMAZING midwife who really listened to me and made things feel so much less frightening. Start telling yourself you can do it! Good luck!

I haven't been induced, but I had a bleed after DD2.
It was only a 'small' bleed (I didn't think it was so small!). But I had nothing after DS. They did watch me closer, but all was fine.
Did they give you the injection to help the placenta come away? I had that the first 2 times. Didn't the 3rd.
I guess you might loose blood again, but there's every chance you wont. As Mak said, all labours are different. :)

Yes and no :)

I had a retained placenta and PPH with birth 2, birth 3 had no issues whatsoever but birth 4 I had a secondary PPH 2 hours later and lost 1.5lt. The cause of that was due to the uterus relaxing for some unknown reason.
The two events are unrelated so my OB said but after having one PPH it does make you more likely to have another but it's not a given that it will happen.

:hug: It is very scary to go through isn't it.

I had one after my 3rd, but didn't with my 4th and my 4th baby was a lot bigger again. I don't think the size of the baby has anything to do it with - retained placenta and PPH is just one of those things that can happen for no reason and while your risk of having another one is slightly higher than if you hadn't had one at all, there is no reason at ALL to rush to have a c-section birth just to avoid it. I think I would be staying firm on not having one, because there is still a risk of PPH with a c-section as well.

My experiences sound a lot like Mak's. DD1 was induced and I lost 3.5L of blood in under 5 mins (yup, they were organising the chopper and telling DH there was a big chance I wouldn't make it), and the recovery process was long, slow and difficult.
DD2 I went into labour spontaneously 7 days past her due date, stayed at home until I was worried I was going to drop her on my lounge room floor and had ARM after being 10cm for over an hour. She was posterior, so it hurt like nothing else, but after she was delivered I lost hardly any blood, got up and had a shower straight away and went home that afternoon - all bleeding was over within a week and lochia stopped after 2 weeks. It was perfect.

I was worried about having a PPH second time around but now I'm sure it was because I was induced - so if you can avoid an induction you should be fine. If you can avoid an induction, they will still give you a canula and put you on fluids just in case, but that's okay, you just get to lay in bed for a few hours :)
HTH! :)

From my experience a c/s won't make a difference. I lost 1.6L of blood with my second one & was very very close to needing a transfusion, so please don't go for a c/s in the hope that you won't have another PPH, because it doesn't guarantee against it.

I had PPH with my first - about 800mls. My second bub it happened again, this time around 1000mls. Third bub - nothing. No hemorrhage. My first birth I had epidural and pethidine, second birth no drugs except gas. The common factor between my first two births? They were both induced. Third birth was completely spontaneous - no induction, no drugs except gas, no hemorrhage at all. Post partum hemorrhage is actually one of the listed side effects of using the induction drug - syntocinon - to bring on labour. So I am convinced that it was the inductions that caused me to bleed the first two times. I agree with Glamourcide - if you can avoid being induced, I think that may help reduce the likelihood of it happening again. And like Sarah said, your chance of hemorrhaging will not be reduced by having a c/s - in fact, c/s itself carries a risk of hemorrhage, even if you didn't have a history.

ETA - my first two babies weighed 7lb 9oz and 7lb 10oz respectively. My third baby weighed 9lb 9oz. Her size didn't create any problems at all - it was the least problematic of all my births.

6 kids, only one PPH - no inductions in the lot. I am a needlephobe so won't agree to an induction until absolutely necessary for the health of my babe.

My PPH was 3l on number 3. Long (mostly ignored) labour so my uterus just shut down. After a PPH they want a canula and syntocinon drip started as soon as you deliver. Not so bad then because it helps the uterus contract and expel the placenta as well as keep contracting to work to prevent a repeat PPH. But yes, Syntocinon used as an induction aid increases the risk of PPH. Insane, isnt it?

Basically, go as long as the health of your baby allows to avoid an induction. Ask for them to monitor bubs and only induce if there is a risk to your baby.

Thanks for your replies ;)

I think it's always encouraging to hear other people's stories...the good ones give you hope and the not-so-good ones help you feel more at peace in some strange way and that you're not alone.

At this stage, I am set to be induced anywhere from 37/38 weeks onwards, depending. Part of that was my idea and part of it is the doctors/midwives/OBs. This is due to a few factors:

- Because so far all the midwives/doctors seem to agree that bub's size has a factor in the risk of PPH...even though I don't agree
- Because I haven't gone into spontaneous labour twice before, they are figuring it won't happen this time, so they are thinking of getting in early to take bub out a little earlier and hopefully control the situation better.
- I was in a major car accident 2 years ago and my back suffered a bad intra-muscular/nerve injury down the base of my spine...as bub is getting bigger and pressing against it, combined with my pelvis doing the whole achy/moving thing I can't remember the name of right now, I don't know if I can handle the pain, particularly if I end up with a bigger bub pressing against my spine or lots of fluid at the end, if that makes sense?

I am dead-set against a CS if I can help it...I have been in a few operations in my lifetime, as well as a few accidents, yet the thought of having a cs terrifies me! I would rather pace myself, go into the labour better informed than ever and try to have some semblance of control than have major stomach surgery. I think a big part of that, too, is that I REALLY don't want an epi needle put anywhere near my already-volatile back/nerves and am not that keen on a general

Perhaps I should push more towards not inducing me - at LEAST until 40 weeks - and see if I can't have bub naturally...sounds like the inducing part is the undoing of it all (apart from all the other obvious negs) I just don't want to get to 40+ and have them say "well, we strongly suggest you have a c/s now, if you had been induced 2 weeks ago you might have been fine, but we think it's too risky now" or something like that. Augh. Frustrating not knowing what to do....I think maybe I need to try and relax and trust my body more...even if it has let me down twice before.

Your body didn't let you down hun - it birthed two babies for you :hug: I felt a bit like that after having my first two aswell, and thought I would definitely never have another baby. But I did and now I am back again lol.

I guess you need to think about the options before you and decide what it is you do want and what you don't want. Personally I think that your health care team are focusing too much on the size issue, but of course I am not an expert lol. I gave birth to my biggest baby the third time and it was the only time I didn't hemorrhage, so in my own experience size is not the biggest factor, if it is even a factor at all. And the fact that you have been induced twice before does not mean you are any less likely to go into labour spontaneously this time - look at me. I was induced twice and went into labour spontaneously the third time. But in the end you need to do what you feel is best - and if you feel that being induced a couple of weeks early would be the best thing, then that's fine. You already know that you definitely don't want a c/s, so if being induced means that you can avoid that happening, then so be it. Just remember that it is your body - and your doctors/midwives can't force you to do anything, they can only recommend.