re : having c/section

hi all i am just wanting to ask a question about my choices about the birth of my third baby i have had two normal births but i had big babes 1# 11 pounds 3 oz and 2# 13pounds and5 oz and i had pph with both of them i have been advised to have a c/section but i dont really want one. I guess if it is best for baby and me i should have one i so unsure what to do about it i have spoken to my obyn abou it he said it is we need to have a scan at 34 weeks and then he will make a choice of what we are going to do i would like to know what you think i should do thanks in advance

Hey Karen, I think you should be fine just to say no, but I will consult some midwives to make sure the risk of PPH is not a problem... will let you know what replies I come across...

The midwives I have heard from have said to seek a second opinion - you can still have a PPH with a C/S - In 'Effective Care' there is some information about how active management can actually contribute to PPH in the 2001 edition.

hi,

Kelly is right about active management contributing to pph. Other management also. Without history it's difficult to say what contributing factors you had with your pph's eg. induction. augmentation of labour , being on the bed etc but changing some of your previous birthing senario may help minimise risk this time.

It is not your Dr decision to make re section regardless to what he thinks and having birthed 2 babies before he should be helping you get a gentle birth this time. You'd be better off getting a more supportive care provider. Someone who doesn't practice in fear but in empowerment.

Lisa

Hi Karen

Do you know how much blood you lost?
This could influence the decision re C/S.
Some hospitals consider 400mls or greater of blood loss to be a PPH where as other hospitals consider 500mls or greater a PPH
Also it is true that you can suffer from PPH even if you do have a C/S.
It would be imposable for me to make any recommendations without knowing more about your medical history.

im sorry,but what is pph???
nikki

post partum haemorrhage

hi i lost over 600mls each time with my first baby i had a blood tranfusion i was so sick with my first with my second i was passing clots (tmi) as big as dinner plates huge i was scared thanks for your replies

hi there,

I don't think we can make recommendations to you at all. I find it difficult to believe that the only option for a previous pph is c/s the next time. You need to do some reading yourself and decide purely what is best for you. The Hinchingbroke trial was a huge study on the third stage in the 90's and had some interesting findings about pph. 600mls is not serious for most people with good health and nutrition these days and some people feel fine after 1000ml loss. On the other hand if you lose 300ml and feel terrible and symptomatic then you've had a loss that your body didn't like and that's a pph for you. Feeling afraid when your bleeding is a response we would all have especially after we hear all the horror stories that go along with birth. Shame on your attendants for feeding the fear and not keeping you calm and confident in them. and Shame on your obs for now scaring you about this birth. How can you hope to have a great birth when there is doubt on their ability to asssist you because they are most obviously scared.
Lisa

I have some extra thoughts to ponder for you from a midwife:

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Re PPH:
It would be interesting to find out if this woman was induced or had active management in last 2 births. Her body may not repond well to the synto....If she can get onto a good homeopath 'Ustilago Maidus' is excellent for prevention of pph .... but must have dosage determined by qualified homeopath. Have seen this used very effectively in a small number of women for abt 10 yrs where woman has had a previous pph and none with remedy. It is not one of the regular homeopathics used. Newtons Pharmacy in Sydney stock it and will do postal orders if her homeopath does not stock it.

Going on the GD (gestational diabetic) Diet sounds good as Gloria has suggested and if she has G.D and is doing her BSL's and they are high ..... the Australian Bush Flower essence Peach Flowered Tea Tree is excellent. I have seen a number of women over the years who are on insulin (sliding scale used to determine dose) for G.D use the essence and within 2-5 days have reduced BSL's and have not required and more insulin for the remainder of the pregnancy.

It could be this woman is tall and a little longer herself and has big bubs .... one woman I know all her bubs are 11-13 pounds and she has never had GD, always normal vaginal births and peri intact everytime.

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Some more from a midwife LOL

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I have heard that a standard 1000mls is lost with every c/s. How big was this womens pph? Its strange (or typical) how at a vaginal birth a women can lose 600mls and thats a considered pph but at a c/s 1000mls is not.

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I have also had pph with both my previous births, first one was about 800mls, second one was 1000mls. I did not need a blood transfusion either time but I did need to take iron tablets. Both my previous births were augmented with synto - first time I had a full on induction at 38 weeks (gel, ARM, drip) the second time I only had the drip. No other interventions were used (eg. forceps).
I have not been told to have a C-section for #3 and from my own research, a c/s still carries a risk of pph and can possibly make it worse, so I will definitely not be going down that road unless it is an absolute medical necessity.
From reading this thread and also my own reading, I wonder if the reason for the pph each time was partly, or wholely, due to the synto. I will discuss this more with the midwives at my ante-natal appointments, but I am planning to have a natural labour, in that I do not want to be augmented at all unless it is a medical necessity, and I will definitely make a more conscious effort to get off the bed and be more active during my labour.

Bon

Way to go Bon!!! Information is power. That's why you should never agree to anything without doing your own research first.

Obs get more money for doing caesars and it's very convenient for them to schedule your birth. Easy to see the seduction for them isn't it?

That's why I am glad to be having all my appointments with midwives at the hospital and being public also I won't be told to have a caesar unless it is an emergency.

Bon

I had PPH with a c-sect so I don't think that a c-sect is a good way to avoid PPH. I had synto prior to the c-sect so maybe that had something to do with it.

Same here, Dach...I had PPH with c/s too, but had synto prior.

Midwife told me that "normal" was 500ml and I lost a bit over 1000ml.

I wasn't told anything about PPH but I know that I lost 800mls blood post c/s as they were getting concerned at one point. But no one ever mentioned PPH either. :-k I had syncto prior to a c/s as well.

I found this on the internet this arvo when I was looking up something:

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Alfalfa, with its deep root system, contains many essential nutrients including trace minerals, chlorophyll and vitamin K, a nutrient necessary for blood clotting. Many midwives advise drinking mild tasting alfalfa tea or taking alfalfa tablets during the last trimester of pregnancy to decrease postpartum bleeding or chance of hemorrhaging. Alfalfa also increases breast milk, as alfalfa hay is fed daily to milking goats and other dairy animals.

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