PPH and pulling out of placenta

[dlj2]

Hi all,

I'm after some advice really... I'll explain my story below but my question is do you think pulling the planenta out could be the cause of a post partum hemorage? Also how do you make a complaint to get things looked into relating to the midwife who did this? Thanks.x

My story is as follows I had my second baby on Christmas Day 2014. To this day 8 months on I'm still so up and down both physically and mentally from it. I feel my chances of having another baby have been taken away due to the risk of this happening again, and I can't accept that I won't get to have another baby possibly due to the midwifed incompetence. So at no point was I told she pulled it out during delivery until I went for an after birth meeting some 5 months later. At that time I was t given a reason just told ' oh she write here she pulled your placenta out' I should have questioned it there and then but stupidly didn't so now I'm still left wondering why and if this is what caused the hemorage. I hemorage do week after delivery at home and was rushed in by emergency ambulance. My two small children were in the house and it was just horrific I honestly didn't think I'd see my babies again 😪. After speaking with my husband and looking at times on photos we took I can see I was up feeding him within 30 minutes of delivery so to me that suggests there was no concerns with the placenta taking a long time to detach and simply that she decided to hurry the process?? In my darker moments wondering if she wanted to finish her shift early as it was Christmas Day?? Although hopefully I'm just being presumptuous about that part. It's taken me months and months to feel well again as I wasn't given a transfusion as my levels were 'just' ok. I also then bleed constantly for 6 weeks when my periods returned so all in all I'm just so depleted it's been a difficult time when it should have been blissful with my toddler and new baby.

Any advice would be amazing thank you for reading xx

 

[MindUtopia]

So sorry you've had such a difficult time. Have you had a birth debrief? I'm assuming you have as you talked about your birth with a midwife. Were they able to offer any explanation for what happened? It is certainly possible that the midwife made a mistake and caused or made the bleeding worse. It sounds like perhaps she used cord traction? Which is pulling on the cord to get the placenta to come out. Cord traction is sometimes used when midwives need to speed up the birth of the placenta when there is a concern about bleeding or the cervix closing up and causing a retained placenta, but I don't think there's a whole lot of agreement on whether it reduces bleeding (that used to be the rationale for doing it - because it prevented PPH) or not, or might even cause more bleeding in some cases, like if the cord snaps or a bit of the placenta is retained (some comes out, but not all of it). It has often been standard practice in a lot of places, though I think it's falling out of favour now because there's no evidence it does much good. Certainly though, if she pulled the placenta out and a bit was left inside (which actually would make sense because of the bleed you had a week later), it could have been what caused the problem. Though it could also have been she was concerned about bleeding that was already happening, which is why she felt she had to intervene. Or it could be like you said, that she was in a hurry. So it's a bit chicken or egg really, and the midwife who went over your notes with you might be better able to explain why they did what they did, but again, it's possible there is nothing noted in your notes to explain it either.

If it helps put it in context though, I didn't have a PPH, though I did have a placenta that was a bit reluctant to come out. It took an hour and half for it to be delivered (no idea if they used cord traction as I wasn't really paying much attention, but I did have a managed 3rd stage after waiting over an hour for it to happen naturally). I also became anaemic after and my levels were really low (6 and 9) in the days immediately after birth, and it definitely took awhile to recover. I went through bouts of feeling really anaemic again for about the next year and a half. Taking Floravital and trying to up my iron levels with diet did help (took the tablets, Spatone, everything immediately after birth). But it was definitely rough and it took some time to recover. I feel fine now, but I'm 2.5 years pp.

 

[Xuxa]

I had a retained placenta that was removed manually. That was with my first delivery.
I just delivered my 5th baby 12 days ago and never had any problems like that ever again.
What makes you think that you won't be able to have another baby?

 

[dlj2]

So sorry you've had such a difficult time. Have you had a birth debrief? I'm assuming you have as you talked about your birth with a midwife. Were they able to offer any explanation for what happened? It is certainly possible that the midwife made a mistake and caused or made the bleeding worse. It sounds like perhaps she used cord traction? Which is pulling on the cord to get the placenta to come out. Cord traction is sometimes used when midwives need to speed up the birth of the placenta when there is a concern about bleeding or the cervix closing up and causing a retained placenta, but I don't think there's a whole lot of agreement on whether it reduces bleeding (that used to be the rationale for doing it - because it prevented PPH) or not, or might even cause more bleeding in some cases, like if the cord snaps or a bit of the placenta is retained (some comes out, but not all of it). It has often been standard practice in a lot of places, though I think it's falling out of favour now because there's no evidence it does much good. Certainly though, if she pulled the placenta out and a bit was left inside (which actually would make sense because of the bleed you had a week later), it could have been what caused the problem. Though it could also have been she was concerned about bleeding that was already happening, which is why she felt she had to intervene. Or it could be like you said, that she was in a hurry. So it's a bit chicken or egg really, and the midwife who went over your notes with you might be better able to explain why they did what they did, but again, it's possible there is nothing noted in your notes to explain it either.

If it helps put it in context though, I didn't have a PPH, though I did have a placenta that was a bit reluctant to come out. It took an hour and half for it to be delivered (no idea if they used cord traction as I wasn't really paying much attention, but I did have a managed 3rd stage after waiting over an hour for it to happen naturally). I also became anaemic after and my levels were really low (6 and 9) in the days immediately after birth, and it definitely took awhile to recover. I went through bouts of feeling really anaemic again for about the next year and a half. Taking Floravital and trying to up my iron levels with diet did help (took the tablets, Spatone, everything immediately after birth). But it was definitely rough and it took some time to recover. I feel fine now, but I'm 2.5 years pp.

Thank you so much for such a detailed reply, it really does help. I'm so sorry to hear you had a rough time as well. It does feel reassuring to know I'm not alone ( hope that doesn't sound bad of me) I've been taking floradix an iron tonic so that seems to be helping.
I did have a debrief but we only discussed when I was reassured after a week of being at home, so my birth notes as it were weren't discussed. The only thing she told me about my birth aspect was that the midwife had written that she 'pulled the placenta out' I asked about heavy bleeding afterwards as I remember the midwife saying if lost more blood than she expected, but in my debrief I was told that nothing was written in my notes regarding that and that sometimes midwives don't think what they are saying and it can be taken out of context.
As it stands at the moment I'm requesting my labour and delivery notes and after reading those I'll decide if I should take it further or if it was just one of those thing I'll never get an answer for.

In terms of me thinking u can't have another baby that just my thoughts based on the midwife telling me I'm at higher risk of it now happening again next time, and for me personally I just don't feel I can put my family through that risk and stress again.

They were unable to provide me with a reason for mine as I didn't show with an infection nor did the scan show retained products, they said they can only assume I had retained products but with such a big bleed and the fact I'd been loosing large clots at home that I'd passed it myself.

Thanks both for your posts I really do mean that xx

 

[Bebedeux]

I had the exact same thing. They manually removed it with an metal hook it took over an hour and it was the single most traumatic event in my life.

It did cause my pph I got 4units of blood after his birth and the rectal bruising was horrific.

However I did get pregnant it did take 7months but I did get pregnant.

The only thing it did to me was left me traumatised I had to get counciling and undergo cognitive behavioural therapy the pregnancy I'm fine with. The birth is a huge trigger for me and I spiral because of it.

Look into counciling aswel, the whole ordeal was deeply traumatic for me and left me bitter and jealous of other women's births.

Have you discussed the birth with your doctor??

 

[dlj2]

I had the exact same thing. They manually removed it with an metal hook it took over an hour and it was the single most traumatic event in my life.

It did cause my pph I got 4units of blood after his birth and the rectal bruising was horrific.

However I did get pregnant it did take 7months but I did get pregnant.

The only thing it did to me was left me traumatised I had to get counciling and undergo cognitive behavioural therapy the pregnancy I'm fine with. The birth is a huge trigger for me and I spiral because of it.

Look into counciling aswel, the whole ordeal was deeply traumatic for me and left me bitter and jealous of other women's births.

Have you discussed the birth with your doctor??

Dear bebedeux
I'm so sorry to hear you went through this too, I must say yours sounds worse than mine you poor thing. I had no explanation as to why the midwife decided to manually remove it and this leaves me feeling very cross as I want an answer.
How you describe your feelings is sooooo identical I find that now when I hear of people having babies I'm just waiting for something to go wrong, it's all very negative.
I did ask for counselling but I had to pay for my treatment due to nhs cuts and unfortunately I'm not able to finance that at present with being a stay at home mummy. I will look into other ideas on that tho.
Have you had your next baby yet? I wish you all the luck in the world for a lovely positive experience this time round.
Thank you so much for replying x

 

[mum140381]

mine was stuck with my 5th and they had to pull it out very painful
it hasen,t happened again with my 6th or 7th x

 

[MemmaJ]

Do you know if you had the injection at/straight after birth to help the placenta separate (usually into your leg)..? Have you received a copy of your notes yet, if you're not sure it should say it in there

 

[xQuinnx]

So sorry to hear you had such a traumatic time. I had a traumatic birth and had to have my placenta manually removed too, it was horrendous! 15 months on I'm having therapy for post natal PTSD and I can't tell you enough how much it has helped! We are even considering trying for #2 2016. Hope you feel better oon

 

[hayz_baby]

I couldn't deliver mine after ds3. I had him at home so I don't know how much this has affect it. It took over an hour for it to come out and I did heamorhage however it was a minor one if that makes sense. My iron levels were also low so I was taken to hospital as a precaution to be monitored. I was explained that because my placenta couldn't come out my body was throwing blood at it to get it out which clotted. I think I got lucky and it came out, however, as I originally requested delayed cord clamping I obviously wasn't given the injection. I was in so much pain trying to deliver this thing (give me child birth anyday) that I begged for the injection (I was willing to try anything) it came out not long after. Thinking about it I think they were pulling at the cord but tbh it was hazy...
I can't speak from experience afterwards but every labour is different. I guess my one bit of advice would be to do what you can to keep your iron up