Pph prevention

[rachieroo]

So I know it's a little early to be too worried about labour and delivery but I had quite serious hemorrhaging after both my girls were born.

I'm looking for any advice on how I can help this be avoided this time. I know there is no guarantee that anything will work but I'm willing to try so that I can avoid going through that again. Thanks

 

[AliJo]

I honestly don't know but it would be a good thing to bring up with your doctor. The only advice that I could give would be a healthy diet with good nutrition. A well nurished body heals and manages better.

 

[ChickenMommy]

Can they give you a shot of pitocin after delivery? When I had #2, his labor was incredibly fast (1hr 23min from first sign of labor to crying baby) and as soon as he was out they gave me a shot of pitocin in my arm to prevent a hemorrhaging. Perhaps thats an option? Admittedly, I dont know a ton about pph, so forgive me if the pitocin is something they usually do. I know red raspberry leaf is great for your uterus and can help it shrink back down quickly after delivery and some quick googling says that it can help prevent pph. So that could be an option to start now. I took it with #2 (probably the reason my labor was so fast) and am taking it this time around as well. I didnt even really have to push. My body did all the work for me on its own. It was amazing. Crossing my fingers that you dont have to go through that again. Im sure its terrifying.

 

[MindUtopia]

The best thing you can do is to avoid the things that increase your risk of PPH (like being induced), make sure the room after birth is kept dimly lit and quiet and relaxed, and consider having a managed 3rd stage.

Induction with synthetic oxytocin (pitocin) increases the risk of PPH by 80%. So if you can avoid anything that starts or augments your labour, have a natural, spontaneous birth with few interventions, that will greatly decrease the chances of another PPH. What prevents PPH is your uterus being able to effectively contract, sheer off the placenta, and then contract down closing off the blood flood from the uterine wall at the site where the placenta had attached. This needs oxytocin to happen and oxytocin being a love hormone flows best when the room is dark, quiet, you're relaxed, there aren't a million people flapping about in a panic, and when it isn't already overly tired. Induction causes the uterus to contract unnaturally hard during labour, so by the time to get to the 3rd stage, you can get some atony, which is basically when the muscles of the uterus are so tired, they can't contract when they are supposed to, so if you start to bleed, they can't stop it. Avoiding induction means you avoid the risk of uterine atony just because your uterus has contracted too hard during labour. Further, if you can request that after baby is born that the lights are kept low (just enough for them to see what's going on), people stay quiet, you have skin to skin or even latch baby on for a feed if you plan to BF, whatever it takes for you to feel relaxed and for the room to be calm and quiet and dark.

Beyond that, if you haven't opted to have a managed 3rd stage already, that would be something I'd consider. In a normal, spontaneous, natural birth with no interventions, it's often best just to leave things to happen on their own. Your body will produce the hormones in the right balance to contract down the uterus and stop any bleeding, if all else is well. So if you have a totally natural intervention-free birth, it might be best just to leave it and let your body do it. But if it hasn't been intervention free or for added peace of mind, management of the 3rd stage can reduce blood loos and prevent a PPH. I'm assuming they would have encouraged you to opt for one last time as well, but if not, I'd consider going this route too.

 

[rachieroo]

Thank you for the advice. I was induced with my second daughter and would like to avoid that if possible anyway but if it reduces the risk of pph then I'm definitely putting that as a last resort.

I had read that delayed cord clamping may help reduce the risk too.

This is the only thing I am afraid of this time around

 

[frangi33]

I'm having a consultant led birth for this reason, they will be dosing me with pitocin as soon as baby is born or about to be to reduce the chances of another pph.

If you've had 2 bleeds previously I would have thought your midwife would also recommend you for a consultant led birth so they can manage the risk.

 

[sippy1989]

How were your iron levels? I've read anemia is a risk factor for pph. Maybe have that Checked closer to due date?

 

[BunnyN]

Like others have said an induction is a big risk factor. If you do need to be induced for some reason then not trying to rush the pitocin levels can help. They can often turn down the drip once labour has gotten going.

I had quite a big bleed with DD which counted just short of a PPH. I think it was because of having a very long labour and a big baby so my uterus was tired. I bled a bit less with DS but still more than average. I had a MC before this pregnancy and had a severe haemorrhage and went into shock and almost died. Because of my history the MW says we should consider a controlled 3rd stage this time. Normally she is quite pro natural and so am I but I'm thinking it might be a good idea. Many hospitals do it as standard practice. I would have thought that is what you already had with your second birth, if not both.

 

[SleepyBaby]

I had a large PPH with my 1st, i was induced and i am pretty sure that caused it, everything was all drama, all the monitors and it all made me so nervous, the induction itself was to fast and strong ( the doc had told the midwife to hurry along with me as he had a vaginal op to do later that day!) everything had me overthinking and panicy!

with my 2nd it was more mellow, i had the morphine? thingy drip on the go ( 7 days of contractions every 9 minutes pushed the "no big drugs" plan out the window) and i slept through the second stage once i got the drip in,( i woke up to press the button then went back to sleep as soon as it kicked in) 15 minutes of pushing everything was just more laid back and relaxed, they had a team waiting incase i had another PPh so i knew all areas where covered and just went with it, everything went well!

 

[smileyfaces]

I had a PPH with #2. I will be bringing it up when I see my consultant in a few weeks.

 

[xsadiex]

I had a small PPH with my first and a bigger one with my second.

It totally baffles me because both were lovely relaxed homebirths!! My babies were quite big which can increase the risk.

I'm totally confused as to why it happened and I really want to talk to a professional about it in detail.

Hugs! It's a scary prospect, good luck to us all this time. I will try everything possible I think. I don't think I will be getting another homebirth though, sad times!

 

[LoraLoo]

Ive been told im having a managed 3rd stage, although for me I feel this is not necessary, im at risk of pph due to having so many babies, but it's never happened before. I'm going to avoid it if possible, im asking for it only if my placenta doesn't come away on it's own, but if Id had 2 in the past, that's the route Id go down.

 

[rachieroo]

Thank you everyone.

I did have a managed 3rd stage with both of my girls and I was not anaemic. In fact I took iron daily from about 26 weeks with my second so to prepare my body.

My first pph was worse than my second. My hb level was half what it was supposed to be.

I am consultant led and will be seeing him on Thurs so will ask him then. I will update you all with what he says x