What happened during my delivery?

[EOOSTHOEK84]

Hi all,

So, I know I will probably never get an exact answer as to what happened during my labor and delivery, but I want to get some opinions and thoughts about it. It's a novel, just FYI.

Here goes:

I had a relatively easy, uneventful 9 months- no sickness, cravings, problems, etc. I had two cervical checks, one at 36 weeks and one at 38 weeks. I was 80% effaced and no dilation at 36 weeks and 80% effaced and a fingertip to 1 cm dilated at 38 weeks.

At 38 weeks, 6 days (a Saturday), I cleaned the house and finalized the nursery. I felt pretty good all day, nothing out of the ordinary. I had been having some pressure really low for weeks, but not much else. We went to bed around 11pm and I woke up to use the bathroom at 2 am. When I got back into bed, I feel asleep for maybe 10-15 minutes and then turned over onto my other side and felt a trickle. Not huge like a gush, but definitely a warm trickle. I went into the bathroom and had a wet spot of my pjs (see picture, if interested). I wiped and had some blood, pretty bright pink/red, but not a whole lot of it (see picture, if interested). No mucus at all. This startled me as I had NO bleeding AT ALL throughout my pregnancy. So, I woke up my hubby and discussed what to do. I planned to labor at home as long as possible, but the blood really got me nervous. I had a bit more blood when I used the bathroom the next time, but no more fluid that I could tell. So, I showered and did laundry and then headed to the hospital at 4 am. Hubby was nervous so we went

When I got there, the nurse checked me and I was about 1 cm dilated and no more fluid had come out, but still had a bit of spotting when I used the bathroom. She seemed doubtful that it was amniotic fluid because it had stopped coming out, but did seem somewhat perplexed when she had me cough. I'm guessing she saw some then. So, she did a test for it (the test where they lay the strip inside of you for a minute) and it came back positive for fluid and I was admitted. Oh, I also had no contractions at this point- that I could tell anyhow.

So, I got to my room and started walking around the halls for about 2 hours to try and get things going. I think I had mild contractions at this point, however, this may have been more in my head and was over thinking my pressure pains Nothing "hurt", I think I was just more aware of everything going on.

I got checked again a bit later (by a different person) and was 1-1.5 cm dilated (if I remember correctly). So, no more fluid, no more bleeding, and no substantial dilation increase. They wanted to start pitocin at this time, but I asked to hold off a bit. I was very much striving for a completely natural childbirth. I did end up getting pitocin a few hours later (I think around 10 hours after the trickle at home, but things still moved very slowly. Contractions were registering on the monitor now, pretty high too, but I really didn't feel them. I got checked again and was at 2 cm. At this time, the nurse said I had a full bag of water and wanted the doctor to come in and check. Oh, also, my doctor was out of town and I had an on-call doctor.

So, over the next few hours, the decision was made to break the bag of water. Oh man, what a gush! And it never stopped haha it would keep gushing randomly, usually with contractions, which really picked up at this point. I had 2 rounds of INTENSE contractions, all on top of each other, no break in-between, for about 30 minutes each round. One round was on the birthing ball, one in bed on all 4's. The whole team (nurse, doctor, doula) assumed this was transition due to the pain, length, and intensity of the contractions. I got checked again, and was only 4 cm dilated!

At this point, I was exhausted and frustrated, so I got an epidural on the advice of the medical team. They wouldn't let me labor in the tub due to
having pitocin and they hoped I would relax with the pain meds. Well, I did relax fortunately and ended up going to 9 cm in about 3-4 hours. They had me lay in various positions to speed up dilating the last cm. Within another half hour I started pushing. I think I pushed for about 1.5-2 hours total and delivered a beautiful baby girl. She did need NICU within our room because she wasn't very alert from being in the birth canal so long and also the cord was around her neck. Within minutes she was fine though. I also had a 2nd degree tear.

Everything was great until about 3-4 hours after birth. I had used the bathroom and was fine, but when I went the second time I started bleeding quite a bit. I asked my hubby to get a nurse just to check, when all of a sudden I started gushing blood and huge clots. About the size of a grapefruit each and the toilet was filled to the rim. The nurse actually looked scared when she came in and somewhat panicked while calling for back-up. I ended up getting very dizzy and somewhat fell onto the nurse for support so they brought in smelling salts to get me alert again. I was transferred back to my bed and about 6 nurses worked on me to get the clots out The pain of them pushing on my abdomen to expel the clots was worse than labor and delivery. They called my OB at this point (he was back in town and saw me about 2 hours after I delivered). His office is right next to the hospital so he ran over, literally. He seemed concerned as well as ordered another round of pitocin, which didn't work. I ended up having a D & C and bled lightly for about 6 weeks after birth. I ended up losing over half of my blood and had to have a stitch in my cervix. No placenta was retained.

From start to finish, it was 27 hours.

So, what happened? What do you think it was the night I felt the trickle? Was it my water breaking? What about the blood with it? Was I not ready to have the baby and was induced? Why the postpartum hemorrhage? My doctor never answered these questions for me, and I feel like I need some insight into my birth experience and why things happened the way they did. Just looking for thoughts and opinions.

 

[feedindy]

Well I don't think anything went "wrong". Every labor is different. PP Hemmorage just happens sometimes. Usually they check the placenta to make sure it all came out, but maybe you just retained a tiny piece and that is why you bled. The fact that your water broke in the middle of the night doesn't have anything to do with the PP hemmorage.

In the US when your water breaks, the hospital usually has a policy to have the baby out within 24 hours (because there is a higher risk of infection), so that is why they gave Pitocin. They don't "need" to give it to you, but they usually do if your water breaks and that 24 hour time limit is going, and your contractions aren't really moving things along. But these things have nothing to do with the bleeding you experienced. I actually had a similar experience with my first baby (minus the bleeding). Water broke at night, but no contractions that I could feel for like 12 hours, so I got the Pitocin.

 

[lily28]

Everything sounds pretty much normal, nothing out of the ordinary. This is what goes on with induced labors and births.

Here are my thoughts, but please don't feel offended, I'm just telling you what I personally believe and because you need answers that the doctors wouldn't give you.

The first trickle sounds like it was a small tear in the amniotic sac and you could leak for 1-2 days without problems for you or the baby. I think you were a bit hasty to go to the hospital.
In the perfect scenario you could labor at home for many hours or days, being relaxed, watching movies, listening to music, taking baths etc.
Running to the hospital with either a bit of laboring, or a bit of leaking they put you on pitocin to give birth quickly. It is what they do.

You weren't dilating fast enough for them, so they gave you pitocin and broke the waters, which brings very intense labor pain without much of an interval. I know because I was also induced and had water broken artificially as I was overdue.

Then you accepted the epidural, which is fine since laboring on pitocin is pretty harsh. I didn't because I knew I was induced and I was prepared beforehand, so I was managing the pain.
However epidural makes laboring and pushing take hours. You could have the baby within 30 min-1 h from the time the waters were broken because of the pitocin, but the epidural makes things slow down significantly.

She did need NICU within our room because she wasn't very alert from being in the birth canal so long and also the cord was around her neck.

The baby wasn't alert because of the epidural, not because of the birth canal or the cord. Ask your pediatrician about this, not a gynecologist.

As for the clots/bleeding and how they handled it: They didn't keep you in the recovery room (outside the surgery room) long enough to see if your uterus was contracting normally, obviously it didn't and thus the heavy bleeding and why they were freaked out. It was entirely their fault, they should be experienced enough to know better.

What causes postpartum hemorrhage?
Once a baby is delivered, the uterus normally continues to contract (tightening of uterine muscles) and expels the placenta. After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta remain attached, bleeding is also likely.

A few things that cause this bleeding is prolonged labor, medications to induce labor, and a tear in the cervix, among others

I don't understand why your doctor didn't explain all these things to you...

I'm glad you are fine now!!!

BTW I had lochia for 10 weeks, so 6 weeks bleeding is very normal.

Congrats on your baby!

 

[laila 44]

Everything sounds pretty much normal, nothing out of the ordinary. This is what goes on with induced labors and births.

Here are my thoughts, but please don't feel offended, I'm just telling you what I personally believe and because you need answers that the doctors wouldn't give you.

The first trickle sounds like it was a small tear in the amniotic sac and you could leak for 1-2 days without problems for you or the baby. I think you were a bit hasty to go to the hospital.
In the perfect scenario you could labor at home for many hours or days, being relaxed, watching movies, listening to music, taking baths etc.
Running to the hospital with either a bit of laboring, or a bit of leaking they put you on pitocin to give birth quickly. It is what they do.

You weren't dilating fast enough for them, so they gave you pitocin and broke the waters, which brings very intense labor pain without much of an interval. I know because I was also induced and had water broken artificially as I was overdue.

Then you accepted the epidural, which is fine since laboring on pitocin is pretty harsh. I didn't because I knew I was induced and I was prepared beforehand, so I was managing the pain.
However epidural makes laboring and pushing take hours. You could have the baby within 30 min-1 h from the time the waters were broken because of the pitocin, but the epidural makes things slow down significantly.

She did need NICU within our room because she wasn't very alert from being in the birth canal so long and also the cord was around her neck.

The baby wasn't alert because of the epidural, not because of the birth canal or the cord. Ask your pediatrician about this, not a gynecologist.

As for the clots/bleeding and how they handled it: They didn't keep you in the recovery room (outside the surgery room) long enough to see if your uterus was contracting normally, obviously it didn't and thus the heavy bleeding and why they were freaked out. It was entirely their fault, they should be experienced enough to know better.

What causes postpartum hemorrhage?
Once a baby is delivered, the uterus normally continues to contract (tightening of uterine muscles) and expels the placenta. After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta remain attached, bleeding is also likely.

A few things that cause this bleeding is prolonged labor, medications to induce labor, and a tear in the cervix, among others

I don't understand why your doctor didn't explain all these things to you...

I'm glad you are fine now!!!

BTW I had lochia for 10 weeks, so 6 weeks bleeding is very normal.

Congrats on your baby!

I'm not sure baby was like that because of the epi. I had a 26 hr failed induction on oxytocin and several epidurals and top ups as it never took properly and my baby was fine. Born very alert and no need to go to nicu. So I don't think it's fair to say that it was due to op choosing to get an epi and not because of the cord. Also, although pp hemorrhages happen I would definitely talk to your ob. Where the hell was he when u were bleeding? Why were nurses working on you? That sounds crazy a staff dr should have been called in immediately. I'm sorry you had to get a stitch put in as this can weaken your cervix greatly in future pregnancies... Talk to your dr. Hope u are better xx

 

[lozzy21]

I think the hospital were far to keen to get you in and get baby out. Chances are if they had sent you home and gave labour a chance to get going on its own you would have had an easier time. A small amount of blood is normal as labour starts, it gets called a bloody show.

 

[amjon]

Everything sounds pretty much normal, nothing out of the ordinary. This is what goes on with induced labors and births.

Here are my thoughts, but please don't feel offended, I'm just telling you what I personally believe and because you need answers that the doctors wouldn't give you.

The first trickle sounds like it was a small tear in the amniotic sac and you could leak for 1-2 days without problems for you or the baby. I think you were a bit hasty to go to the hospital.
In the perfect scenario you could labor at home for many hours or days, being relaxed, watching movies, listening to music, taking baths etc.
Running to the hospital with either a bit of laboring, or a bit of leaking they put you on pitocin to give birth quickly. It is what they do.

You weren't dilating fast enough for them, so they gave you pitocin and broke the waters, which brings very intense labor pain without much of an interval. I know because I was also induced and had water broken artificially as I was overdue.

Then you accepted the epidural, which is fine since laboring on pitocin is pretty harsh. I didn't because I knew I was induced and I was prepared beforehand, so I was managing the pain.
However epidural makes laboring and pushing take hours. You could have the baby within 30 min-1 h from the time the waters were broken because of the pitocin, but the epidural makes things slow down significantly.

She did need NICU within our room because she wasn't very alert from being in the birth canal so long and also the cord was around her neck.

The baby wasn't alert because of the epidural, not because of the birth canal or the cord. Ask your pediatrician about this, not a gynecologist.

As for the clots/bleeding and how they handled it: They didn't keep you in the recovery room (outside the surgery room) long enough to see if your uterus was contracting normally, obviously it didn't and thus the heavy bleeding and why they were freaked out. It was entirely their fault, they should be experienced enough to know better.

What causes postpartum hemorrhage?
Once a baby is delivered, the uterus normally continues to contract (tightening of uterine muscles) and expels the placenta. After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta remain attached, bleeding is also likely.

A few things that cause this bleeding is prolonged labor, medications to induce labor, and a tear in the cervix, among others

I don't understand why your doctor didn't explain all these things to you...

I'm glad you are fine now!!!

BTW I had lochia for 10 weeks, so 6 weeks bleeding is very normal.

Congrats on your baby!

The MFM and OB both told me epi/ spinal don't effect the baby. They didn't want GA for me because IT does make baby groggy. Mine both came out perfectly alert and I had to have anti anxiety meds for the spinal on top of it they were worried could effect them. The way the epi/ spinal works keeps the bab(ies) from being effected by any medicine in it.

 

[lily28]

^ Not really, again, ask a pediatrician about it. Epi goes through the bloodstream and it does effect the baby. There is a real risk of apnoea for the baby. Also because of the baby's immature liver, these drugs take a long time- sometimes days- to be cleared from the baby's body.

This research shows that supine position plus epidural was associated with a significant decrease in the oxygen supply to the baby’s brain (fetal cerebral oxygenation)
C. J. Aldrich et al., “The Effect of Maternal Posture on Fetal Cerebral Oxygenation During Labour,” Br J Obstet Gynaecol 102, no. 1 (1995)

I'm not anti epidural btw, just stating the facts, and we should all be well educated on the facts before making decisions that could affect both ours and our baby's health. Epidural is a better choice than GA during a c section btw.

Don't expect any medication to be without side effects.

 

[justhoping]

Everything sounds pretty much normal, nothing out of the ordinary. This is what goes on with induced labors and births.

Here are my thoughts, but please don't feel offended, I'm just telling you what I personally believe and because you need answers that the doctors wouldn't give you.

The first trickle sounds like it was a small tear in the amniotic sac and you could leak for 1-2 days without problems for you or the baby. I think you were a bit hasty to go to the hospital.
In the perfect scenario you could labor at home for many hours or days, being relaxed, watching movies, listening to music, taking baths etc.
Running to the hospital with either a bit of laboring, or a bit of leaking they put you on pitocin to give birth quickly. It is what they do.

You weren't dilating fast enough for them, so they gave you pitocin and broke the waters, which brings very intense labor pain without much of an interval. I know because I was also induced and had water broken artificially as I was overdue.

Then you accepted the epidural, which is fine since laboring on pitocin is pretty harsh. I didn't because I knew I was induced and I was prepared beforehand, so I was managing the pain.
However epidural makes laboring and pushing take hours. You could have the baby within 30 min-1 h from the time the waters were broken because of the pitocin, but the epidural makes things slow down significantly.

She did need NICU within our room because she wasn't very alert from being in the birth canal so long and also the cord was around her neck.

The baby wasn't alert because of the epidural, not because of the birth canal or the cord. Ask your pediatrician about this, not a gynecologist.

As for the clots/bleeding and how they handled it: They didn't keep you in the recovery room (outside the surgery room) long enough to see if your uterus was contracting normally, obviously it didn't and thus the heavy bleeding and why they were freaked out. It was entirely their fault, they should be experienced enough to know better.

What causes postpartum hemorrhage?
Once a baby is delivered, the uterus normally continues to contract (tightening of uterine muscles) and expels the placenta. After the placenta is delivered, these contractions help compress the bleeding vessels in the area where the placenta was attached. If the uterus does not contract strongly enough, called uterine atony, these blood vessels bleed freely and hemorrhage occurs. This is the most common cause of postpartum hemorrhage. If small pieces of the placenta remain attached, bleeding is also likely.

A few things that cause this bleeding is prolonged labor, medications to induce labor, and a tear in the cervix, among others

I don't understand why your doctor didn't explain all these things to you...

I'm glad you are fine now!!!

BTW I had lochia for 10 weeks, so 6 weeks bleeding is very normal.

Congrats on your baby!

I'm not sure baby was like that because of the epi. I had a 26 hr failed induction on oxytocin and several epidurals and top ups as it never took properly and my baby was fine. Born very alert and no need to go to nicu. So I don't think it's fair to say that it was due to op choosing to get an epi and not because of the cord. Also, although pp hemorrhages happen I would definitely talk to your ob. Where the hell was he when u were bleeding? Why were nurses working on you? That sounds crazy a staff dr should have been called in immediately. I'm sorry you had to get a stitch put in as this can weaken your cervix greatly in future pregnancies... Talk to your dr. Hope u are better xx

Im a nurse and a mama of r4 and what above you is someones opinion and boy is it misinformed..@@

Im sorry, just because its done different then the UK doesnt mean everything said above. I had pit and epi's and nothing happened to my babies in fact it helped and saved there life.

 

[justhoping]

^ Not really, again, ask a pediatrician about it. Epi goes through the bloodstream and it does effect the baby. There is a real risk of apnoea for the baby. Also because of the baby's immature liver, these drugs take a long time- sometimes days- to be cleared from the baby's body.

This research shows that supine position plus epidural was associated with a significant decrease in the oxygen supply to the baby’s brain (fetal cerebral oxygenation)
C. J. Aldrich et al., “The Effect of Maternal Posture on Fetal Cerebral Oxygenation During Labour,” Br J Obstet Gynaecol 102, no. 1 (1995)

I'm not anti epidural btw, just stating the facts, and we should all be well educated on the facts before making decisions that could affect both ours and our baby's health. Epidural is a better choice than GA during a c section btw.

Don't expect any medication to be without side effects.

I'm well informed my medical school informed me so did my OB. You know what they say about google...lol
Don't!

 

[lily28]

OB is not a pediatrician, I highly suggest you talk w/ your pediatrician.