Reducing risk of PPH

I didnt have Post Partum Haemorage last time, but had enough of a bleed to significantly drop my hb to almost needing transfusion.

I am wanting to have a home birth. Midwife is reading my notes from last time (diff midwife) to decide weather she happy to have homebirth, and then we will most likely do things to reduce the risk such as having a iv line in proir to birthing, and having syntocin to contract uterus, and bf asap after birth too.

I would like to know of natural ways to help reduce rick of pp bleeding please.

TIA!

Kellz - I was in the same boat, which was a big part of why I chose homebirth.

We had synto on hand, but only a single dose worth for if there were any issues birthing the placenta. It can sometimes have the opposite to it's desired effect and make bleeding worse.

I also stipulated NO cord traction, which means absolutely no-one pulling on the umbilical cord to 'help' you birth the placenta.

Breastfeeding as soon as you and baby are able is definitely important in terms of avoiding PPH as you would of course know it helps the uterus contract back down to it's regular size.

MrsH is also correct in that having a full bladder can hinder things, so making sure you try to pee during and after labour is important, as well as keeping hydrated enough to pee.

There are also herbal remedies you can take to help stop PPH in addition to pharmaceutical drugs, Shepherds Purse and Black Cohosh are two (I'm sure there are more but I can't remember).

Personally I would want to avoid having the IV lure in beforehand, I *hate* the feeling of them and to me it would have felt like I was undermining my own confidence yk?

If you want, flick me a PM (here or on Facebook) and I can find my birth plan for you which there is probably some more useful stuff in that I have forgotten already

Sorry for typos if any, doing the one handed chicken peck...

From the research I did on PPH, the less the placenta is interfered with, the less likely you are to have bleeding issues. Also, having had bleeding/PPH issues in a previous birth is not an indicator or risk factor for bleeds with future births.

Though I must admit I'm a little surprised that your mw hasn't addressed this aspect of your history sooner, *especially* since you are wanting to home birth.

With my first birth I lost nearly a litre post partum, and had a managed third stage, followed by a god awful 5 day recovery in hospital and 3 units of blood.

More recently however I made the decision to stay at home where I would be most comfortable and not have to enter an overly medicalised, fear filled environment.

Labour was 2hrs all up (compared to 13hrs previously), I had no excess bleeding issues whatsoever, and the placenta came away within 20 minutes - no traction or drugs required there either.

The thing for me was, with home birth, it meant anyone and everyone involved in the birth itself was on *my* turf and that I wouldn't have to ask permission for things. If you want to home birth, it is your right to put your foot down - had I not found the midwife I did (who was VERY flexible and openminded) I would have chosen to go the UC route.

I know homebirth is not everyone's cup of tea, but personally, it was the best decision I could have made for all of us.

If you can get your hands on a copy, I'd highly recommend having a read of Dr Sarah J Buckley's "Gentle Birth, Gentle Mothering" and in particular the section on third stage management.

There is also an article on this from her website that is a good read:

http://sarahjbuckley.com/articles/leaving-well-alone.htm


Another amazing blog you should check out is that of Australian homebirth midwife Lisa Barrett:

http://www.homebirth.net.au/

Here is a link to all of her articles / entries to do with the third stage of labour:

http://www.homebirth.net.au/search/label/Third%20stage%20of%20labour


I'll leave you with the following from the results of a study which was published in the New Zealand College of Midwives Journal:

Guilliland, K. (2007). The current global effort to prevent post partum haemorrhage: how likely is it to be effective? New Zealand College of Midwives Journal, 36, 28-31 wrote: In New Zealand about 30% of all women, with a midwife lead maternity carer (LMC) who is a member of the New Zealand College of Midwives' Maternity Provider Organisation (MMPO), have physiological management of third stage of labour (NZCOM, 2007). The women choose this option as a result of the informed consent culture in New Zealand. This allows them to assess their own risk and make their own decisions about care. Out of a total cohort of 12,061 women cared for by 369 midwives in 2004, the rate of PPH in those 30% of healthy women (who chose physiological management) was lower than that of the healthy women who chose active management (ibid). In NZ most women start their pregnancy with an LMC and some 78% in 2003 had a midwife LMC. (Ministry of Health, 2006). It is common therefore for midwife LMCs to have a mixed caseload of low to moderate risk women. They either provide care for these women on their own responsibility or they work in consultation with specialists. The incidence overall of PPH following vaginal birth in the MMPO 2004 cohort of mixed low to moderate risk status women was 8.3%. Of the women who chose an actively managed third stage, some 6% had a PPH of between 500 and 999mls, compared to 3% of women who chose a physiologically managed third stage. Some 1% of women in the actively managed group had a PPH over 1000mls. No women in the physiologically managed group had a PPH over 1000mls. Manual removal of the placenta was required for 0.4% of the women, and this was the same rate in both groups. The main incidence of PPH in this cohort, and in New Zealand in general, was not following spontaneous vaginal birth but was predominantly associated with operative birth both forceps and caesarean section (Women's Hospitals Australasia, 2005)."

If you've managed to get this far through my wee novel, and are interested in some more resources I'd be happy to hunt them out for you.

I'm in the same boat, Kellz.  I lost just under a litre of blood after having Jett (about 6 hrs later).  They say anything over 500mls is classed as a PPH.  My HB dropped to just over 80, and was about 96 before I gave birth.

 

MW is aware of this, and although I'm birthing in hospital, I'm still freaking out about it happening again.

Gee thats a bit extreme, dont think I'll be going there, lol, but thanks for all the other related articles!