Bag of blood

Postpartum Haemorrhage – Maternal Bleeding Post Birth

by | Feb 18, 2021

The complications of birth can sometimes be an afterthought for most mums. We are all focusing on a healthy pregnancy, preparing ourselves for a natural birth and smooth transition into parenthood, that we forget to remind ourselves that sometimes things don’t necessarily go as planned. As a midwife, I have seen it too often where things do go a little pear-shaped during pregnancy, birth and postnatally. This is why at BirthHQ we are so passionate about ensuring that mothers are educated in all areas of becoming a parent. Whether it’s good or bad, parents have the right to be informed in preparation for a journey that encourages self-determination and in turn empowering decision making that is knowledgeable.

There have been many times in my professional and personal life, where I’ve reflected on the birth of my third child. As I have previously shared, he was a chubby baby at birth and that was mainly due to the fact that I had Gestational Diabetes Mellitus (GDM) during my pregnancy. As I discovered during my birth, a larger baby increased my risk of a postpartum haemorrhage (PPH). A PPH is defined as excessive bleeding following birth and is generally more than a loss of 500mls for a vaginal birth and 1000mls for a caesarean birth (Queensland Clinical Guidelines 2020). Every woman is different to how their body adapts to the blood loss and therefore management is different depending on the situation and the woman.

Having had two births previously, I expected to have some blood loss similar to a menstruation cycle and had my maternity pads packed and ready to go post birth. After the birth of my son, I remember skin to skin was immediate and then very quickly my husband was asked to hold the baby as the midwife and obstetrician managed my blood loss. Being a midwife now, I know skin to skin and breastfeeding would have helped my uterus to contract and assist in reducing the chance of a PPH. I remember quite a busy birth suite as they rubbed my belly and gave me an oxytocin injection to assist the firming of my uterus. I also remember looking over at my son in my husband’s arms and falling madly in love with him. My hormones kicked into gear and my bleeding stopped. The obstetrician then advised the nurse and myself that if the bleeding recommenced, they would need to prep me for theatre. All of this was happening but still the feeling I remember the most was the love for that little boy in his dad’s arms.

I was returned to the ward and breastfed with no concerns. I finally had my baby and the blood loss seemed to have stopped. It was approximately 10 hours later that I fainted in the shower and when I woke up, I managed to call for help. It took me by complete surprise, and I was just grateful I didn’t have my baby in my arms at the time. The nurse took my vital signs, a cannula was placed in my arm and blood pathology was sent off. Within hours, it was discovered my PPH may have been a little larger than originally thought and a blood transfusion was administered. Complications at birth were discussed during my GDM management but having had relatively normal births previously, I still felt unprepared for a transfusion!! By the next day I was back to normal, rosy cheeks and happy to be a mummy of three beautiful children.

I had learned so much during the process and was bewildered by the talent of an amazing group of midwives.  I was so impressed that weeks later while at home with my baby boy, I enrolled to become a registered nurse and midwife. The team in the maternity unit responded to the PPH emergency with such calmness that I trusted the competent and safe care that was provided. According to the Mater Mothers Hospital (2017), only 5-10% of women giving birth experience a PPH. Having a PPH is not part of the normal birthing process but there are complications that could contribute to it. Risk factors may include but not limited to, a multiple birth, a larger baby, the placenta not separating from the uterus properly, a vaginal tear, and/or an assisted birth. We advise all mothers to be well informed of any possible complications specific to them. During this birth, I learned my blood group but most importantly that not every birth is normal and that each experience can deviate from the plan. The unexpected and unknown can be scary, childbirth education can make a woman feel empowered and supported.

This experience for me, demonstrated the importance of donating blood because you never know when you or a loved one may need it. If you’re interested in becoming a blood donor, please contact the Australian Red Cross for further information.

Be Prepared. Be Confident. Be Empowered. By Midwives.

Gillian
BirthHQ Midwife & Mum of Three

Gillian cuddling a baby in hospital

References

Queensland Clinical Guidelines. Postpartum haemorrhage Guideline No. MN18.1- V9-R23 Queensland Health.2020. Available from: http://www.health.qld.gov.au/qcg
Mater Patient Information. 2021. Postpartum haemorrhage – Mater Patient Information. [online] Available at: <http://brochures.mater.org.au/brochures/mater-mothers-hospital/postpartum-haemorrhage> [Accessed 1 February 2021].

 

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