Postpartum Hemorrhage: The Postpartum Experience I Wasn’t Prepared For
Being pregnant for me was like being a kid in a candy store. Literally. I ate whatever I wanted, whenever I wanted, because I was totally fine with packing on the pounds if it meant making sure my oven was warm, toasty, and nourishing to my little bun.
With this being my first child, I napped at my leisure and meticulously decorated my nursery with the notion that it would be seen and not touched. I planned to breastfeed and make my own baby food and fully expected my child to be a member of Mensa while never being sick a day in her life. Today, we’re six months in and only a handful of these things actually came to fruition.
When you’re pregnant for the first time, you have a tendency to daydream of your life beyond nine months. From pregnancy to labor and delivery, I had such visions of grandeur for myself. I wanted to do everything naturally for many health related reasons, but also to prove to myself that I could do anything I set my mind to as long as I was prepared. I had no idea that my birthing experience was going to be everything I didn’t plan for and then some.
Preparing for Delivery
To prepare myself for delivery, I read every book I could get my hands on. Birthing From Within, Ina May’s Guide to Childbirth, and HypnoBirthing were just a few of the many titles that lay beside my bed for me to reference in preparation for the most miraculous feat my body was to ever achieve. I spoke with women who themselves delivered without medication or intervention. I watched videos of water births and listened to the sobs of women who could take full responsibility for bringing their children Earth-side. I was convinced my experience would be just as simple and beautiful.
I learned amazing things about how my body would react as labor progressed, such as my hips widening, my cervix dilating, and the steady increase of uterine contractions to help lower my baby into the birth canal. All of this sounded so methodical, so matter of fact to me. These are things that happen to every woman during labor and delivery, and if I was mentally tough like the women I was reading about, I could endure it all without the need for any medications or interventions. Why, I could catch my own baby with my bare hands and a smile on my face if I really wanted to!
Reality Sets In
Fast forward to May 12, 2016. I survived 23 hours of labor, completely unmedicated and absolutely insane with fear and extreme pain. This was all due to my being ridiculously stubborn and not at all because the contractions felt like waves washing upon the shore like they said they would in my books. No. They felt like an alien was trying to tear through my abdomen to eat the Jimmy John’s sandwich I had abandoned three bites in the night before because I was too nauseous to finish it.
But I survived. After fending off my fight-or-flight reflex, I had a long talk with Jesus while I sat alone on the toilet. I decided I had made it this far and I wasn’t going to give in now. I walked out of that bathroom and after ten whole minutes of pushing, I saw the face of an angel appear from my nether regions, and all was beautiful and amazing in this world. Until I had to deliver my placenta.
Worst Case Scenario
My daughter was born with the cord wrapped around her neck three times. She was blue and unresponsive. This was both alarming and confusing to me in my state of euphoria. They cut her cord and handed her to the neonatologist while my Midwife went about helping me to deliver my placenta. While my umbilical cord was intact, it was incredibly thin by what I assume is most common standards, and she was concerned that if she tugged on it to get the placenta to lower it would sever. After a few more pushes (and a healthy, screaming baby nursing away at my breast) I delivered my placenta. At this point I was ready for another go at a Jimmy John’s sandwich when I heard what I can only describe as the sound of a waterfall suddenly appearing in the room. The delivery of the placenta brought on a hemorrhage to my uterus, and I was losing blood at a rapid pace.
My Midwife and nurses acted quickly by pressing hard on my abdomen from the outside to try to get it to contract. This went on for several minutes with little success, and despite their best efforts my uterus remained “boggy.” The details of this period of time are very foggy to me. I’m not sure if it was because I was losing so much blood and was in shock, or because I was just overstimulated and exhausted. Probably all of the above.
The pain of them pushing and kneading my uterus from the outside was almost as bad as what I had experienced during labor and delivery. I kept begging them to make it stop and for it to be over with. I pleaded out loud with God to help me and to save me. At one point my Midwife called for the doctor and told me they had to get the bleeding to stop or I was going to end up in the operating room. I couldn’t allow myself to be taken away from my baby or lose my uterus, so I bit my lip and prayed harder than I ever had before.
After an injection of Pitocin to get my uterus to contract, they were finally able to stop the bleeding. I lost over 1,000 cc’s of blood post-delivery and came within a hair’s length of needing a transfusion. My blood pressure was extremely low and I had trouble standing due to dizziness so I had to stay in the hospital for three days before being released to bring our baby home.
PPH (postpartum hemorrhage) is the leading cause of maternal mortality occurring in 18% of births in developed countries. Even with proper management, approximately 3% of vaginal deliveries will result in severe PPH.
In all of the literature I read and educated myself with, it never made mention of this as a possible scenario I might encounter. Obviously chances are slim given these stats, and there was nothing my Midwife or anyone could have done in the moment to prevent it, but a part of me would have appreciated the knowledge beforehand in spite of my inability to change the outcome.
But what caused the hemorrhage? Two weeks after delivery, I discovered that I had what is called a retained placenta.
A piece of my placenta still remained inside of my uterus and was causing heavier than expected bleeding, discharge, and severe pain. Simply put, when the placenta detaches from the uterus, there are blood vessels which get compressed by contractions that stop the flow of blood to that area. My uterus was not contracting as it should have been, thus rendering those vessels to bleed freely and inhibiting a portion of my placenta from exiting. A sonogram identified the remaining tissue and thankfully after a round of medication it removed itself without further intervention.
Who is at Risk?
If you’ve experienced a postpartum hemorrhage before, you are more likely to experience it again. Asian and hispanic women are also at a higher risk of PPH though doctors haven’t determined yet why that is. These conditions are also associated with PPH:
- Uterine atony (when the uterus doesn’t contract well after birth)
- Uterine inversion (when the uterus turns inside out after birth)
- Uterine rupture (when the uterus tears during labor)
- Retained placenta (when the placenta is not fully expelled after delivery)
Suffering from a retained placenta like I did is extremely rare. In fact, only 2% of deliveries are complicated by this unfortunate circumstance. While it is difficult to say with certainty that any specific risk factors can guarantee it will happen to you, these types of individuals are more likely to be affected:
- Women over the age of 30
- Preterm delivery before the 34th week of pregnancy
- Prolonged first or second stage of labor
- Having a stillborn baby
Childbirth is a miracle. What the female body can create and do amazes me each time I think about it. Having a baby is the happiest and holiest thing I have ever done in my life. It is my greatest achievement, honor, and privilege that is sadly denied to so many. But it is also scary and unpredictable, and ladies we can all admit that it HURTS! So, whether you’re opting for an epidural, plan to go all natural, or maybe for medical reasons will have a c-section, make sure you are educated in your choices and prepared for any outcome.
But, also keep in mind that anything can happen. As they say, the best laid plans of mice and men often go awry. Certainly no one knows this better than a mom!
Tags: babies, baby, birth, delivery, hospital births, labor & delivery, mom, motherhood, natural, natural birth, postpartum hemorrhage, postpartum issues, preparing for labor, unexpected situations, what to expect
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