Avoiding Post Partum Hemorrhage (PPH)

11 07 2012

One of the things that concerns laboring moms (particularly freebirthers, but not limited to these women) is a fear that they may “bleed out”, and experience post partum hemorrhage. “Oh, I’m a bleeder”. “Oh, all redheads bleed more.” Whatever. Whether this is true or not is usually not studied in such a way that we rationally take into account that various factors which lead to post partum hemorrhage. Know the causes and you can eliminate the undesired effect. Here are some scenarios.

Problem: laboring too long or too hard/fast.
Solution: Take it slow and easy. Sometimes birth is precipitous and sometimes it is slow, but if you are able to have control over the circumstances, we should take care to keep everything balanced. Labor on your own time. When labor is unhindered and undisturbed, things take their own course and tend to flow beautifully. This is not to say put a time frame on your labor. If you are consciously or subconsciously holding a stopwatch to your birth, you may be inadvertently sabotaging yourself. Your mentality will set you up to tense your body and create fear around your timing. However, if you’ve had a calm mind and body and instinctively and logically feel this labor has been too long or that something isn’t right, you may require additional expert medical assistance. Also, avoid purple pushing or letting someone else tell you when to push. Dilation of centimeters and counting to 10 to push are birth management techniques that are standardized, not personalized… your body is unique and playing by those rules (unnecessary exams, forced pushing or cessation of pushing) can lead to swollen cervices, hemorrhage, further invasive intervention, and worse. Letting the body push the baby out naturally in a normal birth has the gentlest impact on mother and child. Pushing only when you have the urge and being as easy on yourself as possible is very important.

Problem: having a disturbed birth space.
Solution: honor what mammals require during birth. Women are animals who experience a specific kind of brain activity in natural labor. Work with it, not against it, for a peaceful birth by providing them with dimness/darkness, warmth, quiet, and solitude (no feelings of being observed… even cameras may add to this). If you don’t, the consequences include activated fight/flight adrenaline response, heightening the mother’s fear (subconsciously or otherwise), thereby adding risk and difficulty to the birth for mother and child.

Problem: rushing the third stage (placenta delivery).
Solution: be patient and do not manually extract it. I took a nap after my 2nd stage of labor. This meant for a couple of hours, I ignored the third stage. I was exhausted. My baby and I needed to sleep, and I was comfortable and secure enough to know what was best for us, and I honored that.  Some women get really worried if the placenta doesn’t arrive after 20 minutes, or 1 hour. While some women can deliver the placenta within 10 minutes, there is no sense in panicking if yours doesn’t come right away. Give it time. Enjoy your solitude and warmth and peace and quiet in this stage. Getting freaked out and attempting to use cord traction or going to the hospital for a doctor’s manual extraction often leads to avoidable post partum hemorrhages. Remember… the placenta wants to come out. It’s meant to. Unless you are certain something isn’t right, don’t assume that something is wrong. If your instincts tell you to acquire assistance, follow through. If you retain placenta due to hasty interference, this will increase your risks of infection and PPH.

Problem: laboring on your back.
Solution: labor freely in positions that come to you instinctively.Being on your back is unnatural and makes labor longer and harder for you and baby. You want to allow labor to flow along, not impede it. Not only does back delivery increase tearing and produce more immediate blood loss, but the various effects stemming from the disadvantage of the position could stress the body out and increase PPH risk.

The baby actually has to move in a way not conforming well to the pelvis if the mother is on her back. This can distress the baby, overwork the uterus, and cause detriment to the mother.

Problem: being induced or having other unnatural interventions.
Solution: don’t give in to induction. Drugs can cause hyper-stimulation of the uterus. Forceps and other instruments can cause undue damage to mother and baby; simply laboring naturally on one’s own and in natural positions would eliminate their “need”. Blood loss can be significant with these invasive factors. Any stimulation of labor outside of the baby’s hormonal signaling of readiness to start is usually totally unnecessary. C-sections also increase the risk of PPH.

Problem: doing too much after the birth.
Solution: stay off your feet and get some rest. Spend time nursing your newborn in a cozy bed, darkened room, and have that one on one skin to skin time whenever possible. Skin to skin contact directly after birth is desirable, anyway, for the health of mother and baby (especially if the baby is premature). It is normal, acceptable, and healthy for  the mother and baby to stay in a relaxed and peaceful environment for many weeks after birth. Overextending yourself may not create a hemorrhage but could still result in excessive bleeding, so take care.

Most people will also tell you that how you look after your own health in pregnancy, specifically nutritionally, will have an impact on whether or not you experience post partum hemorrhage. Surely that (so eat healthy), these factors, and many more play a role in what your risk is. By eliminating as much of this static as possible, you increase the probability that your birth will be as peaceful and healthy as possible. Armed with this, you’ll be taking responsibility for your birth and doing the best you can to have the safest outcome for you and baby.

If you fear your bleeding may be a bit excessive after birth, consider consuming some placenta. Swallowing it raw can reduce bleeding greatly and quickly. Avoid rough uterine massage as that can increase pain and bleeding. Things you need to watch for are fever, symptoms of shock, and long, slow, steady excessive bleeds. None of this is to be construed as medical advice. Do your own research and be well.



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