A well managed emergency 🙂 The following has a load of “too much information” in it, mostly pertaining to post partum bleeding and hemorrhaging.
After our son made his entrance into the world flawlessly and in perfect health, it was time for me to climb out of the birth pool and retreat to my bed for some post-partum care: Assessment for tears and monitoring of the post-partum blood flow.
For those curious, the placenta was also birthed in the pool and was birthed whole with no fragments or pieces missing. We delayed clamping the cord until after the placenta had stopped pulsing, which was amazingly quick. Also, as I was getting out of the tub, pitocin was given to me via an injection.
I laid down on my bed which I had prepared by putting a plastic sheet on top of the sheets, then putting on another set of sheets overtop and finally another plastic sheet on top. Hoping up on our ridiculously tall bed was close to impossible because of my darn pelvis and the further injury it sustained during the birth.
They found a tear that required three stitches so they went to work stitching me up, all the while I was bleeding as expected after a birth. One of my midwives palpated my uterus and found it firm, yet off to the side. My bladder was becoming full, so I brushed it off and asked to be helped onto my recliner once the stitching was done. A firm uterus is a uterus that is contracting well. A boggy uterus is one that is not contracting and is potentially filling with blood and clots. This is why I call this my “silent hemorrhage.” My body likes to hide issues and be a tricksy hobbit.
My primary midwife helped me sit up on the side of the bed. The world was suddenly distant and I was no longer present. Voices and sounds were coming from some far away place and my vision became very dark and blurred. I whispered out “I’m going to pass out.” To my midwife whom immediately called out to my other midwife to come help as she laid my back down on the bed asking me to talk to her. I heard her requests for me to talk, but instead of responding, I was focusing on a spot on the ceiling and repeating in my mind “I’m not going anywhere. My kids need me. I’m not leaving.”
My midwife was now putting an IV into me while the other midwife was now on top of the bed, massaging my uterus. I hate the word massage in this context. To describe it more appropriately, my midwife was on the bed, putting all her arm strength into pulses/pushes into my uterus which caused massive clots and gushes of blood to expel. Pitocin was again administered. Once the blood had stopped coming with the uterine “massage,” they gave me a catheter to drain my bladder. And boy oh boy did it drain! In a matter of 10 minutes (I’d guess), I had lost 1.2 litres of blood and my midwifes had gained control of the situation.
The ambulance was called in the mean time and my IV was hooked up to a normal saline solution with more pitocin inside of it. My body, as awesomely overdramatic as it is, maintained a decent blood pressure. I think it managed to drop to 90/60 but almost immediately popped back up to 110/76. My norm is 118 over 80.
The ambulance show up and we decide that my primary midwife will stay with me overnight to watch over in case anything comes up again. I was stable and in good spirits at this point. We chat with the ambulance for a while and sign the forms saying that we were denying care at this point. There was no longer an emergency and I had two medical professionals with me still.
I have no idea what the time frame is like now, but at one point my son was brought to me and we attempted to nurse, but failed. Sometimes, I’m almost positive that babies know when their moms need to rest. He didn’t nurse for 13+ hours, but now he’s a pro.
The night continues on and I marvel in how amazing the birth experience was and how my 5-year-old had slept right through it. My mom and sister had taken seats to beside the bed and we all chatted. My husband was at the foot of the bed peering over. I apologize for scaring everyone. My blood pressure is normal.
At some point I look down at my feet and I notice that they are white. Yeah, I’m Caucasian, but I mean my feet are white! Hollywood-celebrity-teeth-white white.
“Go get my midwife, please…”
In a split second and completely out of the blue, I am freezing my damn butt off. Absolutely freezing! I’m shivering and my teeth are chattering so much that my midwife is concerned that I’m about to shatter my teeth. They’re trying to take my blood pressure while my husband puts socks on me and my mom and sister pile blankets on me, yet I can’t hold my arm still even though I am trying my damnest to hold my arm steady so they can take their reading. Eventually, they get the reading and my BP is fine. Go figure. My body is a drama queen.
They call the ambulance again after checking for more hemorrhaging, but my uterus is firm and three fingerbreadths below my umbilicus — right where it should be — and my bladder is empty. The blood flow is normal for a post partum mother, but my midwife gave me a dose of misoprostol/cytotec just in case. I had entered into shock about two-three hours after the initial hemorrhage. That’s pretty freakin’ delayed. And unnecessary. I was already stable, body. Duh!
By the time the ambulance comes, I am warm and cozy again… Just in time to stand up and be taken to the stretcher in the hallway (hallway is too narrow to allow the stretcher to get beside my bed). So I get out to the stretcher and am freezing my butt off again. Fortunately, I’m not shivering nearly as badly as I was before.
Little baby Keagan is strapped in his car seat and secured safely in the ambulance. My husband rides up front and I am in the back on the stretcher, randomly spiking a fever of 39.4 degrees celsius (just under 103 fahrenheit).
At the hospital, my blood is drawn to check for infections and complete blood count. I show no infections and my iron levels have dropped from 114 to 94 (11.4 to 9.4 in american measurements). Pretty much, the hospital visit ends up being of no real significance aside from the free breakfast and lunch 🙂
We are discharged just before dinner and back home we go.
A few morals to the story:
1. Pee. After you give birth, pee. I’m going to bet that this hemorrhage could have been avoided had I not been drinking coffee while in labor like an idiot.
2. Unassisted childbirth is dumb. Seriously. Get a health professional to be with you. You can educate yourself until the cows come home, but you will not have the equipment or medications needed to help you in an emergency.