Thursday, July 7, 2011

A note about post-partum haemorrhage.


PPH is defined as excessive bleeding from uterus any time following birth up to 6 weeks post-partum. PPH usually occurs as a result of birth trauma (such as instrumental birth, pulling on the cord/placenta), retained placenta, anaemia, or atonic uterus (no tone). Signs & symptoms include: pale skin, increased pulse rate, decreased BP, drowsiness or restlessness, uterus may enlarge (fills with blood).
What to do? – 
  • Prevent anaemia during pregnancy with adequate iron, B12, & folate stores, as women who are anaemic are at higher risk. A diet high in organic leafy greens and fruit will supply this sufficiently however if you have experienced any compromise to your gut it would be wise to take a b12 supplement.
  • Deciding on a physiological (ie: ‘hands off’) third stage with care providers leaving the placenta alone.
  • If haemorrhage occurs, putting the baby to the breast releases maternal oxytocin which stimulates the uterus to clamp down. Biting or sniffing the placenta has also helped due to it’s rich store of oxytocin. Herbs such as shepherd’s purse (30 drops under tongue) can stop PPH. 
  • If you are in hospital or a birth centre, the midwife will first determine if the uterus is firmly contracted or atonic to figure out a possible cause. If atonic they will want to give syntocinon (synthetic oxytocin) & perform uterine massage to expel clots (rubbing on a contraction). If the placenta isn’t birthed they will also want to give syntocinon, manual removal may be attempted, or surgery may be suggested.  However, retained placenta(with or without haemorrhage) may also be treated herbally as well.). 

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