PPH or Postpartum Haemorrhage or excessive bleeding after childbirth is the leading cause of maternal mortality worldwide. Preventing this condition is not easy and some studies show that it occurs in women without any risk factors in 20% of cases. Read a first-hand account of a woman’s experience of Postpartum Haemorrhage during her first pregnancy. Due to the sensitive nature of her experience, the author has chosen to remain anonymous.
Disclaimer: The opinions expressed in this article belong solely to the author. Miyara Women does not undertake any financial/reputational/legal/misrepresentational impact or other obligations/ liabilities that may arise from the content.
Please consult your physician for personalized medical advice. Always seek the advice of a physician or other qualified healthcare provider with any questions regarding a medical condition.
I was expecting my first child about a decade ago. The pregnancy was a breeze for the most part. Thanks to my gynecologist, I was active and upbeat as I had always been and was able to work till week 37. My gynecologist was traveling around my due date and I did not want an unknown doctor handling the delivery. So we decided to induce labor at the end of week 38. I prepared for D-day with enthusiasm: walking up and down 25 floors everyday (yes, you read it right!), practising labor breathing and floor exercises.
Induction and labor progressed as expected and the gynecologist decided to break my water bag (an additional intervention). At about 5 hours into labor, I requested an epidural as I was exhausted, super hungry and could not take the pain anymore. Then on, my labor progressed very well (apparently the crowning happened quick for a first-timer, according to the nurse) and I had a strong urge to push. However, at one point, I was asked to hold pushing as the crew wanted my gynecologist to be present when the baby came out. I did as I was told and eventually delivered my baby when the doctor returned. However, within a few minutes, I was told that my bleeding wasn't stopping and I was being transferred to the operation theatre.
From that point, all I remember is: the image of the lights above my table, gasping for breath as the team helped clear the froth from my mouth and being asked by my doctor to sign a consent form for surgery while in a trance state and unable to open my eyes, as I kept passing out in between. I woke up in the ICU about 8 hours after childbirth and discovered that I had had cardiac distress due to quick and heavy blood loss (hence the frothing). The team was left with no choice but to remove my uterus as it didn’t shrink back, leaving the blood vessels open. The condition is called uterine atony i.e. loss of elasticity. Loss of a very large volume of blood further led to failure of blood clotting (coagulopathy), further exacerbating the condition.
I was truly grateful to be alive, after having literally felt my body shut down slowly. The next 3 days were overwhelming, to say the least, both physically and emotionally. I was only able to meet my baby after about 30 hours as I was under observation in the ICU. However, my doctor encouraged me to breastfeed the baby irrespective of my health, which was a solace when I was feeling incapable in so many ways. But I couldn’t sleep a wink for fear of passing out again (this took more a week to settle down). Also, the question of “why me?” kept gnawing at my mind, especially during the lonely nights at the hospital. All of this, while was recovering from a major surgery that required multiple units of blood transfusion.
My Haemoglobin was at 7 g/dL (the normal level is above 12) when I was discharged on day 4. So I had to be in isolation and strictly no visitors were allowed. The silence in my house was deafening. My chest felt heavy if I walked while holding my baby due to low oxygen circulation. There was an instance when I went breathless inside a closed elevator in the second week, which only worsened my fears multifold.
Slowly, my mom nursed me to good physical health by 5 weeks and I was finally ready to make a public appearance. Forever grateful to my (usually pessimistic) husband who approached this situation with great positivity when I was feeling handicapped. After crying my eyes out for weeks, I was able to come to terms with the situation and stop self-blaming with the support of my family. This greatly helped me focus on the baby and, in the long run, not attach any negative emotions toward him that time of the year (anniversary effect), which have been widely reported in such traumatic cases. However, this had some repercussions on my mental health over the next few years (That’s for another post).
Being a researcher, I couldn’t just let it go. I read up and understood that the risk of such bleeding issues is higher with the use of epidural since it interferes with the way a woman’s body responds to labor and the natural pain management signals (endorphins). More so, when the labor is artificially induced, the contractions build up quicker and stronger than in natural labor, which puts the uterus under physical stress. Therefore, women who undergo induced labor are more likely to require heavy pain medication and request epidurals, and this combination did not work well for me.
Such uterine bleeding (postpartum haemorrhage, PPH) can be managed using some drugs or by temporarily cutting out the blood supply to the uterus to arrest bleeding. But none of these worked in my case. However, I feel lucky to have been in the hands of an efficient medical team that managed the situation and gave me a second chance at life. Sadly, this is not the case for many. Some other risk factors for PPH include episiotomy, placental position, prior cesarean section, augmentation of labor, gestational age, BMI and birth weight.
My understanding from this experience is that medical interventions during childbirth are commonplace these days but need not be availed of unless there is a genuine necessity. I do not mean to put epidural or labor induction in bad light. In fact, two of my friends had gone through the exact same procedure as mine (induction+ epidural+ breaking the water) and have had no such issues. But labor induction and interventions also have a flip side to them and do not work out the same way for everyone.
Therefore, I urge fellow women to gain a thorough understanding of the pros and cons of a procedure they are undergoing, especially during childbirth. Discuss with your doctors and other caretakers, take charge of your health, and make informed decisions. Not that mine was forced up on me, but in retrospect, I feel I should have done my homework ahead in time. I might have trusted my body better and waited for natural labor, and perhaps all the trauma could have been avoided.
As the author’s experience shows, PPH can be managed and treated with well-trained medical professionals, proper monitoring and support. However, women who have experienced PPH could have long-term psychological repercussions. In Part 2, the author will speak about dealing with the aftermath of her experience, and the effort she put into her recovery – both physical and mental.