Fear of bleeding after birth is making me afraid to deliver at home

I want to have a home birth but have been worrying about bleeding after delivery. What happens if the bleeding gets too heavy? How do the midwives control this? Is this something that happens alot?
I have been worrying about this alot and I'm afraid it's going to bother me to the point that I'm afraid to deliver at home because of fear of bleeding to death. Is this a common or normal worry?

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I am a student midwife, but I will try to answer your question. I am in Switzerland, so it may be slightly different where you are.

It is normal and healthy to talk about your fears. It's a valid question. True postpartum hemorrhage (too much bleeding after birth) is quite rare, especially if you have an un-managed labour, birth, and physiological third stage. That said a trained midwife should have no problem addressing a postpartum bleed and will have protocol in place in case of a need to transport to hospital.

A trained midwife will often discuss with you, third stage management (what happens after your baby is born) during your prenatal visits. She will discuss with you, your previous births (if applicable) and how those went with your third stage. She is likely to discuss your preference and her protocol for third stage. You can have a physiological third stage. Meaning your baby's umbilical cord will remain attached (uncut) until it stops pulsating and the placenta will detach and be expelled by you naturally without the use of drugs (pitocin) barring medical complications. Likely you will be encouraged to hold your baby skin to skin and attempt nursing very soon after the birth to help with the detachment and passing of the placenta. This is what will happen in the majority of births.

Sometimes women bleed more than "normal" after delivery and then you will have a "managed" third stage. The level of bleeding can vary and doesn't always mean there is a problem, necessarily. Very likely your midwife will give you an injection of pitocin to stimulate your uterus to clamp down and expel the placenta. Different midwives have different ways of managing postpartum hemorrhage/bleeding. Some will try herbs first. Some will go straight to pharmaceutical management. It is definitely something to discuss, so you will know what the plan is in case of postpartum hemorrhage. All midwives will have a plan for this.

Remember your midwife is a trained medical professional with the skills and equipment to manage the minor complications that arrive. They will also have protocol in place for major complications. These are things to discuss during interviews and during your prenatals.

I hope this has helped you a little. It's important to address your fears and discuss them. A problem shared is a problem halved. :)
I delivered my first baby at a free-standing birth center and my second baby at home and both times I had more bleeding than my midwife felt comfortable with and I was simply treated with an injection of pitocin.
As Olivia said, speak with your midwife about your concerns and I'm sure she'll be able to allay your fears.
Good luck!
No need to worry! Certified Nurse Midwives carry pitocin, just the same treatment as you would receive in the hospital. Don't forget--they are trained to deal with just these kinds of concerns. Talk to your midwife about what the options are for hemorrhaging!
Courtney Poulos said:
No need to worry! Certified Nurse Midwives carry pitocin

Many Certified Professional Midwives also carry pitocin. Also, many midwives carry herbs to control hemorrhage and others recommend the use of placenta.
Also, find yourself a copy of Sprirtual Midwifery by Ina May Gaskin. I read it when I was pregnant with my first and it changed my life. Seriously.

Jenn George said:
Almost all Midwives (CPM, CNM, LM, TM) have either herbs, pitocin or both to control bleeding. If there is something wrong that they can't deal with they will either call 911 or drive you to the Hopsital themselves. I would discuss this with your Midwife, tell her this is a fear and what she can do about it if it happens. The Baby Catcher by Peggy Vincent is a book about Peggy who is a Midwife and its pretty much all stories of her births that she attended. I think its a great book to read because it addresses these same fears and problems people have. I am also going to have a homebirth with my next baby and this is a fear of mine aswell, even as being a student Midwife myself. Its completely normal to have fears or doubts, just make sure you discuss them. Good luck to you!
It is normal to worry.

Midwives do carry pitocin shots, at least some do, so if nothing else works before a transfer is done they would inject pitocin into you. That would be my last resort option.

Some common solutions are nursing, which helps clamp the uterus, uterine massage, shepard's purse tincture or hemhalt tincture, and ingesting the placenta. :)

2 cups of blood is considered a hemorrhage, 4 cups can be transfer worthy.

You should address your fears with your midwife, who should be able to ease them and answer your questions. If she can not, I would find another midwife.

While these scenarios are handled differently at a hospital, a midwife will use more natural and less invasive methods. :)

I had an unassisted homebirth and had shepard's purse on hand.
Hi Candice,
There can be different worries that can come up with birthing your baby. It seems that you are doing what the next step would be and that is gathering information regarding your fear. If you have a previous bleed after birth or know someone who bled, it can be frightening to think it could happen to you. If you are working with a certified midwife she will take this into consideration not only at the birth but during your prenatal care. Perhaps she will work with nutrition, supplements,or herbs as well to get your body in optimal health. At the birth she has medications to control bleeding if that be necessary. Often being able to process your fear with her is enough that it moves it right along. Before making any discissions talk with a highly recomended home birth midwife in your area. Enjoy the process! Gayla NY
I had the same fear, until a few days ago a friend of mine shared with me that she 'almost bled to death' after the birth of her first child, (in the hospital)(!) Apparently they failed their protocol of transferring her bag of Pitocin when they moved her from L & D into recovery. Her body was so used to the pitocin during labor, that it caused a hemorrhage when she was suddenly without it. She had to have a blood transfusion. This was at a world renowned hospital which shall remain nameless.

She said herself that she feels if she had had a home birth, none of that would ever have happened, as she would never have had the Pitocin in the first place.

I just thought I'd share, as her story made me feel so much better about my home birth decision.
I am 22 weeks pregnant with my fifth child and this will be my third homebirth with a midwife. I have never had an issue with postpartum bleeding, but since this is my fifth child I was slightly concerned that perhaps I may bleed more because my uterus is "tired". I spoke with my midwife, who is a CPM, today about how she manages PPH. She carries herbs, homeopathics, pitocin and also has begun carrying cytotec. What she uses depends on the bleed. She explained that all blelds are different and what she looks for. In some cases she may use a pitocin shot but explained that while that helps stop a bleed in about five minutes the shot really only lasts about 15 minutes and the mother can begin bleeding once it has worn off. If the bleed is bad enough and the uterus is just not contracting down she sometimes administers cytotce rectally. She said it is very fast acting and long lasting.

I think you should talk this over with your midwife. Bring up all the different protocols you have heard here and other places and see what she thinks/does.
If you are really worried, only about bleeding, there is something you can do to PREVENT heavy bleeding. During your pregnancy, especially towards the end, be sure to consume foods that are high in vitamin K. Taking a supplement such as spirulina, blue-green algae, or alfalfa are all great, easy ways to get vitamin K which aids in blood clotting.
I like alfalfa tea. This is what I do: Buy a bulk bag of cut and sifted alfalfa greens for tea. Add 1 cup of tea to 1 gallon of boiling water, remove from heat, cover and steep for 20 minutes. Strain through a mesh strainer and chill. I like to drink it cold with stevia added for sweetness. Drink several cups of tea each day. Also, you can use 1/2 cup alfalfa and 1/2 cup red raspberry leaf, since red raspberry leaf is full of calcium and nourishes the uterus. If you like mint, add some mint leaves for flavor!
Let your midwife know what supplements you are taking/drinking and why you chose them.
The leading cause of postpartum bleeding/hemorrhage is uterine atony not lack of blood clotting. After expulsion of the placenta a wound is left on the uterine wall and the blood vessels that supplied blood to and from the placenta are severed. If the uterus does not clamp down and become and remain firmly contracted (that blood flow) bleeding continues.

That is why uterine stimulants, such as oxytocin, ergotamine and prostaglandins are used. Next step might be misoprostol (Cytotec). Preventative could include putting baby to breast ASAP to release natural oxytocin and uterine massage to excite the receptors on the uterus to contract and keep contracted.

Rarely do coagulation (blood clotting) disorders contribute postpartum bleeding/hemorrhage to as most of these disorders will be identified during routine prenatal care.
When I was a practicing midwife, I would counsel my clients to eat a lot of raw cabbage during the last few weeks of pregnancy. Raw cabbage is loaded with vitamin K, which helps to clot blood.
Also, you might want to acquire some black cohosh tincture and have it on hand.
In my opinion, though, if you're having a home birth with an experienced midwife, you should be in good hands. Keep us posted.



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