Hello,
I wanted to find out some opinions. I am 22 weeks along and starting to think about birth options, if there are any for me...

My first childbirth was traumatic, active labour was approx. 3 hours and there was severe bleeding all the way through the birth. I have no idea what caused the bleeding, or even if it was PPH, but they were sweeping the blood off the bed into the wheely bin..approx.1 lt blood lost (seemed like heaps more)
Baby aspirated Meconium and was in SCN for a week post birth. Wasnt able to breastfeed at first so baby was FF in SCN due to low Blood sugar (also unable to BF due to drugs administered whilst in ICU after heart issues).

Afterwards, I was borderline for a transfusion, but they decided just to chuck me a few iron tablets and then left me to go home on about day 5. On Day 8, was back in hospital, couldnt breathe, swollen with fluid (10kg of water weight), and couldnt walk. My GP was the one who noticed my grey colour and insisted on my return to hospital..

Diagnosed with PPH and resultant cardiomyopathy and advised to not get pregnant for 2 years to allow heart to recover.

It's now almost 4 years later, and I just dont know whether to choose an Elective C section this time, or chance the same issues again with a natural birth. I mean, you only get 1 heart, and if it fails again..well...is it worth the chance?..I have discussed with my GP who does shared care, and she strongly advised the controlled environment as Elective C section would be the best option. Public system OBs are not in agreeance (yet) . I will go to a private OB if necessary (if not too late) , but the local private OB is the head of Obstetrics at the hospital, so dont see the point of paying $3000 to get the same person...

How on earth do I decide? I dont want to be cut open, but if this is safer, I will go that way..However, I have been told that a PPH and bleeding can be worse and riskier with a C section. I am not frightened of natural birth, but how can I be reassured that this wont happen again. I blame the post natal care I received completely for the issue of the heart failure, if they had done their jobs properly, they would have seen what my GP was able to notice immediately and prevented or caught the issue earlier. I dont trust the hospital at all.

Add to that, I also suffer from severe depression and anxiety, I have had a difficult pregnancy so far with spotting early on then I had an amniocentesis to rule out Downs Syndrome, so it's been very difficult mentally so far. I am not on any medications for my anxiety, but suspect I should be, trying to get through without medication. Oh, and i have pretty bad SPD which I can only assume will get worse...

anyone got any advice?

You are right about only having one heart and not risking at again. My gut feeling would be to go with an elective CS. That way you can relax knowing that the same thing won't happen again. Unfortunately there are risks with whatever method you chose however given your circumstance I'd say this way is the best solution overall. As for the OBs not agreeing, I would think this shouldn't be an issue given what has happened to you in the past!! Are they aware of the whole picture? If not I'd be making them aware.

I am sure a lot of your anxiety is related to what has happened in the past. Don't get me wrong,its a very complex area but to have a baby in the SCN for a week and having to go back to hospital after discharge for problems cause by incompetence at the hospital must have been awful!!! Myself, it was bad enough giving birth to a healthy baby and going home normally without complications. I think people underestimate the implications of all you have been through.

I hope someone else can post here who knows more about this or may have been through something similar.

And I wish you all the best for whatever happens!!! Whatever the case you will have a beautiful little bubba at the end

Hey!

It's such a hard decision to make, especially if you have little faith in the hospital or their ability to care for you appropriately!

Considering the cardiomyopathy I would suggest that you ask to see a cardiac specialist. They will be able to assess you and give you information about your best options. The chance of PPH is increased with a section. However, it sounds like it wasn't really the PPH that caused the problem it was the lack of treatment afterwards.

In your position I would arrange to have a meeting with the medical team and get them to tell you what they think the best course of action is. Tell them all your concerns, especially in terms of aftercare and see what they say. Take a really assertive support person along with you and don't let them fob you off!!

Good luck with it!

Hi there

Ok, I have no personal experience of the cardiomyopathy side of things (I have cardiac nursing qualifications but not in the context of antenatal women so can't offer any help there), however I can give you my personal experience regarding the PPH side of things. I don't know that I can offer advice as such, but sometimes it helps to hear others stories.

With my first (a VB), amongst many other complications I had a PPH. I lost what was estimated to be just under 3 litres, which is a pretty severe PPH. I had 4 transfusions, and was hugely emotionally affected by the birth.

I got to where you are now - pregnant again and terrified - and sought debriefing at the public hospital where I had birthed and was to birth again. There were other complications to our first birth that made me query a possible elective C/S. The ob I saw suggested that despite a C/S possibly being an option for other reasons, advised against a C/S based on the fact PPH's can be worse with Caesars. Having being told that, I was happy to go with that, I didn't want to risk a bigger PPH.

So a few months on we were induced at 41wks and at 10cm dilated needed an emergency C/S. Due to complications I was under GA but told later I had a PPH again. I have just accessed my medical records and it is documented at 1.6 litres, so nowhere near the first. I had 2 transfusions following this birth.

We are considering a third, so have been contemplating the same question again. Last week I went to see a private OB (who also happened to do my C/S for DS), to seek advice on the possibility of PPH recurrence and the possibility of an elective C/s for a possible third. In my case he specified clear reasons for both my PPH's - first was a retained placenta, and second was tearing of the muscles around the incision as the baby was big (4.34kg) combined with - to use his words - a 'flogged' uterus from the induction. He was understanding and agreeable to an elective CS for a third.

I guess what I am getting around to saying is you really need to sit down with your care providers and ask some questions specific to your history and therefore be able to ask the question about the best plan of action for this birth. I think you need to arrange a meeting, with one of the Obs and request they have present your medical records of your birth admission and your re-admission the week later. Perhaps ask them how they might manage a repeat PPH in view of your cardiac history? Do they know about your anxiety and depression?... I also agree with the PP about seeing a cardiologist - I would be seeking their opinion on the risks of VB v C/s in view of your history. If you go to your GP you should be able to get a referral to a cardiologist. Once you have had a consultation with them, if there is any advice or plan they recommend they will send a letter to your antenatal care providers which should carry a bit of weight.

Good luck with your decision, and with the birth. I know how you are feeling and really feel for you, hope it all goes beautifully.