Midwifery Today Community

Hi, I am a doula and a midwifery student so I have two reasons to ask this.   I was at a most beautiful hospital birth the other night, however, it seemed as if the mother bled a bit much after the delivery.  The nurses massaged her fundus and the doc seemed confident that all was well.  However, they left the room and mom began to crash.  She was turing white and moaning and could barely hold her baby.  I ran to the nurses station and they acted very nonchalant about it.  In about 5 minutes they came in and her bp was 67/20 or so and her temp was dropping.  (Going into shock?)  They gave her an IV of fluids and she seemed to perk up.  I went to see her today and she told me how they let her walk down the hall to the bathroom and she almost passed out.  She also conveyed that she was bleeding A LOT but the doc didn't seem concerned.  Her hemoglobin is at 6.  I am very concerned about her but am not sure exactly what to do, as I am only her doula.  Any ideas as to why she could still be bleeding?  Any ideas as to how to get her iron back up?  She does NOT want a blood transfusion and is pretty adamant about it.  As far as I know, they are still planning to send her home tomorrow!  

Whoa, holy moly.  I would really love to know more details as it is hard to ascertain what happened and why from what you wrote, but a hemoglobin of 6 is just insane.  Is she still actively bleeding?!  Or is it just normal lochia, though even that will continue to deplete her stores.  The fact that she perked up with fluids is normal...her body would have been so desperate that even an expanded blood volume would be helpful but will not help as far as long term recovery.  Does she have other kids to look after?  Sounds like she is in for a very rough recovery of trying to rebuild her blood volume if she doesn't want transfusions.  Any idea when the bloods were done that said her hemoglobin was 6?  I cannot imagine any hospital approving the discharge of a woman with that level.  There are all sorts of supplements and dietary considerations with such an extreme anemia, I can throw some ideas out if you want, but I am really perplexed at going home with that low of a reading...

They did send her home yesterday and threatened that if her milk supply isn't in by today, they will have her supplement.  She was upset that they gave baby a pacifier.  I'm still not sure why the bleeding....  I suggested that she take Floradix to get her iron back up.  I plan to call her today to see how she doing.  Post partum time can be tough anyway, but with this I think it would be tougher.

"Threatened"?  What do you mean  by "threatened" her about her milk supply?  With a pph, milk supply can be low and moms can have issues.  Perhaps they were talking to her about that and she got confused or were they menacing about it?

I'm amazed that they sent her home with a reading of 6. ??  She refused treatment because ...?

I didn't leave her alone, the father was with her.   I went to the nurses station because I knew that after hitting the call button, it could take 15 minutes for them to come to her room.   During her labor we pushed the call button because she said she felt pushy...ino one came.  I finally went and told them.  The response?  ""Babies don't just fall out."   Baby was born shortly after....  Even during her stay there she pressed the call light after her bath to get help.  No one came so she proceeded to head back to her room alone.  She told me she blacked out and started to stagger and then all the nurses were eager to help.  

This morning she texted me and told me she is being readmitted....  

I hope she actually gets the care she needs now...

If she is still refusing transfusions, there are many other ways to build her blood.  You can contact Jehovah's Witness organizations for some pretty incredible methods for non-blood product ways of dealing with hemorrhage.  If her Hb is 6, she is looking at months and months of rebuilding, not to mention potential danger of organ damage.  I can't remember what level organ damage occurs but it is very close to 6 or so if I remember correctly

I would also encourage her to take a high quality iron supplement - the hospital will probably be pumping her full of iron in the form of ferrous sulfate, which is SO hard on the system and makes women constipated, sick, black tarry stools, etc.  Chelated forms of iron are great, and ferrous fumarate or ferrous gluconate are ok, too.  Floridex or floravital are awesome but at 12 or so mg per dose, it is not exactly a blood builder but more of a blood tonic.  I would get the big guns in terms of supplements going for sure.  All the food she is consuming should be an iron source - greens with citrus, dried apricots, blackstrap molasses, organ meats (can she eat her placenta?), etc.  

Vicky, it sounds like this hospital is in the Dark Ages! YIkes!

How's baby doing with mom having to be readmitted?

She was doing a little better as of last night.  She said her bleeding has slowed down and her milk is coming in.  I am SO happy!!  She still needs to get her iron count up and I think that recovery will be long and slow.  

 About those call buttons... yeah, they do get ignored a lot! At the hosp. I used to work at, if it was an emergency, you just yanked the call button cord out of the wall, instead of just pushing the button, All kinds of folks would come running! Remember that "trick" next time you want the bell answered STAT!