I love sharing my labor and childbirth experience. It was a very empowering day for me, and it resulted in the best thing ever, of course – William! My labor wasn’t entirely ideal, however. I had a somewhat severe post-birth complication, which I was still figuring out more than two months after Will was born. I wanted to share my experience, and offer what I learned in case a mama out there confronts the same challenges.
Put simply, I hemorrhaged significantly after pushing sweet William out. My placenta didn’t detach easily or cleanly, and my midwife tried three times (what ended up being in vain) to coax the remaining pieces out of my uterus. This was what I now lovingly refer to as my “manual D&C,” as my midwife used her arm and hand to scrape, as best as she could, the small pieces of placenta that remained inside me. Thankfully, I had morphine for two of these three attempts (after my husband asked on my behalf after the first attempt). The morphine didn’t really remove all of the pain and discomfort of this experience, but it did provide enough of a haze that I have mostly forgotten how terrifying, traumatic and incredibly unenjoyable the hour after I gave birth was.
It’s likely that I had some form of placenta accreta. I later found out that my mother had a similar experience right after she gave birth to me, her second and final child. I entertained deep fears after my labor that my uterus was damaged and that I might not be able to carry and give birth to a child again.
As I was readying to leave the hospital after birth, my midwife chatted with me about how the placenta issues might not be over. She alerted me to pay very close attention to the warning signs of retained placenta, including:
- persistent heavy bleeding beyond the normal postpartum lochia (enough to soak a maxi pad in an hour or less)
- blood clots larger than a golf ball
- foul smelling discharge
- pain or cramping
- fever and/or chills
At four days postpartum, I thought I was experiencing a few of these symptoms so I called the on-call midwife. She asked me a few questions, but because I had no fever, she determined all was likely well. I was so glad because I was deeply afraid of having to go the hospital without my newborn son (my feelings were so amplified the weeks after Will’s birth!), and what a hospital stay might mean in terms of breastfeeding.
At four weeks postpartum, I had a ‘surge’ of bleeding, but not enough to meet the first criteria above; it was just bright red, heavier bleeding than I’d had in weeks. So, again, I called my midwife and went in to be seen. I saw a midwife (one I had actually never seen before) and she did a quick cervical check to see if anything was amiss. Again, though, she ruled out any irregularities, including retained placenta problems, and I went about my merry way.
At my postpartum check up at seven weeks, my midwife (who was there for my labor and birth) decided to prescribe me an antibiotic (Keflix/cephlaxine) and uterine cramping drug (Methergine/methylergonovine) ‘just in case’ anything did remain. I took them as assigned, and it seemed they worked – my bleeding stopped for two days. When it began again, I was frustrated AND slated to return to work. So, back to work I went at eight weeks postpartum still wearing pads (ugh!), and feeling a bit more rundown than I thought I would.
Finally, after another call to on-duty midwife, they sent me a lab order for an ultrasound, found clear signs of retained placenta, and I had a (rather late in the scheme of things!) D&C. The day of the procedure was not altogether difficult, but here is what I experienced and you could likely expect if you have a D&C at a hospital surgical inpatient location:
- Bloodwork and physical the day before. They gathered my blood type and other key information, put it on a wrist tag and shared it with the OBGYN doing the procedure the day of.
- No eating or drinking. I wasn’t allowed even water after dinner the night before. I was so thirsty, especially as a nursing mama!
- An early check-in/procedure. I was supposed to arrive by 7:30 for a 9:00 AM surgery.
- No jewelry or contacts. And don’t forget your glasses case, as I did. My glasses went into a fancy plastic bag with my nurse as they wheeled me back.
- An IV hook up. In the hand, likely!
- Meeting with your attending nurse, anesthesiologist, and physician performing the surgery. I had intimate meetings with all three prior to the actual surgery, with a basic review of what each would be doing, and a check of my personal information. It was with the nurse that I shared I was nursing mama and had brought my pump. I asked about when I could nurse again (24 hours post surgery, I was told), and was able to quickly get my husband and pump post-op because I made this a priority that everyone knew about.
- Very little remembrance of the procedure. I was staring at the ceiling and then I was upright! I hope this everyone’s experience – I’m grateful.
- Juice! Oh sweet juice and crackers after the anesthesia wore off. Nothing had tasted so good — not even post-labor food!
- A check-in with your OBGYN. After she spoke with my husband (while I was coming to), she came to visit me and shared what she had found and how the surgery had gone. This is when I learned the placenta had actually begun to calcify inside my uterus but was easily removed. I asked if I should expect any complications and was told no.
- A few hours to recover and get a course of any necessary and remaining prescriptions. I had to go through a full round of antibiotics again, and so had to remain in the recovery area for an additional three hours.
- A friend or family member to drive you home. Despite not feeling any weird things from the surgery, I was glad my husband was there.
- Time to relax as needed. I actually had no side effects, including cramping, from my D&C, but it is common so having someone around to help (especially with a newborn) for the day after is pretty key.
There are many things I still worry about – was there really no impact on my uterus and future children-bearing abilities? But mainly, I regret not being more forceful and advocating for myself. I wish I had researched some of the things that can be done for those who hemorrhage and have suspected or confirmed placenta issues after birth. It was so easy and non-invasive to get an ultrasound – why wasn’t this ordered immediately? I constantly ask myself this and have learned to ask more questions and when something doesn’t feel right, politely but firmly request real action other than reactionary prescriptions. Having a D&C a full ten weeks after birth due to retained placenta is incredibly unusual and not healthy at all. Untreated, it can lead to fertility problems and real illness. I was incredibly lucky!
Did you learn any key lessons from your experience giving birth?