Trying Again After Loss

Trying again after loss can be a very touchy subject, and can add to the taboo as many people around the couple try to avoid the subject as they are worried about upsetting them. When you do mention the possibility of trying again, everyone seems to have an opinion, and you can find yourself doing what you think others want and expect… rather than what you want for you and your family.

When is the right time to try again? Only you can answer this question and the answer will be different for everyone; it will depend on many factors including:

  • What gestation you were when you lost your angel?
  • Have you healed physically?
  • Did you need a caesarean section?
  • How do you and your partner feel about trying again?
  • Are there any genetic tests which need to be done first?

I have known people who try again straight away, and also people who have chosen to wait a while; whatever you choose has to be right for both you and your partner. There is no medical reason to wait if the doctors have cleared you physically, so the only thing that you need to worry about is how you will feel emotionally going into another pregnancy.

When we told people that we were going to try again we had a whole range of comments, it seemed like everyone had an opinion! Some were good…. And some were not so good! Ultimately, it is down to you and your partner and other people really need to either support you in your decision or keep their opinions to themselves!

After we were told that Sophie has passed away we were sent home for two days while awaiting the induction. This was probably the hardest part for me as I could feel that inside things had changed; my stomach was hard and heavy, Sophie was slumped to one side, at the bottom which made it very uncomfortable, and emotionally just knowing that she had passed away but was still inside me and frightened of what was to come was extremely difficult. Emotions can make you react in a way that some people can’t understand.

During our time at the hospital before we were sent home the doctor was discussing the possibility of trying again and at the time I was adamant that it wasn’t going to happen… EVER! Well, you can imagine Paul’s surprise when the following day I turned around to him and said ‘once Sophie is born I want to try again straight away’ he was very shocked by this and thought that I wasn’t thinking clearly… which I now know I wasn’t! My emotional state at the time was, as you can imagine, all over the place. I remember feeling very guilty for admitting that I wanted to try again so soon, but after speaking to the Midwife I realised that actually, those feelings, are very normal.

These are some of the questions I asked myself to decide when the time was right for me. However, this was after a stillbirth, when I had gone through labour and birth, my milk needed to dry up, and I needed time to heal physically and have the post mortem and all the genetic testing done; after our miscarriages we tried straight away… so these questions can be adapted depending on the gestation.

When is it right to try again?

This is something that is personal to each couple, and no one else should try to influence them in any way. I am hoping that this post will help to answer this question.

Are You Physically Prepared?

With the physical aspect of trying again it is best to be guided by what your doctor recommends. My doctor recommended waiting until after my 6-week postnatal check-up, but each doctor will have their own recommendations based on your own personal circumstances, the reason for your loss and the method of delivery. They may also recommend that you take vitamin supplements for a set period of time to replenish the stores which reduced during pregnancy.

Are You Emotionally Prepared?

Your doctor can assess your physical state, but your emotional state is just as, if not more important when trying after a loss. In all honesty, no one knows for certain how they will react when they conceive after a stillbirth, miscarriage or infant death; psychologically it can affect you for the rest of your life, and although you move forward, when you conceive these feelings may come rushing back. However, there are a few questions that you could ask yourself when preparing to try again:

  •  Have you had a chance to work through some of your grief?
  •  How would you cope if you were to experience fertility problems?
  •  Are you ready to cope with the stress of another pregnancy?

Talk about your feelings with your partner

Do you both feel the same? It’s important to discuss and listen to each other. I know Paul was shocked and overwhelmed by my eagerness to try again so soon. Women can sometimes become obsessive and carried away, while very often, for the man, it takes time to want to try again. So, you really need to listen to each other in order to agree on a course of action that you are both comfortable with.

Emotions while Trying Again

Trying to conceive can be torturous and frustrating… even for people who haven’t experienced a loss. Women can easily become obsessive as the months go on (charting, taking temperatures, buying ovulation predictor kits etc). Very often people lose sight of the intimacy and sex becomes robotic… this can make things much harder, not just to conceive, but also your desire to be together. For couples who have experienced a loss this can be even more challenging…. You want things to happen, but at the same time are scared of them happening. It is far better to just relax and let nature take its course; and you will then find that you enjoy the process rather than allowing your emotions to get in the way.

What Others Think

It is a fact that everybody will have their own opinions on whether or not you should try again. However, ultimately that is down to you and your partner. Until I decided to write a post about this there were very few people that knew we were trying again… mainly because I didn’t want, or need to hear their opinion! Of the people we have told, we have had a range of opinions… from the supportive ‘we will stand by whatever you decide’ to ‘we think it’s a complete mistake’ but ultimately it is our decision, and with the doctors promising that I will be closely monitored, I think we may regret it if we don’t ‘try’ once more.

How to Know When You’re Ready

This is a really hard one to answer! You will have days when you are obsessed about trying again and really want it to happen asap, and then you’ll have days when fear takes over and you are terrified about conceiving and losing again. These are both completely normal emotions. Most people who have lost a baby ‘just know’ when the time is right; it’s a gut instinct that takes over. However, I am under no illusion that pregnancy will never be the same again, I will worry about every single thing and will no longer be ‘relaxed’ once I hit the 12-week milestone.

Final and Most Important Question

Do the rewards outweigh the risks? This is a personal question that only the couple can answer! Once you feel that the answer is yes, then you are ready to try again

An Open Letter to a Grieving Dad

I am so sorry that you are in this devastating situation, I am so sorry that you have lost your precious baby and I wish I could take your pain away and make everything ok again. It is hard being a dad walking this path, everyone is asking how your partner is coping, how are your other children coping, if there’s anything they can do to help your partner and do you think she would benefit from extra support like bereavement counselling. You answer this questions, you field the phone calls, you try to protect her and comfort her; while all the time inside you are screaming ‘what about me!? I’ve lost a baby too!’.

As a man you feel you need to be strong, you feel protective towards your partner, and you feel that you need to give her a shoulder to cry on; well, I need you to know that in this situation you don’t need to be strong, you can be protective whilst also grieving your loss too, and you also need to have a shoulder to cry on, to vent at, to shout and scream about how unfair this is… because it IS unfair and it IS ok to express that, to let it out, and to hate the world.

Right now, you might have more questions than answers; you may not have received the test results yet or they might not give a definite reason for your baby passing. This limbo is horrible, it really is, and it is my hope that that one day you will find the answers that you seek. I know that you probably feel numb, angry and upset, and I also know that you feel you will never be able to accept what has happened… how could you? How could you possibly accept that your baby will not be coming home? How could you ever accept that you had to leave your baby with strangers, cold and alone, while you returned home to an empty house, and a nursery full of things that your baby should be using? I also know that as time goes on, more people will almost expect you to carry on (much sooner that your partner), they will expect you to return to work (maybe before you are ready), they will expect you to be the strong one… I want you (even though it’s hard) to block these people out, there is no time limit on grief, it ebbs and flows; these are people that fortunately don’t know how it feels to lose a child; they are the lucky ones.

I want you to know, even though you feel like it, you are not alone. I want you to know that you and your baby matter, and I need you to know that there are people who you can talk to, other dads who have been through the same, devastating and life changing thing… because losing a child is life changing, and no matter what others might say, things will never be ‘normal’ again… but you will, in time, find a ‘new normal’. One where you find ways to honour your baby, whilst also looking towards the future.

I know (from my husband) that as a loss dad it can be very hard, people need to realise that you lost a child too, and you are hurting. Please share your baby and your experience as much as you want; your baby is not just a statistic… he or she is a baby with a family who love and miss him/her, and therefore he/she deserves to be recognised and remembered. I know that, occasionally, as a loss dad, you may receive negative comments when you talk about your baby, or share their photos. These comments may put you off sharing, you may feel like you ‘have to move on’ and not share any more, you may then feel more isolated, upset and alone.

When I first started to share Sophie I received comments like this, mostly from people who care a great deal and thought that I was torturing myself. At first, it really upset me, and I stopped sharing Sophie’s story and her photos; but after a short while I realised that sharing her, as much as I share my other children, was helping me and not hindering me! If people don’t want to look then they are welcome to scroll past, and the positive comments certainly outweighed the negative, which made me happy! For the people who do post the odd unhelpful comment, I no longer feel upset or angry; instead, I feel grateful, grateful that they don’t know, and don’t understand, what it’s like to lose a child; because I would never wish this on any one.

I want to let you know that it’s ok to not be ok, I say this to people on Sophie’s Angels because it’s true… sometimes breathing IS enough! Sometimes you may not feel like doing anything, or you may want to do things to keep busy… both of these are perfectly ok. Taking things one step at a time, taking each minute as it comes… all these things will help you to get through today; and that’s ALL you need to do.

Lastly, I want to let you know that it is ok to not be ‘strong’; it is ok to shout, scream, cry; it is ok to shut yourself away and it is ok to not want to talk about your baby if that helps. However YOU need to grieve is ok, everyone grieves differently; and sometimes we can be triggered by things long after we ‘think’ we’ve finished grieving… because grieving a child never really ends, it ebbs and flows like the waves. However, there will come a time, when you find yourself smiling again, you find yourself wanting to look to the future, and you find yourself enjoying life once more; you may not see it now, but it will happen.

Lots of love and hugs to you, your family, and your precious angel

Maria

xxx

If you feel that you would like to join Sophie’s Angels, then please click here.

How to Know When It’s Time to Try Again

This is something that I have been asked a few times recently. ‘How do I know when the time is right to try again?’ This is a very personal question, and the answer is going to be different for everyone. So, with this post I am going to give a very general answer based on conversations that I’ve had with various bereaved parents.

You are the only person who knows how you feel about trying again, and therefore you are the only one who knows when the time is right. However, there are some things to take into consideration.

• How does your partner feel?
• Have you had all the tests available so that you know any risks in future pregnancies?
• Are you happy with your care team?
• Are you confident that you will be well looked after?
• Do you feel ready, emotionally, for another pregnancy?
• Are you physically healed from your last pregnancy?
• Are you taking any suggested medication?

The main thing is that you, and your partner, feel ready. Rainbow pregnancies are not easy; you are no longer naïve about things that can happen, and this can be very stressful. I would urge you to work with your doctor to make sure that you are fit and healthy, and that any concerns are taken seriously; as this will help to ease your mind.

Some people feel ready immediately, others want to wait a while. What I will say (and I’m being a complete hypocrite here as I wanted to try straight away after Sophie!), is that it is best to wait for tests, especially genetic tests, to come back first; this way you can be sure that the care plan your doctor puts in place for you, is tailored to your individual needs.

I wish you the best of luck when you do decide to try again, and I’m keeping everything crossed for you!

Research into Loss

Tommy’s conduct research into miscarriage, stillbirth and premature birth; they have four research centres (London, Manchester, Edinburgh, and the National Research Centre which is the largest in Europe). Hundreds of doctors and midwives work together across the Tommy’s research centre network to improve pregnancy outcomes for both mother and baby.

There are specialist clinics within the centres for women at risk of pregnancy complications, they also have the opportunity for people to join in research trials.

London

The Tommy’s Preterm Surveillance Clinic – This is held at Guy’s and St. Thomas’ hospital, and they have been providing care for over 10 years. Tommy’s states that ‘In 2017, the total number of referrals from women at high risk of giving birth too early doubled compared to 2016. We are now seeing an average of 200 referrals each month’.

The hypertension in pregnancy clinic – This is based in St. Thomas’ Hospital and helps women with high blood pressure. They have helped 150 women since 2015.

The diabetes clinic – This is based at Guy’s and St. Thomas’ Foundation Trust, the clinic helps women with diabetes, women suffering from endocrine disease and other disorders like cholestasis. ‘The research carried out in the clinic has been a driving force for the adoption of universal screening for gestational diabetes’ Tommy’s

Manchester

The Placenta Clinic – This is the UK’s first placenta clinic and was opened in 2009; they work with women whose babies have growth restriction, and study the placenta carefully to reduce the risk of stillbirth.

The Rainbow Clinic – This is based at St. Mary’s and they provide care to women who have suffered a previous stillbirth or neonatal death.

The Lupus in Pregnancy Clinic –Tommy’s is supporting this clinic which helps women with the autoimmune disorder Systemic Lupus Erythematous and related diseases. Tommy’s supports the clinic through access to our research midwives.

The Manchester Antenatal Vascular Service – This is based at St. Mary’s hospital in Manchester, and offers extra monitoring and pregnancy care to women with a history of high blood pressure, and those at risk of related complications. Tommy’s states that ‘MAViS is currently home to exciting research funded by the National Institute for Health Research’. Tommy’s supports the clinic through access to our research midwives.

Edinburgh

Tommy’s Metabolic Antenatal Clinic – This clinic helps women with severe obesity, they have specialists in pregnancy care and diabetes, as well as midwives and a specialist dietician. 25-30 women each week are seen in this clinic. Last year women attending this clinic were 8 times less likely to have a stillbirth than women attending clinics not specialised in helping obese women.

Tommy’s Lothian Preterm Birth Clinic – This clinic aims to continue reducing preterm birth and late miscarriage rates, to improve the quality of care for women and to develop expertise in managing complex cases.

Miscarriage centre clinics

Tommy’s National Centre for Miscarriage Research has recurrent miscarriage clinics in three different sites in the UK. All of these offer close monitoring and care during the early stages of pregnancy to women who have previously suffered miscarriages. They are also able to take part in Tommy’s clinical trials, which hope to provide women with reasons for their loss. The clinics are based in:
• Birmingham Women’s Hospital
• University Hospital Coventry
• St. Mary’s Hospital London

If you would like to be referred for one of these clinics, then please visit: https://www.tommys.org/our-organisation/help-and-support/clinical-trials

If you would like to take part in one of the trials, then please visit: https://www.tommys.org/our-organisation/help-and-support/i-would-take-part-tommys-trial

To sign a petition I made to cut the stillbirth rate in the UK, please visit: https://you.38degrees.org.uk/petitions/cut-stillbirth-rates-by-half

HELLP Syndrome

What is HELLP Syndrome?

HELLP Syndrome usually occurs during the third trimester, but around a third of cases occur after the baby is born, rarely it can occur before 21 weeks of pregnancy; it is a rare liver and blood clotting disorder that affects around 1 in 125 women during pregnancy or after giving birth. It is a serious and potentially life threatening condition so please contact your care provider if you exhibit the signs or symptoms.

What is HELLP Syndrome?

HELLP stands for:

H – haemolysis (the red blood cells break down)

EL – elevated liver enzymes (proteins) (a high number of enzymes in the liver is a sign of liver damage)

LP – low platelet count (platelets help the blood to clot)

Symptoms of HELLP Syndrome

The symptoms of HELLP Syndrome are very similar to the symptoms observed with pre-eclampsia (the two conditions are often related). You may experience one or more of these symptoms:

  • Headache
  • Nausea/vomiting/indigestion with pain after eating
  • Abdominal or chest tenderness and/or upper right side pain (from liver distention)
  • Shoulder pain
  • Pain when breathing deeply
  • Bleeding
  • Changes in vision
  • Swelling/weight gain

Your midwife or doctor will check for the following signs during your antenatal appointments:

  • High blood pressure
  • Protein in the urine

The most common reason for HELLP becoming fatal is liver rupture or stroke (cerebral oedema or cerebral haemorrhage), which can usually be prevented when caught in time.

How HELLP Syndrome affects babies

If a baby weighs at least two pounds at birth, they have the same survival rate and health outcome of non-HELLP babies of the same size. Unfortunately, the outcome for babies weighing less than two pounds at birth is not as good; these babies may need longer hospital stays and will have a higher chance of needing ventilator care because their lungs did not have enough chance to develop in the womb. Around 1 in 10 babies born to women with HELLP will pass away and this is often link to their prematurity.

Treatment of HELLP Syndrome

With treatment, the mortality rate of women with HELLP Syndrome is around 1 in 100, although complications can occur in about 1 in 4 women. The only way to treat the condition is for the baby to be born as soon as possible. Many women suffering from HELLP syndrome will also require a transfusion of some form of blood product (red cells, platelets or plasma).

What can I do to prevent HELLP Syndrome?

Unfortunately, there’s currently no way to prevent this illness. Things that could help to make sure it’s diagnosed early are:

  • Regular antenatal check-ups during pregnancy
  • Inform your midwife about any previous high-risk pregnancies or family history of HELLP Syndrome, pre-eclampsia, or other hypertensive disorders
  • Understand the warning signs and talk to your midwife or Doctor immediately
  • Trust yourself when “something just doesn’t feel right”.

Antiphospholipid (Hughes) Syndrome

Antiphospholipid syndrome, also known as Hughes Syndrome, is an autoimmune disorder which causes an increased risk of blood clots. People with this condition are at an increased risk of developing:shutterstock_53224042_height-400.jpg

  • Deep vein thrombosis
  • Arterial thrombosis
  • Blood clots in the brain
  • Pregnant women have an increased risk of miscarriage or stillbirth

What causes antiphospholipid syndrome? 

With antiphospholipid syndrome the immune system attacks healthy tissue; abnormal antibodies are produced which target proteins attached to fat molecules, making the blood more likely to clot.

Diagnosing antiphospholipid syndrome

Blood tests are used to diagnose antiphospholipid syndrome; these tests look for antibodies responsible antiphospholipid syndrome.

How antiphospholipid syndrome is treated

Antiphospholipid syndrome cannot be cured; however, it can be managed successfully. Blood thinning injections, such as fragmin can be self-administered and aspirin can also be taken to help thin the blood. These medications can also improve a pregnant woman’s chance of having a successful preEIS05000.jpggnancy.

Pregnancy 

Antiphospholipid syndrome can cause recurrent miscarriage or stillbirth, as well as other pregnancy complications. At least 15% of recurrent miscarriages occur as a result of antiphospholipid syndrome, and with prompt treatment, the pregnancy success rate has risen from 20% before 1990 to over 80% today.

Pregnant ladies are usually treated daily with low dose (75mg) aspirin, and if a previous loss has occurred in the second or third trimesters they may also be given fragmin injections.

Pregnancies can be affected in a number of ways:

Early pregnancy loss

Most miscarriages occur during the first 13 weeks; antiphospholipid antibodies can cause early miscarriages by preventing the embryo from embedding properly in the womb. Early miscarriages are common, and there are many possible causes. Therefore, women will not be tested for antiphospholipid antibodies until they have three consecutive early miscarriages.

Late pregnancy loss

In most pregnancies foetal death in the second and third trimesters is rare; however, it is strongly associated with antiphospholipid syndrome and therefore women with a late pregnancy loss should be tested for antiphospholipid antibodies. Women with antiphospholipid syndrome can develop clots in the placenta or around the cord which reduces the baby’s oxygen supply.

Pre-eclampsia 

Pre-eclampsia is twice as likely to occur in women with antiphospholipid syndrome.

Intrauterine growth restriction 

Intrauterine growth restriction (IUGR) are babies with a very low birthweight and they usually weigh less than 90% of babies at the same gestational age. With antiphospholipid syndrome the reduced blood flow to the placenta can cause the baby to be small for dates.

Research

What is being done to treat Antiphospholipid (Hughes) Syndrome? And what research is in place to find things to help someone with this condition? I recently came across ‘The London Bridge Hospital’ website, they are a private hospital which specialises in treating Lupus and Hughes syndrome as well as conducting clinical research.

From The London Bridge Hospital website ‘In 1983, our group described a condition in which there was an increased tendency to blood clotting. Such clots can occur at any time, and can affect veins or arteries anywhere in the body. During pregnancy, clotting of the placenta results in a tendency to miscarriage – some women suffering a dozen or more miscarriages before correct diagnosis and treatment. Features include leg and arm clots (DVTs), headache and migraine (leading in some to stroke), memory loss, chest pain, cold circulation. We initially reported the condition in a group of lupus patients but soon recognised that it could occur in individuals without any evidence of lupus’

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Clinical Studies for Antiphospholipid (Hughes) Syndrome Research

Units throughout the world are researching Antiphospholipid Syndrome; The unit at St Thomas’ obtains some funding from the Hughes Syndrome Foundation and publishes up to 40 research papers each yeaaps3r; and The London Bridge hospital is now carrying out studies with groups in America, Argentina, Brazil, France, Italy, Japan, Portugal and Spain. The International Antiphospholipid Syndrome meeting (Dr Hughes first started this in 1985) is now in its 12th meeting, and it attracts up to 1000 doctors and researchers. The discovery of Antiphospholipid Syndrome in obstetrics has meant that the odds of carry a baby to term has increased dramatically; before the discovery patients only had a 20% chance of a successful pregnancy but treatment patients now have an 80% chance.

General treatments

The aim of treatment is to ‘thin’ the bloody so that the tendency to clot is reduced, this is achieved with anticoagulant medication. There are currently three main anticoagulant medications (aspirin, heparin or warfarin) and for most patients one low dose aspirin (75mg) a day is enough to stop the blood from clotting. Heparin (such as Fragmin) is a very effective anticoagulant and is offered in injection form. It cannot be used for long term treatment due to an increased risk of osteoporosis. It is, however, used in some Antiphospholipid Syndrome pregnancies, as warfarin is potentially toxic to the developing baby.

Aspirin 

  • aps5Low dose aspirin (baby aspirin) – at a dose of between 75mg to 100mg a makes the blood platelets less sticky.
  • Side effects are rare (indigestion; allergy especially in asthmatics)
  • Safe in pregnancy

Heparin

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  • Newer “low molecular weight” heparin (such as Fragmin) has replaced older preparations
  • Only available as injection
  • Used to treat thrombosis, prior to warfarin use
  • Safe in pregnancy

Warfarin (Coumadin)

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  • Warfarin is a safe and effective medicine; despite being dismissed as ‘rat poison’ by some journalists
  • Side effects are rare – the only vital issue is to keep the dosage correct
  • The thinning of the blood achieved by warfarin is measured on an ‘International’ scale called ‘INR’ ‘Normal’ is “1” – half thick blood is “2” and one third blood is “3”
  • Not allowed in pregnancy

Placenta Previa

The placenta is the baby’s lifeline during pregnancy, it’s an organ which grows in the womb and is connected to the baby via the umbilical cord; it provides baby with Oxygen and nutrients which pass from your blood supply into the placenta and are then carried to your baby via the umbilical cord; carbon dioxide and other waste products are also carried away from the baby by the umbilical cord to the placenta and then into your bloodstream for disposal. Hormones produced by the placenta help your baby grow and develop; It offers your baby protection against bacterial infections while in the womb, and towards the end of pregnancy it passes antibodies from you to your baby which should give him or her immunity for about three months after birth. However, it only passes on antibodies that you already have. In most pregnancies, the placenta attaches at the top or side of the uterus. Placenta previa occurs when a baby’s placenta partially or totally covers the mother’s cervix, which can cause severe bleeding during pregnancy and delivery.

If you have placenta previa, then you may bleed throughout pregnancy and during delivery; and your doctor will probably recommend that you avoid certain activities, such as, having sex and running. If the placenta previa is diagnosed early in pregnancy then there is a chance that the placenta will move as the uterus grows, however, If the placenta doesn’t move then you will need a caesarean section. You should call your doctor if you have vaginal bleeding during the second or third trimester, and if the bleeding is severe then you should seek emergency care.

Diagnosis

An ultrasound scan will be used to diagnose placenta previa, and you will probably need extra ultrasounds throughout your pregnancy to check the position of the placenta.

Treatment

There is no medical treatment for placenta previa, however there are ways to manage the bleeding; the recommendations will depend on various factors:

For little or no bleeding

  • Pelvic Rest – avoiding activities that can trigger bleeding, such as sex and exercise.
  • Seek emergency care if bleeding starts.
  • If the placenta is low lying but doesn’t cover the cervix, you might be able to have a vaginal delivery. Your health care provider will discuss this option with you.

For heavy bleeding

  • Seek immediate emergency help, Some women with severe bleeding may require a blood transfusion.
  • A Caesarean will be planned for as soon as the baby can be delivered safely (ideally after 36 weeks of pregnancy)
  • If bleeding persists you may need an earlier delivery and you will be offered steroids to mature your baby’s lungs.

For bleeding that won’t stop

  • If your bleeding can’t be controlled or your baby is in distress, you’ll need an emergency C-section — even if the baby is premature

Risk Factors

Although the cause of placenta previa is largely unknown, there are certain things that have been found to increase the risk. These are:

  • Have had a baby before
  • Have scars on the uterus from previous surgery (caesarean deliveries, uterine fibroid removal, and dilation and curettage)
  • Had placenta previa with a previous pregnancy
  • Multiple pregnancy
  • Are age 35 or older
  • Smoking

Complications

You will be monitored to reduce the risk of serious complications such as:

  • Severe bleeding (haemorrhage) which can occur during labour, delivery or in the first few hours after birth.
  • Severe bleeding may prompt an emergency C-section before your baby is full term.

Have you experienced placenta previa? What was the outcome? What support did your care provider offer you?

Flashbacks

One of the hardest things for me to deal with at the moment are the flashbacks I seem to be getting. I can’t control them and they are never the nicer memories… ‘It doesn’t look good guys’ is what the doctor said when he told us the news, ‘what will she look like’ I asked a different doctor, to which she replied ‘she will look like a baby’… this last one has stuck with me, because although comforting at the time, she will not LOOK LIKE a baby… she WAS a baby… MY baby!!! She was loved, wanted and cherished and she always will be! I will always have a piece of my heart missing, and it will never be complete again. I understand that now… I don’t like it and I can’t accept it… but I do understand it.

One of the biggest flashbacks I’m getting is of Sophie being wrapped in a towel and me being taken to theatre to remove my retained placenta; when I got back from theatre Sophie was bathed and dressed. I asked Paul if he had washed and dressed her, and he said ‘no the midwife did it’… this I accepted at the time (I had just given birth to a stillborn daughter and didn’t want to make a scene!), but it has affected me… really affected me! I can visualise every single part of Sophie, except her feet! I never saw her feet so I have no idea what they looked like! I should have bathed her, I should have washed her, and I should have told the midwife not to do it… but I didn’t, and now I never will be able to… and that crushes my heart sometimes.

The flashbacks are so hard, I had a dream 2 nights ago that I gave birth and the doctors were wrong and Sophie was alive… then I woke up and cried! I have had dreams where I’m in labour and Sophie is born with a smile on her face, waving as she flies into the air to be with the other angel baby’s… and I just try to pull her back. Dreams can be very upsetting sometimes.

 If you are experiencing flashbacks then please write a comment.

 

Placental Abruption

Overview

The placenta is the baby’s lifeline during pregnancy, it’s an organ which grows in the womb and is connected to the baby via the umbilical cord; it provides baby with Oxygen and nutrients which pass from your blood supply into the placenta and are then carried to your baby via the umbilical cord; carbon dioxide and other waste products are also carried away from the baby by the umbilical cord to the placenta and then into your bloodstream for disposal. Hormones produced by the placenta help your baby grow and develop; It offers your baby protection against bacterial infections while in the womb, and towards the end of pregnancy it passes antibodies from you to your baby which should give him or her immunity for about three months after birth. However, it only passes on antibodies that you already have.

In 2013 the NCBI (National Center for Biotechnology Information) published a study which found that placental abruption affects 0.7% – 1% of pregnancies; however, according to Tommy’s it is suspected that this figure may be higher as abruption isn’t always diagnosed. This is a serious condition in which the placenta begins to detach from the uterus, meaning that the baby can become starved of oxygen and nutrients.

Causes and Risk Factors

Very often the cause of abruption is unknown; however, there are factors that can increase the risk. These are:

  • Abdominal trauma – maybe from a fall or a car accident
  • Previous placental abruption
  • High blood pressure
  • Smoking
  • If your waters have broken prematurely
  • Blood-clotting disorders
  • Multiple pregnancy – the delivery of the first baby can cause changes in the uterus that trigger placental abruption before the other baby or babies are delivered.
  • Maternal age – women over 40
  • Using drugs (especially cocaine) in pregnancy
  • Previous caesarean birth
  • History of recurrent miscarriages

Symptoms

Placental abruption occurs most frequently in the last trimester of pregnancy (especially in the last few weeks) and symptoms include:

  • Vaginal bleeding
  • Abdominal pain
  • Back pain
  • Uterine tenderness
  • Rapid uterine contractions, often coming one right after another

Abdominal pain and back pain often begin suddenly and the amount of bleeding can vary. If the blood becomes trapped inside the uterus by the placenta it is also possible to have a severe placental abruption with no visible bleeding. In some cases, placental abruption develops slowly. If this happens, you might notice light, intermittent vaginal bleeding. Your baby might not grow as quickly as expected, and you might have low amniotic fluid (oligohydramnios) or other complications

If you notice any of the symptoms then please get medical help immediately because they may signify an emergency.

Treatment

The treatment for placental abruption will depend on the severity and gestation. Women under 34 weeks with a minor placental abruption are usually monitored closely in hospital, your care provider will ensure that baby is growing correctly, and will also look for any signs of preterm labour. If there is a risk of your baby not growing properly then labour may be induced. If the abruption is more severe, you are losing lots of blood and the baby is in distress or at risk of not growing properly you may need to have your labour induced or have an emergency caesarean.

Complications

Placental abruption can cause life-threatening problems for both mother and baby.

Mother

  • Shock due to blood loss
  • Blood clotting problems (disseminated intravascular coagulation)
  • The need for a blood transfusion
  • Failure of the kidneys or other organs
  • Hysterectomy

Baby

  • Oxygen and nutrient deprivation
  • IUGR
  • Premature birth
  • Stillbirth

The study showed that:

19% of cases were stillborn, 11% of new born baby’s had an apgar score under 7 at 5 minutes, 34% of newborn baby’s had weight less than 2500g (2.5kg or 5lb 8oz) and 40% of newborn babies were admitted to NICU.

Have you suffered with placental abruption? Please feel free to share your story