Haemorrhage and Third Stage difficulties – notes – Gail Hart

Written by FairyDoula. Posted in Midwifery notes

  • ‘1/3 of women die in childbirth’ IS A LIE!
Women at full term can die of
  • septic miscarriage
  • blood loss

Symptoms of haemorrhage

  • Fainting
  • Sickness
  • Mothers face pale
  • Lips blue
  • Low blood pressure
  • Rapid pulse (100, 110)
  • Convulsions

Notes on haemorrhage

  • Average blood loss is 435 cc ( 4 cups ) to 800cc (6 cups) – 1 full pad = 1/2 a cup
  • Women can lose up to a litre of blood ( 8 cups) and still survive ! – however we should be vigelant about blood loss and keep it to a minimum
  • 500cc of blood loss = 1g haemoglobin loss
  • In waterbirth, if you can see the bottom of the tub then the blood loss is normal.
  • If a woman is bleeding too much her uterus needs to be closed – if the placenta is still in it has to be removed.
  • To keep the cord intact helps the placenta trigger the separation – the whole system remains oxygenate
  • Routine use of Pitocin ( synthetic oxytocin) or oxytocic herbs to over stimulate labour can be cause of bleeding

Normal birth= normal placenta delivery

  • Let the uterus expel the baby- assist the baby and mother to skin-to-skin contact
  • To watch the physiological stages of separation means to assist the true way of expulsion
  • Placental expulsion can take from 30 mins to 6 hrs!
  • To pull on the cord when the womb is not contracting will only cause problems
  • Hold the cord, feel the womb, feel the slack – DO NOT TUG!
  • Watch, Wait, Allow physiology to progress – be like the animal and let nature take its course
  • Shepherds purse herb can stop bleeding and contract the uterus
  • You can also use your hands to contract the uterus- rub the mama’s belly flat-handed, support under the uterus and push from above – you are trapping those blood cells and stopping the bleeding.
  • Also, nipple stimulation and breastfeeding can help
  • A thumbnail piece of placenta in the mother’s mouth activates uterus contractions in 20 seconds!
  • Getting upright and blowing in a bottle can help the placenta to separate
  • Get the mama to cough or sneeze this can also help
  • The best way is to not disturb the natural bonding space of mother and baby- leave the room for 20 mins*  make yourself invisible – leave the woman to birth her placenta herself with no fuss!
*hi lara, you take great notes, but I need to post a correction there. I probably mispoke something in the class. “I” was not the midwife who said to leave the room for 20 minutes to give the mother privacy to birth her own placenta. I said I know of this teaching and assisted a midwife once who followed this. I don’t personally do this or advocate it; I just know of some who do, but I’m personally not comfortable with leaving her. I always stay with the woman, nearby but as much out of her way as possible, so I can observe her and her baby and help if needed. But I try to stay quiet and pretty invisible and unintrusive. I could be on a chair nearby, or perhaps just by the door, but I don’t leave. About using your hands to stop bleeding: The hands are the best and most effective tool. Faster than medications. About placenta — it is a very effective emergency treatment, and the knowledge should be reclaimed. It used to be known throughout the world but has been forgotten in many on haemorrhage and third stage difficulties – Gail Hart

Don't miss the latest Fairy Doula updates! Keep in touch...