1-1-23
S. Tenuta
Monitoring mother after birth, and after the birth of the placenta is artful. The midwife needs to be alert to mother’s cues. Notice her skin color, her voice, and her eyes. Notice the discharge from the vagina intervalically. Listen to the voice inside your head. Check in to see that mother is ok, that baby is ok and that your intuition says things are ok.
If for some reason, one of the signs are not ok, follow through to find the cause of the discomfort. If there is a hemorrhage, or other not visible complication, find the reason and root of the problem. If it is a hemorrhage, know there are more than one way to calm the body and to stop hemorrhaging.
Know that most PPH hemorrhaging is due to uterine atony. So initially find the fundus and if it is boggy, massage it. Determine whether mother needs to empty her bladder. This could inhibit the uterus from contracting fully. If there is a cervical tear that needs repair, the legal midwife may repair 1st or 2nd degree tears. For 3rd or 4th degree tears, most midwives prefer to transfer repairs to the hospital setting, unless in an area where there is no hospital.
Hemorrhage stopping options
It is ok for mom to know that she can direct the bleeding to stop by her conscious intention and request that the bleed stops. It is important mother believes her request will be honored by her body. This is making a conscious connection to the wisdom of the brain, linked to the blood circulation system. A 2nd way is to use herbal tinctures to stop the hemorrhage. Yarrow, Witch hazel and Blue cohosh, motherwort and alfalfa are known to be uterine tonics. Alfalfa is high in vit. K. Several companies distribute their own formula for such use.
A 3rd way is to use a powder of the Traditional Chinese Medicine called Yunan Pao. Some people say hot pepper works, or cinnamons. Do research to see what your preferred hemorrhage stopper might be. A homeopathic treatment is suggested to be Cantharis or Ferrum Phosphoricum or Phosphorus.
Some women want a cut a piece of the placenta and they chew on that piece. Claims have been make that indicate this stopped bleeds. Others will take a corner of the placenta and make it into a smoothie in order to ingest it, trusting the hormones in the placenta will stop the bleed.
The next possible effective remedy for a postpartum hemorrhage is to puncture Spleen 1. It can be needled per acupuncture procedures, or lanced with a lancet, or have moxa burned on it. If the hemorrhage does not stop in a few seconds, then move to a different protocol.
Compression techniques can be used to control bleeding as well. There is the abdominal uterine compression, held for 15 min, or bimanual abdominal compression or internal bimanual compression or as a last resort for compressions, using an external aortic compression.
In the Midwife kit and hospital, it is common to give a dose of pitocin and /or cytotec. These can also be used along with other techniques.
So, be informed learners of the world. Make a decision how you would like your hemorrhage treated if such would be your experience. Be informed. Make choices. Know the body has wonderful, abilities to heal itself, if given the tools it needs.
References:
Holistic Midwifery vol.2 by Anne Frye
Birth Emergency Skills Training by Bonnie U. Gruenberg
Varney’s Midwifery by Helen Varney