All midwives worry about postpartum

All midwives worry about postpartum hemorrhage. The three main keys to avoiding its occurrence are 1) good nutrition and supplements as needed; 2) knowing the mother; and 3) not rushing the delivery of the placenta. I have found that by applying these three keys as fully as I can both prenatally and in the third stage, my practice has a very low incidence of postpartum hemorrhage.

The first key to preventing postpartum hemorrhage is good prenatal nutrition and supplements. I always require that my mothers keep a five-day diet diary to give me early information about their diet. As soon as possible I recommend changes in their dietary habits if they are needed. I encourage them to use such supplements as liquid chlorophyll, red raspberry and nettles. I also make a tincture of nettles, yellowdock, alfalfa and red raspberry, which I have on hand if it is needed. I have found the Spectrum 2C multivitamins by NF Formulas to be unsurpassed in their effectiveness for pregnant and lactating women. My families and I firmly believe in these vitamins, and many of them order from me long after the "big day." I also use them to maintain my own energy level, as I am a busy midwife and the mother of two teen girls and a baby!

The second key, knowing the mom, entails making sure that you have recent blood work for this pregnancy. Check hemoglobin and hematocrit, of course, but also platelet count. You want to make sure the mother’s blood will clot properly after the placenta detaches. This key also includes knowing the mother’s nutritional status as discussed above.

The third key to preventing postpartum hemorrhage is to not rush the delivery of the placenta. Almost all postpartum hemorrhages, in my opinion, are caused by being in a hurry to deliver the placenta. In these cases, I believe hemorrhage is caused by the intervillous spaces not having a chance to contract and help control the flow of blood. Also, the overmanipulation of the uterus to facilitate placental delivery can cause lobes to be left on the uterine wall which result in uneven contraction of the uterus. These lobes need to be manually removed to prevent postpartum hemorrhage and infection. This is not any fun for the mother or the midwife! I have seen many physicians and a few midwives who will not give the placenta time to deliver on its own. I, too, have fallen victim to feeling a little harried as I waited for the placenta to come. But a policy of hands off, unless there is due cause, is the most important key to preventing postpartum hemorrhage. I have seen some bad postpartum bleeds, which may have been avoided if the practitioner had not intervened and over-managed the placenta delivery.

Uterine atony is also a major reason for postpartum hemorrhage. This can be caused from a long labor, or a precipitous labor, either of which can induce uterine fatigue and facilitate possible partial separation of the placenta. Try to anticipate this if she has had either of these labor patterns. Also, check and ascertain that she has not displaced her uterus by not emptying her bladder, either shortly before pushing and/or after delivery of the baby.

One of my favorite stories of postpartum hemorrhage concerns a mother who had all five of her babies at home. My proctor and future partner handled the first two. This mom’s uterus wouldn’t maintain its firmness after delivery no matter what was done. We resorted to the old trick of icing down small pieces of the placenta and giving them to her! The reasoning behind this "trick" is that the hormones from the placenta will be absorbed into the maternal bloodstream. Placing a small piece between the cheek and gumline causes the hormones to be transferred sublingually into the mother. This facilitates clamping of the uterus and helps staunch blood flow. Icing and rinsing the piece down is for the comfort of the mom and to remove the extra blood from the piece. (Animals eat their placentas after giving birth for this same reason; by disposing of as much afterbirth material as possible, they also help prevent predators from coming after them and their young.)

Giving the mother the iced placenta helped, but with her first birth she did end up at the emergency room the morning after the birth, where she was given Methergine to control the bleeding. The second birth was uneventful until after the delivery of the placenta. Once again, she bled quite a lot. We were able to control the bleeding better with this birth, but it was very worrisome to see that amount of blood. The third birth was about the same, with lots of blood, but we got the bleeding under control in a timely manner. I had served as her primary midwife with the last two babies, and because of her history of bleeding I started her on the above supplements. She didn’t, however, use the vitamins with the fourth baby. She dumped a bowl of blood with the placenta, but we got her under control very rapidly.

During her fifth pregnancy, she added the vitamins. My assistant caught the baby, and I took over for the third stage. Mom sat on the birthing stool. As I waited for the placenta, I silently reviewed what to do when she bleeds out. Everything was ready. Then came a small gush of blood, followed by the placenta. I thought so far so good, looks complete and delivers in a reasonable amount of time, but where is the huge gush of blood that is so typical of this mom? We got her off the stool, put a pad on her (tip: use a newborn diaper for the first couple of hours postpartum; it really helps control blood seepage onto the bed and/or clothes), and I continued to watch and wait for her to gush, but she never did. Her bleeding was very normal and never gave us any cause for concern. I can only attribute it to the supplements she took prenatally. She never had an episode of heavy bleeding and stopped completely about eight days postpartum.

Margarett Scott is a certified professional midwife with a thriving practice in Oklahoma. She has been practicing for more than eleven years and specializes in waterbirths, VBACs and primips. She currently shares office space with her backup physician, whom she highly appreciates for his professionalism and respect toward her and her families. She homeschools her two teen-age daughters and is the mother of a baby boy.

ผลลัพธ์ (ไทย) 1:

All midwives worry about postpartum hemorrhage. The three main keys to avoiding its occurrence are 1) good nutrition and supplements as needed; 2) knowing the mother; and 3) not rushing the delivery of the placenta. I have found that by applying these three keys as fully as I can both prenatally and in the third stage, my practice has a very low incidence of postpartum hemorrhage.The first key to preventing postpartum hemorrhage is good prenatal nutrition and supplements. I always require that my mothers keep a five-day diet diary to give me early information about their diet. As soon as possible I recommend changes in their dietary habits if they are needed. I encourage them to use such supplements as liquid chlorophyll, red raspberry and nettles. I also make a tincture of nettles, yellowdock, alfalfa and red raspberry, which I have on hand if it is needed. I have found the Spectrum 2C multivitamins by NF Formulas to be unsurpassed in their effectiveness for pregnant and lactating women. My families and I firmly believe in these vitamins, and many of them order from me long after the "big day." I also use them to maintain my own energy level, as I am a busy midwife and the mother of two teen girls and a baby!The second key, knowing the mom, entails making sure that you have recent blood work for this pregnancy. Check hemoglobin and hematocrit, of course, but also platelet count. You want to make sure the mother’s blood will clot properly after the placenta detaches. This key also includes knowing the mother’s nutritional status as discussed above.หมายเลข 3 เพื่อป้องกันการตกเลือดหลังคลอดจะไม่เร่งรัดการจัดส่งของรก เกือบทั้งหมด hemorrhages หลังคลอด ในความคิดของฉัน เกิดจากการรีบส่งเข้าสู่รก ในกรณีเหล่านี้ ผมเชื่อว่า เกิดจากช่องว่าง intervillous ที่ไม่มีโอกาสที่จะสัญญา และช่วยควบคุมการไหลของเลือดตกเลือด ยัง overmanipulation ของมดลูกช่วยส่งรกลอกสามารถทำกลีบไว้บนผนังมดลูกซึ่งทำให้เกิดการหดตัวของมดลูกไม่สม่ำเสมอ กลีบเหล่านี้จำเป็นต้องถูกเอาออกด้วยตนเองเพื่อป้องกันการตกเลือดหลังคลอดและติดเชื้อ นี่ไม่ใช่ความสนุกสนานใด ๆ สำหรับแม่หรือฮีบรู ได้เห็นแพทย์จำนวนมากและ midwives บางที่จะไม่ให้เวลารกจะส่งมอบของนั้นเอง เกินไป มีลดลงเหยื่อให้ความรู้สึกเล็กน้อย harried เป็นผมรอรกมา แต่นโยบายมือปิด เว้นแต่จะมีครบกำหนดทำให้เกิด เป็นกุญแจสำคัญเพื่อป้องกันการตกเลือดหลังคลอด ฉันได้เห็นบางอย่างไม่ถูกต้องหลังคลอดสี ซึ่งอาจมีการหลีกเลี่ยงถ้าผู้ประกอบการไม่ได้เข้าแทรกแซง และจัดการส่งรกมากเกินไปมดลูก atony ยังเป็นเหตุผลสำคัญในการตกเลือดหลังคลอด มีสาเหตุมาจากแรงงานยาว หรือแรง precipitous อย่างใดอย่างหนึ่งซึ่งสามารถก่อให้เกิดความเมื่อยล้าที่มดลูก และสามารถแยกบางส่วนของรกอำนวยความสะดวก ลองตัดนี้ถ้าเธอมีรูปแบบของแรงงานเหล่านี้อย่างใดอย่างหนึ่ง ยัง ตรวจสอบ และตรวจว่า เธอมีไม่พลัดถิ่นมดลูก โดยไม่ล้างกระเพาะปัสสาวะของเธอ ในเร็ว ๆ นี้ก่อนที่ จะผลักดัน หรือ หลังคลอดของทารกOne of my favorite stories of postpartum hemorrhage concerns a mother who had all five of her babies at home. My proctor and future partner handled the first two. This mom’s uterus wouldn’t maintain its firmness after delivery no matter what was done. We resorted to the old trick of icing down small pieces of the placenta and giving them to her! The reasoning behind this "trick" is that the hormones from the placenta will be absorbed into the maternal bloodstream. Placing a small piece between the cheek and gumline causes the hormones to be transferred sublingually into the mother. This facilitates clamping of the uterus and helps staunch blood flow. Icing and rinsing the piece down is for the comfort of the mom and to remove the extra blood from the piece. (Animals eat their placentas after giving birth for this same reason; by disposing of as much afterbirth material as possible, they also help prevent predators from coming after them and their young.)Giving the mother the iced placenta helped, but with her first birth she did end up at the emergency room the morning after the birth, where she was given Methergine to control the bleeding. The second birth was uneventful until after the delivery of the placenta. Once again, she bled quite a lot. We were able to control the bleeding better with this birth, but it was very worrisome to see that amount of blood. The third birth was about the same, with lots of blood, but we got the bleeding under control in a timely manner. I had served as her primary midwife with the last two babies, and because of her history of bleeding I started her on the above supplements. She didn’t, however, use the vitamins with the fourth baby. She dumped a bowl of blood with the placenta, but we got her under control very rapidly.During her fifth pregnancy, she added the vitamins. My assistant caught the baby, and I took over for the third stage. Mom sat on the birthing stool. As I waited for the placenta, I silently reviewed what to do when she bleeds out. Everything was ready. Then came a small gush of blood, followed by the placenta. I thought so far so good, looks complete and delivers in a reasonable amount of time, but where is the huge gush of blood that is so typical of this mom? We got her off the stool, put a pad on her (tip: use a newborn diaper for the first couple of hours postpartum; it really helps control blood seepage onto the bed and/or clothes), and I continued to watch and wait for her to gush, but she never did. Her bleeding was very normal and never gave us any cause for concern. I can only attribute it to the supplements she took prenatally. She never had an episode of heavy bleeding and stopped completely about eight days postpartum.Margarett Scott is a certified professional midwife with a thriving practice in Oklahoma. She has been practicing for more than eleven years and specializes in waterbirths, VBACs and primips. She currently shares office space with her backup physician, whom she highly appreciates for his professionalism and respect toward her and her families. She homeschools her two teen-age daughters and is the mother of a baby boy.

ผลลัพธ์ (ไทย) 3:

ผดุงครรภ์ทั้งหมดกังวลเกี่ยวกับภาวะตกเลือดหลังคลอด . หลักสามปุ่มเพื่อหลีกเลี่ยงการเกิดขึ้นของ 1 ) การโภชนาการที่ดี และอาหารเสริมที่จำเป็น ; 2 ) ทราบว่าแม่ และ 3 ) ไม่เร่งการส่งมอบของรก ฉันได้พบว่าโดยการใช้เหล่านี้สามปุ่มครบถ้วน ตามที่ผม prenatally และในขั้นการฝึกของฉันมีอัตราการเกิดต่ำมากของภาวะตกเลือดหลังคลอด

คีย์แรกเพื่อป้องกันการตกเลือดหลังคลอด คือ โภชนาการก่อนคลอดที่ดี และอาหารเสริม ฉันมักจะต้องการให้แม่เก็บไดอารี่อาหารห้าวันให้ฉันแรกข้อมูลเกี่ยวกับอาหารของพวกเขา เร็วที่สุดเท่าที่จะเป็นไปได้ ผมแนะนำการเปลี่ยนแปลงในนิสัยอาหารของพวกเขาหากพวกเขาต้องการ ผมสนับสนุนการใช้ผลิตภัณฑ์เสริมอาหารดังกล่าว เป็นคลอโรฟิลล์ , ราสเบอร์รี่สีแดงและตำแย .ฉันยังทำให้ทิงเจอร์ของ nettles yellowdock alfalfa และราสเบอร์รี่สีแดง ที่ผมมีในมือถ้าจำเป็น ฉันได้พบสเปกตรัม 2C multivitamins โดย NF สูตรจะไม่มีที่เปรียบในประสิทธิภาพของพวกเขาสำหรับหญิงตั้งครรภ์และให้นมบุตร . ครอบครัวของฉันและฉันเชื่อมั่นในวิตามินเหล่านี้และหลายของพวกเขาสั่งซื้อจากผมยาว หลัง " วันใหญ่" ฉันยังใช้พวกเขาเพื่อรักษาระดับพลังงานของฉันเอง ฉันเป็นภรรยาไม่ว่าง และแม่ของวัยรุ่นสองคน หญิงและเด็ก

ที่สำคัญที่สอง ทราบว่าแม่ใช้ให้แน่ใจว่าคุณมีงานเลือดล่าสุดสำหรับการตั้งครรภ์นี้ ตรวจฮีโมโกลบินและฮีมาแน่นอน แต่ยังเกล็ดเลือด . คุณต้องการให้แน่ใจว่า เลือดของแม่จะจับตัวอย่างถูกต้องหลังจากรก แยก .คีย์นี้ยังรวมถึงการรู้ภาวะโภชนาการของแม่ตามที่กล่าวข้างต้น

คีย์ที่สามเพื่อป้องกันการตกเลือดหลังคลอดต้องไม่เร่งการส่งมอบของรก เกือบทุกจุดเลือดออกหลังคลอด ในความเห็นของผม เกิดจากการเร่งรีบเพื่อให้รก ในกรณีเหล่านี้