Since when is it physiological to have a retained placenta and major hemorrhage?

Natural childbirth and homebirth advocates have made “physiological” birth a gold standard. Unfortunately, they seem to have confused “physiological” with “refusing medical care” regardless of complications.

Consider this acolyte of Janet Fraser’s who boasts of her “physiological” 16 week miscarriage. In the first place, miscarriage by definition is pathological. Second, retaining the placenta for days, hemorrhaging and requiring assistance in evacuating the uterus is not even normal for a miscarriage.

No matter. The mother tells her tale as if it were something other than objective evidence that her midwife is ignorant and she is completely clueless.

… I’ve already begun to think of this miscarriage as my first home birth, which gives me some comfort.

On Tuesday 3rd of Jan I woke up feeling like my body was gearing up for a period. I had a loose bowel movement, normal for me on the first day of my period. My body felt crampy. I was not surprised when I wiped after a pee to see a small amount of mucusy blood…

For the next 24 hours or so I was filled with fear. Not for my dead baby. But for what might lay ahead for my miscarriage…

Nice. No fear for the baby, only for herself.

The next morning, my waters broke… It struck me with full force then- my instincts were right …

Her instincts? She didn’t have instincts; she had symptoms. You don’t need any special insight to figure out that bleeding and cramping is a sign of an impending miscarriage.

I had mild cramping exactly like period pain… I stood up from the toilet and took a step towards the door. My baby just fell out of me…

She called the midwife, whose behavior was nothing short of criminally negligent:

I began passing clots and blood, not a crazy amount but constant. The cramping was coming and going, rhythmic like in labour…

… I lay back to rest and tried to see my baby, still between my legs, attached to his/ her cord but it was tricky… I really wanted to give him/ her a chance to stay connected to his/ her placenta.

Around 4 pm, with no cramping or passing of blood/ clots, 8 hours after I birthed my baby we decided to cut the cord. I finally got a good look. It was a girl.

Now the real crazy begins. The mother had a retained placenta for 8 hours, a pathological complication by any stretch of the imagination, and the midwife … left. Retained placenta leads to pain and bleeding or both. Far from demonstrating “physiological” miscarriage, the patient and her midwife demonstrated the natural history of untreated miscarriage complications.

Fully 4 days after passing the baby (but not the placenta), the mother began to hemorrhage. The midwife offered more midwifery nonsense (tincture of angelica).

The midwife returned 36 hours later:

We both felt that my miscarriage was coming to an end…

The next day, Tuesday … around 5pm, very suddenly and with a force and pain that left the previous big bleeds for dead my contractions started up again…

My midwife came and supported me through the next few hours. I passed some significant lumps of membrane and many smaller dense lumps and so much free running blood into a bowl, into the toilet, into towels…

Despite continuing bleeeding, the mother and her midwife felt no sense of urgency:

Before my wonderful midwife left … we decided I would see my GP the next day…

I saw a doctor I’d never met before… [S]he did a blood test and organised a scan to take place within 20 mins down the road.

… Later that day my doctor phoned to say the scan was clear, it looked like I had nothing left in my uterus. She said to go to bed and rest and let my body recover…

Later that evening my doctor called back with the blood results. Suddenly she was not so relaxed. My haemoglobin was very low, 75 for those that know what it means. She gave me her mobile number and said I absolutely must not bleed anymore and to go to hospital if I started to…

Guess what? Cramping started up again.

It was about 10pm I think when we arrived in emergency at RPA…

Eventually a female Ob walked in…

… Within moments of inserting the speculum – this terrifying large cold metal thing that she turned a screw and expanded once inside my vagina- she said she could see a ‘clot’ or something and was going to give it a little tug… She had to use considerable strength to remove it, a huge compacted piece of placenta about the size and shape as an erect penis…

My body felt so different. Even as soon as the piece of placenta was removed colour returned to my lips. Within a few hours I felt entirely different and realised just how fucking awful I had been feeling with my cervix blocked up…

The mother was called back to the hospital to discuss the issue of her extremely low hematocrit (blood count). She was offered a transfusion, but declined.

The next couple of days are again a blur… I had long spells of shortness of breath, numb or tingly weak limbs and at times chest pain. The only position my body could handle when like this was flat on my back with my feet raised above my head…

This woman is lucky that she did not die from hemorrhage or infection or both. There was absolutely nothing “physiological” about the miscarriage or about the major complications that she experienced. Declining treatment does not turn a pathological situation into a physiological one. It merely turns a pathological situation into a life threatening one.

In pursuit of a bizarre ideal, this women nearly killed herself … and she’s proud of it.

  • I survived!

    This article is ridiculous!! I had a miscarriage with retained placenta that lasted 4 months. I am going through the medical system with doctors, not midwifery. It has been a joke. I went back to my doctor every two weeks regarding my prolonged bleeding. After blood tests and an ultrasound it was decided I needed to see a specialist to determine if I still had retained placental tissue. While on a wait list, I passed placental tissue — nearly 5 months after my miscarriage was considered complete! The only reason I maintained my health despite astonishing blood loss (every day for more than five months, is that I have used my own brain and knowledge of health and alternative health to keep me well. It is a miracle I did not get a major infection or develop other complications. All this was through the medical system, with doctors. Maybe I would have been better off with midwife care! It appears there can be cases where both midwives and doctors can be irresponsible and ignorant.

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