Recovering from a Shocking Hemorrhage, Part 4/4

Important, read first:  This article was written to teach homebirth midwives and other birth professionals about effective naturopathic responses to excessive blood loss in childbirth.  If that’s not you, this frank discussion may be alarming.  It’s not gory or anything, but I would normally protect pregnant clients from doing a deep dive (and getting the mental imprint) on such a topic, unless they had a past event and needed this info. But I’m old-fashioned that way.  On the other hand, since women who’ve hemorrhaged in hospital births are often sent home with very little guidance and a prescription for constipating iron, this info is desperately needed out in the world! 

Full article first appeared in Midwifery Today, Issue 132, Winter 2019.

And Then Later, Recovery Over Time

Nutrition. Food-based support to help mama restore her healthy blood volume is usually the most sustainable and helpful. What are her family’s or her culture’s preferred high-iron solutions? I’ve seen grandma’s fried liver and onions, local plants, nettle soup, and magical dishes from other parts of the world do wonders. Bringing in traditions or family favorites lets everyone feel helpful and recover from their worry together. In the US, high iron foods include:

1. Dark leafy greens like spinach, Swiss chard, romaine, kale, collard greens, and wheatgrass juice. Steamed or roasted greens will nourish her more right now than cold salads, which need a lot of “heat or fire” to break down—hard for a blood-deficient mom to summon. Avoid parsley and sage, which are used to reduce milk supply.

2. Dried dark fruit such as raisins, currents, black mission figs, or prunes.

3. Blackstrap molasses daily; this is a great time for cheering her up with gingerbread and real whipped cream, too.

4. Dried beans and legumes.

5. Eggs, red meat, and organ meats (if she eats them).

6. Sea vegetables, such as varying seaweeds.

7. Herbal sources such as nettle, dandelion, yellow dock, kelp, alfalfa, watercress, and fennel.

8. Bone broths and/or herbal infusions will help restore mineral balance.

Check under the lower eyelid. The mucous membrane, revealed when the lower eyelid is pulled down, reflects the oxygen-carrying capacity of the blood in real time; anemia makes it paler. Familiarize yourself with this surprisingly accurate visual by checking your own and those of your clients, especially at their low points and when their Hgb is known through lab work.

Attend to the baby. Tell the baby what happened. “We’re really sorry that mommy had to leave so quickly to get help. She loves you very much. It was not your fault. You are together now and both of you are safe and sound.” What future perception do you want them to have? Addressing the baby’s narrative now will help diffuse the potential of being held back in life by that newborn experience such as, “If I make a move, someone I love leaves.” Coach the parents to address the baby with positive language; “If I were the baby, what would I need to hear?”

Attend to the family. Did the wide-eyed children see an ambulance take their mommy away? Did a family member later wash out birth bedding, experiencing a tangible shock of the red blood lost? Sometimes just calm listening is needed; sometimes down the road they also may need a bit of tenderness, rescue remedy, or hug. Helping family trauma heal also helps shift the family story about this birth, freeing mother and baby from a forever link to emergency triggers.

Lab results from using this naturopathic protocol

Here’s how the numbers actually went for Zoey*, who was supported with this protocol during and after bleeding that began suddenly post-placenta, after an otherwise smooth and relatively swift homebirth:

1. At 30 weeks, Hgb 12.2 g/dl.

2. At hospital one hour post-birth, Hgb 11.6 g/dl, with accurately measured blood loss (home/transport/hospital combined) that totaled 11.5 cups. This is approximately half her blood volume.

3. Remedies were brought to the hospital by two hours post-birth and she took them about every 10 minutes/hour, along with nibbling fresh cherries
   and eating lightly. She also received a total of two liters of IV fluids.

4. At discharge, approximately 10 hours post birth, Hgb 9.2 g/dl.

5. Three days postpartum, Hgb 6.8 g/dl, the lowest measured point.

6. Two and a half weeks postpartum, Hgb 10 g/dl.

7. Five weeks pp, 12 g/dl.

Other details of postpartum—She was careful to get ample fluids orally, in addition to continuing most of this protocol throughout her recovery. Her family and friends rallied to protect and provide for her over three weeks of resting and caring for her newborn, but not household or other children. She was mildly dizzy for the first few days if she sat too much and had a ferocious headache for over a week despite a wide range of approaches. (She now wonders if 2 liters IV was too much, and was partially responsible for headache.) At seven weeks she reported a high level of satisfaction with her birth and recovery, no emotional trauma from the experience, and an excessive milk supply.

To compare, the Red Cross requires women to wait at least eight weeks between blood donations of a half-liter (about two cups) of blood so their hemoglobin has sufficient time to return to at least 12 g/dl. Zoey essentially returned to her beginning hemoglobin within five weeks by using multiple iron-rich supplementation sources, even after more than five times that amount of blood loss.

In conclusion

 A birth professional using a comprehensive naturopathic approach to assist her client after a serious bleed can make a profound improvement in the client’s experience and memory of that postpartum experience. Doulas are also well positioned to offer holistic approaches as a healing ballast for their medically birthing clients, who are commonly discharged shaken and scared, with a prescription for iron and instructions to “resume normal activity.” Applying these naturopathic approaches when a serious bleed occurs expands your care in safe, effective, and cost-effective ways that are also medically compatible and empowering to all.

Now, dear ones, take a deep breath! Most birth professionals have witnessed a bleed that scared us deeply. We, too, must breathe deeply and release our highly-charged emotions around these events. And we can. Using these remedies will create a healing bridge back to normality and health for us to witness and absorb as well.

*Info shared with permission, pseudonym used to protect privacy.

References:

1. Association of Ontario Midwives. 2016. “Life after Postpartum Hemorrhage: Recovering from the Unexpected.” Accessed August 25, 2019. ontariomidwives.ca/sites/default/files/CPG%20client%20resources/Life-after-PPH-English.pdf.

2. ———. “PPH CPG Work Group.” 2016. Accessed August 20, 2019. ontariomidwives.ca/sites/default/files/CPG%20full%20guidelines/CPG-Postpartum-hemorrhage-PUB.pdf.

3. Brennan, Patty. 2018. Homeopathy for the Birth Bag, 5th ed. Ann Arbor, MI: Dream Street Press.

4. “Chlorophyll.” 2012. Hippocrates Health Institute. Accessed September 1, 2019. hippocratesinst.org/chlorophyll.

5. “The Donation Process.” 2019. NHS Blood and Transport. Accessed September 1, 2019. blood.co.uk/the-donation-process/after-your-donation/how-your-body-replaces-blood.

6. Gesicki, CR. 2018. “Postpartum Nutrition from a Traditional Chinese Medicine Perspective.” Accessed September 10, 2019. birthfit.com/blog/2018/04/24/postpartum-nutrition-from-a-traditional-chinese-medicine-perspective.

7. Higley, Connie and Alan. 2018. Reference Guide for Essential Oils. Spanish Fork, UT: Abundant Health.

8. Kruzel, ND, Thomas. 1992. The Homeopathic Emergency Guide: A quick reference handbook to effective homeopathic care. Berkeley, CA: North Atlantic Books.

9. National Institutes of Health. 2015. “Study shows iron supplementation after blood donation shortens hemoglobin recovery time.” Accessed August 25, 2019. nih.gov/news-events/news-releases/study-shows-iron-supplementation-after-blood-donation-shortens-hemoglobin-recovery-time.

10. Strange, K. “Simple Tools for Mothers.” Accessed August 18, 2019. static1.squarespace.com/static/57766acbff7c5070b30f351b/t/5ad5736470a6ad9f6119a096/1523938148634/Simple+Tools+for+Mothers+%282%29.pdf.