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Henrietta

Age at interview: 31
Age at diagnosis: 29
Brief Outline: Henrietta was expecting her first child. Her daughter was born without complications, but after the birth Henrietta started to haemorrhage.
Background: Henrietta works in the energy industry and is married with one daughter.

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Henrietta was expecting her first child. Her pregnancy was uneventful, and she went into labour at 40 weeks. She labored for a day, and then called out the midwife, hoping for a home birth. The midwife monitored her at home for a while, but after she became concerned that the baby’s heartbeat was not recovering sufficiently after each contraction, they decided to go into hospital. Her daughter was born without complications. However, when Henrietta went to have a shower after the birth, she noticed that she seemed to be bleeding quite a lot. Not having had a baby before, she wasn’t sure if this was normal or not, but there was too much blood to get dressed again. She wrapped herself in a dressing gown and went back to bed. 
 
She mentioned the bleeding to the midwife, who did not seem interested or alarmed at first. However, when she did come and have a look they could see that the bed sheets were getting stained consistently with blood. Henrietta was moved to a different room where she was monitored. A Senior House Officer asked them to strip the sheets and weigh them at regular intervals to try and work out how much blood she was losing. They assumed that she was bleeding because her uterus had not contracted, so they gave her Syntometrine, via a drip. However, the bleeding did not stop, and Henrietta was feeling more and more tired. After several hours, a consultant decided that they needed to operate to see what was going on. A spinal block was put in and she was wheeled into theatre. She signed a consent form, and was told briefly during the operation that they had found some tears, but no more information and follow up was offered. The doctor did not come and see her after the operation.
 
She was sent back to the post-natal ward about 10pm, visiting hours were over, and she faced the night trying to look after her baby while the spinal block was still in effect, and she had a catheter in. She found it very difficult. She was given injections the next day, but she didn’t know what for. They took tests and decided she didn’t need a blood transfusion, and just told to eat steak and chocolate to boost her iron levels.
 
She was discharged from hospital the next day and had no more than her GPs six week check, at which they didn’t know she had had a Post Partum Haemorrhage (PPH). Eighteen months on she is pregnant again. While not overly worried about at PPH, she has been told by the midwife that there is an increased risk of it happening again, and she would like more information about why that is. Generally, more information about what a PPH is, what to expect, would have been welcome. Given the prevalence of PPH, she would like to have been warned about it in ante-natal classes. 
 
 

Henrietta had her daughter naturally, and noticed that she was bleeding quite a lot when she went...

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So they called an ambulance about half five in the morning, something like that. And then got to hospital, had an epidural, which was quite nice. And everything else was absolutely fine, then, had her naturally no problems. I think she was born at about quarter past ten in the morning and everything seemed well.
 
And went off to the post natal ward. Had a shower, things like that. And obviously it’s very difficult when it’s your first, to know how much you should be bleeding. 
 
So I went to have a shower and felt very uncomfortable, like I couldn’t put my clothes back on, because I was bleeding so much, that it just seemed silly to put any clothes on, because they were just going to get covered in blood. 
So I felt a bit awkward. 
 
Went back to the post natal ward. You know, I said, after a while I said to the midwife, “You know, I’m bleeding quite a lot.” And the trouble is you know, the post natal ward is quite busy, so she said, “Okay, I’ll come and see you in a minute. I’ll come and see it.” And went off and did a few other things, and eventually came back, and was like, “Oh yes, you are bleeding quite a lot.” Sort of thing. It just seemed to be, it seemed she wasn’t particularly bothered or interested. 
 
So I just stayed in the bed in the post natal ward for a little and, and eventually she came back with a couple of other midwives and they decided to remove me from the room. So they wheeled the bed out, and the only room that they had empty was, something like, well I think it said on the door something like you know, ‘Emergency Recovery Room’ or something quite daunting, but actually it was obviously just a room that they stored loads of gear in, so they had all sorts of machines and things sitting there, and while we were in there, people would just keep coming in and taking things, taking equipment out the room, and they were just like people wandering in and out all the time, which was a bit weird.
 
Yes, so that was probably about 2 or 3 in the afternoon at that point that we went into a different room. And I think they called one of the doctors I think an SHO and they came and they said to keep the changing the bedding and to weigh it. So they were changing the sheets and the padding and everything on the bedding every fifteen minutes or so and weighing it to see how much blood loss there was.
 
And then you know, another doctor would come in. The registrar came in later and was saying, “Oh yes, you know, it’s quite a lot of blood and everything, they just sort of carried on for a while.” They kept on giving me Syntometrine because they thought that it was that my uterus hadn’t contracted, which I believe is the most common cause of haemorrhage, that’s what I’m told. That wasn’t the case with me. 
 
So they kept giving me Syntometrine and I was on a Syntometrine drip and it obviously didn’t have any effect. And it got quite frustrating because they kept wanting to feel the uterus to see if it had contracted. “Oh yes, yes, it has contracted really well, but we’ll just keep giving you more Syntometrine.” And it felt a bit like, well if you can tell that’s not the problem, then maybe it should be something else. But they kept trying to treat what they thought was the most common cause.
 
So I was just there all the time, and they were weighing the bedding and giving me more Syntometrine, this kind of thing. And they kept putting in different cannulas all the time. I ended up with five difficult cannulas in because they just kept messing it up and obviously at this point I was really qui
 

Henrietta thought it would have been nice for someone from the hospital to explain to her a bit...

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Okay and did you have any sort of follow up at the GP in terms of you know, monitoring your iron levels and how you recovered?
 
No, nothing at all, no. No I mean I don’t know that, I don’t know how it works with your notes or anything. I mean I had my follow up six week check with the GP as normal and you know, they certainly didn’t know anything about my birth. You know, I had to tell them what had happened and things and they didn’t seem really concerned.
 
Right so they hadn’t heard that you’d had this post partum haemorrhage?
 
No. They didn’t know that.
 
Right and do you think it would have been a good idea for them to know?
 
I guess it probably would have been, because if I’d had any follow on problems it probably would have been the GP that I would go to first in that circumstance, so yes it probably would have been good for them to know. Yes, and in some ways, I guess I kind of feel like it would have been nice to have something from the hospital to say, you know, ‘This is what happened. This is what we did. And this is what we expect the ongoing consequences to be, if there are any, you know, if there is things like if you have another baby there might be an increased chance of it happening again.’ Or even if they say, ‘There’s no risk of that or whatever, you know, it would be nice to have something that kind of concluded it, I guess. Because you don’t get your notes, you don’t ever know what really happened I guess, or what, what it appeared like from there point of view. It would just be nice if they had sort of said, you know, ‘this is what happened, and this is what we think might happen in the future’. Or, I don’t know just something to conclude it.
 
You were never offered any follow up via the hospital to go and see the doctor or the surgeon?
 
No, no.
 
And do you think that would have been helpful?
 
Well yes, I mean I guess just in terms of closing it off it would be nice for somebody to sort of say what had happened and explain it a bit more I guess. And yes, and to know if there was going to be anything in the future that might be an issue or not.
 
 

Henrietta had delivered her first daughter without complications. When she was in the shower...

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So I went to have a shower and felt very uncomfortable, like I couldn’t put my clothes back on, because I was bleeding so much, that it just seemed silly to put any clothes on, because they were just going to get covered in blood. 
So I felt a bit awkward. 
 
Went back to the post natal ward. You know, I said, after a while I said to the midwife, “You know, I’m bleeding quite a lot.” And the trouble is you know, the post natal ward is quite busy, so she said, “Okay, I’ll come and see you in a minute. I’ll come and see it.” And went off and did a few other things, and eventually came back, and was like, “Oh yes, you are bleeding quite a lot,” sort of thing. It just seemed to be, it seemed she wasn’t particularly bothered or interested. 
 
So I just stayed in the bed in the post natal ward for a little and, and eventually she came back with a couple of other midwives and they decided to remove me from the room. So they wheeled the bed out, and the only room that they had empty was, something like, well I think it said on the door something like you know, ‘Emergency Recovery Room’ or something quite daunting, but actually it was obviously just a room that they stored loads of gear in, so they had all sorts of machines and things sitting there, and while we were in there, people would just keep coming in and taking things, taking equipment out the room, and they were just like people wandering in and out all the time, which was a bit weird.
 
Yes, so that was probably about 2 or 3 in the afternoon at that point that we went into a different room. And I think they called one of the doctors I think an SHO and they came and they said to keep the changing the bedding and to weigh it. So they were changing the sheets and the padding and everything on the bedding every fifteen minutes or so and weighing it to see how much blood loss there was.
 
And then you know, another doctor would come in. The registrar came in later and was saying, “Oh yes, you know, it’s quite a lot of blood and everything, they just sort of carried on for a while.” They kept on giving me Syntometrine because they thought that it was that my uterus hadn’t contracted, which I believe is the most common cause of haemorrhage, that’s what I’m told. That wasn’t the case with me. 
 
So they kept giving me Syntometrine and I was on a Syntometrine drip and it obviously didn’t have any effect. And it got quite frustrating because they kept wanting to feel the uterus to see if it had contracted. “Oh yes, yes, it has contracted really well, but we’ll just keep giving you more Syntometrine.” And it felt a bit like, well if you can tell that’s not the problem, then maybe it should be something else. But they kept trying to treat what they thought was the most common cause.
 
So I was just there all the time, and they were weighing the bedding and giving me more Syntometrine, this kind of thing. And they kept putting in different cannulas all the time. I ended up with five difficult cannulas in because they just kept messing it up and obviously at this point I was really quite tired. So I wasn’t too impressed with what was happening and yes, eventually I guess a consultant came and said, “Right well we’re going to take you into theatre to see what it is, because it could be a number of different things.” And then she disappeared again and an anaesthetist came back to say, you know, going to give me a spinal block so that I could go into theatre and so on, and so they sort of briefed me on that and then they took me down to theatre and it was change over time on the shifts. 
 
 

Doctors were able to stop Henrietta's bleeding quite quickly and she did not need a blood...

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So the next day then they decided that you didn’t need a blood transfusion. Did they put on any iron medication or..?
 
No, they didn’t. They said that I should eat some steak and some dark chocolate which went down very well [laughs]. And that was basically it. Yes, they had no problem with it really. And we then just had to hang around to be sort of signed off and discharged and everything and the thing was it’s the whole, you know, the doctor comes round every afternoon to sign off all the babies. And we’d miss that you know, I mean [daughter] had been on the list the day before, but because we then got moved into another room, she’d missed betting signed off. So we had to wait for her to get signed off that day, and in the end we didn’t wait. Because I just was ready to go home, so we just left.
 
 

In her current pregnancy Henrietta has been told by her midwife that she will have to give birth...

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I don’t think about it too much, because if it happens then it happens. And at least at this time I might be a bit more familiar with what might be going on. I guess I’m not really sure. I guess I’m probably worried that afterwards I’ll be really conscious of like how much blood there is and I’ll be worrying about this, is this, you know, is this too much, how does this compare to last time? Sort of thing. I think I’ll be worrying about it quite a lot then.  And again like not having any experience of what it should be like, you know, I don’t, you know, I won’t really be able to really to have… I don’t know I think that’s the only thing I’ll probably be a bit twitchy afterwards.
 
Have you spoken to anyone about. I mean how do you feel about being pregnant in terms of haemorrhaging and have you said anything to anybody about that?
 
I haven’t really, I mean I just kind of assumed you know, that it’s just one of those things, totally random, it was a tear, you know, that could happen to anybody, so I’m not that bothered by it, and I haven’t ever thought that it would happen again. I mean it might you know, but there’s no more chance of it happening again than for anyone, so I’ve not been that worried about it. But I have to say that when I saw the midwife for the first time, for booking in for this one, she did say, “Well you’ll have to have it in hospital, because there’s an increased chance that’s I’ll haemorrhage again.” And I was like, “Really is there?” But she didn’t explain why that was. And that’s quite frustrating because just I’d like to know why? If there is why is that? You know, and just out of interest really, I guess, just to understand and I guess may be its just me I’m a bit cynical, because she couldn’t explain I kind of feel like well may be you don’t, I’d rather here that from a doctor. You know, if a doctor could say to me, you know, there’s more chance of haemorrhage of this, it’s all right.” Then that would, I’d accept that and that would be okay. I kind of feel a bit like you know, maybe she’s just saying that, and that’s a bit frustrating.
 
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