Breastfeeding after blood loss - Leanne's story part 1

Although the episode title refers to blood loss, Leanne’s story is about far more than that. It is important to flag up that Leanne’s birth contained trauma and her calm and articulate description of her experience is testament to who she is as a person, and the support and debriefing she has received. It won’t be an easy listen for everyone so please consider this a trigger warning for birth trauma. How does someone get breastfeeding off to a good start despite a very challenging and difficult birth? What factor can blood loss play? Leanne’s story is an example of the value of good support, communication and a mother’s determination.

We’ve split Leanne’s story into two parts, so that you can skip this episode if you prefer not to hear the details.

My new book, ‘Supporting the Transition from Breastfeeding: a Guide to Weaning for Professionals, Supporters and Parents’, is out now.

You can get 10% off the book at the Jessica Kingsley press website, that's uk.jkp.com using the code MMPE10 at checkout.

Follow me on Twitter @MakesMilk and on Instagram  @emmapickettibclc or find out more on my website www.emmapickettbreastfeedingsupport.com

Find out if you are eligible to give blood at www.blood.co.uk

Information and support for traumatic births can be found at The Birth Trauma Association and MIND

This podcast is presented by Emma Pickett IBCLC, and produced by Emily Crosby Media.

Transcript

Hi. I'm Emma Pickett, and I'm a lactation consultant from London. When I first started calling myself Makes Milk, that was my superpower at the time, because I was breastfeeding my own two children. And now I'm helping families on their journey. I want your feeding journey to work for you from the very beginning to the very end. And I'm big on making sure parents get support at the end to join me for conversations on how breastfeeding is amazing. And also, sometimes really, really hard. We'll look honestly and openly about that process of making milk. And of course, breastfeeding and chest feeding are a lot more than just making milk. 

Emma Pickett  00:43

I'm just about to be joined by Leanne Fitzpatrick, and we're going to be talking about her lactation journey, which includes touching on the impact of blood loss on lactation. But before she joins me, I thought I perhaps should give you a little bit of information about lactation and blood loss. And it seemed a little bit insensitive to do that with her sitting in front of me. So I'm just recording these few minutes just before she joins me. So there's a couple of sources I'm going to use to help me talk about this. We've got the brilliant book Making More Milk by Lisa Marasco and Diana West, every lactation consultant has making more milk on their shelves. It's a brilliant book to really dig deep as to why somebody might not be producing a film milk supply and what might be going on with milk production. And then another book, which is Breastfeeding Answers by Nancy Moore Bakker, which is one of the recommended texts for anyone who's going to become an ibclc and do the ibclc exam. So we're going to talk about the impact of blood loss in delivery. Now, losing blood, when you give birth is normal. It's normal to lose up to a pint. So that's 500 millilitres of blood. If you're giving birth vaginally, it's normal to lose about double that about 1000 millilitres, if you're having a C section that those are considered within normal limits. But once we get beyond those normal limits, and that's maybe more than about 1500 millilitres of blood, we could potentially be seeing an impact on milk production. So there are two reasons for that. One is about the drop in iron, and the loss of those iron rich red blood cells and possibly tipping into anaemia. So if we see a fall in haemoglobin by about four grammes per deciliter, or it becomes less than seven grammes per deciliter, we see a relationship with poor milk production. So in one study, 70% of women who lost less than 200 millilitres were fully breastfeeding in the first week, compared with 50% of those who lost more than 3000 millilitres of blood. Now some of that could be because, you know, the conditions of lack blood loss were to do with having a more complicated delivery, you know, someone's health was being threatened. There were other priorities and in the care for that family could also possibly be connected to the drugs that are given when someone's troop having a postpartum haemorrhage, treated. The second risk from haemorrhage isn't so much about the iron levels dropping, but what happens to the pituitary gland. So when there is a sudden loss of a large amount of blood, that pituitary gland kind of freaks out and essentially collapses and stops being able to function now a bit of damage. So mild to moderate damage is referred to as a pituitary insult, and that's going to recall cause reduced functioning. But severe damage can actually cause those lactation hormones to fail completely. So the the hormones of lactation prolactin and oxytocin are in the pituitary gland. They're not to do with your ovaries are not to do with sex organs, they're to do with what's in your pituitary gland. So if the pituitary gland is essentially failing, we're not going to be able to produce that prolactin which is what we need to make milk production work. And when we have severe damage to the point, we have complete lactation failure. We have something called Sheehan syndrome. And when somebody has complete lactation failure, from Shihan syndrome, we're really going to struggle to get breastfeeding off to a good start. That means that essentially, milk is not going to come in, they're not going to transition from colostrum to mature milk, and they're going to struggle to lactate at all. Now she had syndrome is very rare. It's very, very rare in developed countries where people are going to get access to good hospital care. But there are some cases still, in countries where there is hospital care where things have gone really pear shaped and pituitary function has been compromised, much more common in developed countries to see people with mild to moderate pituitary insult rather than she had syndrome. We used to say that when somebody had she had syndrome, that was it for the rest of their time as a parent, they wouldn't be able to ever breastfeed. But we do have some cases now of somebody going on to lactate with a second baby. So not all hope is lost. One thing that's important to know is we can't necessarily guarantee what's going to be happening with someone's lactation journey. So even if somebody has lost more than 1500 millilitres even if they've had that big fall in haemoglobin, even if they've lost 2000 millilitres, we don't necessarily know what the impact on lactation is. But when somebody has experienced that significant blood loss, we're going to need some careful monitoring, it is a red flag, we're going to need to keep an eye on baby's nappies in that first week, we're going to need to make sure that milk removal is as absolutely as effective as it can be. These are the families who are going to really need help with positioning and attachment. They may need some extra support to get their milk supply off to a good start. These are the families where we may be seeing the mom or lactating parent having a prescription of something that may increase prolactin if we're just dealing with pituitary and salt. So that's all the sciency stuff. If you're still with me, well done. Let's now talk to Leanne about her experience of blood loss and lactation. 

Emma Pickett  05:49

Thank you very much for joining me for my conversation with Leanne. Leanne Fitzpatrick is a first time mum, who's here today to talk about her experience of breastfeeding after blood loss. And before we get started, Leanne, I just want to flag up that when you listen to this episode, this is about four minutes, four or five minutes in, because I've just spent the last four or five minutes explaining about lactation after blood loss and giving the sciency stuff and talking about she had syndrome and pituitary insult and an X amount of desperately, you know, grammes of iron per deciliter, etc. So the reason I'm highlighting that is because I don't want you to listen to that and get a bit of a shock and think, hang on, she's just banging on about all this sciency stuff, where do I appear. And you might even want to skip over that stuff. Because it might not be stuff you necessarily feel you need in your life. But so I've done a little sort of four, four or five minutes summary of some of the issues around lactation and blood loss because a lot of people don't know what the impact of blood loss can be on lactation. And actually, before we talk about your story, I just want to ask you, did anyone talk to you antenatally about blood loss and lactation? Did you have any understanding of what the impact could be or the relationship between those two things?

Leanne Fitzpatrick  06:58

Not antenatally. But four days after my blood loss, I was subsequently informed that it was highly unlikely that my milk could potentially come through just because I'd had such major blood loss and but not antenatally. Okay. At all, although I'd done quite a lot of antenatal classes before labour.

Emma Pickett  07:17

Okay. Yeah. I mean, I guess some people would say, gosh, do we want to give the information antenatally? I mean, we could have a whole nother hour debating on what the purpose of antenatal education is, and how much information is too much. But I guess, I would feel the four days feels like a long time to deliver that information. But I guess it depends a little bit on what state you were in. So let's take a step back and talk about your experience. So thank you very much for joining me today to share your story. Tell me where you are. Now. How old is everybody? I don't necessarily mean you. How old is the family? What family have you got yet. 

Leanne Fitzpatrick  07:49

So my little boy Lorcan was born on the second of September last year. So he's six months now. So just starting our introduction to solids, which offers extremely quick but also really long at the same time. had six solid months of lovely exclusive breastfeeding. And now I'm like, Oh my gosh, shipping other things to to that diet. So here we are.

Emma Pickett  08:12

I remember that feeling. It's a funny one, isn't it? It's kind of fun and exciting. But also Oh, I was doing it all. And I knew I knew that I was responsible for those fat rolls and that weight gain. And now the world of food is kind of fun, but also that big and scary at the same time. How are you feeling about it?

Leanne Fitzpatrick  08:29

Yeah, absolutely, I think is that because I've also got quite a chunky little boy who's already over 10 kilos who was born at 4.12, I don't impact again, I'm going to do the terrible thing of switching between metric and imperial. But it was nine pound two and a half ounces at birth is a big boy. And therefore has like lovely fat rolls that he's developed over the last six months. I feel very proud for the breastfeeding. And now I'm starting to think, oh, we probably lean out a little bit with all this food. But currently just literally licking looking a bit of a pepper this morning. That was the highlight of this morning yesterday. pots in the tomato slices of tomato. The purees are just a disaster at the moment. That's just too stressful to clean up after 

Emma Pickett  09:14

oh gosh, I remember those days of mess. I remember once saying you know what? Every household needs a really friendly trained rat that you can like chain up underneath the kitchen table and there's just trained to like run around and clean everything and eat all the bits of food that fall on the floor. And just Yeah, okay, I can see from your face that you don't think that's a very good idea. But I just there's so much mess everywhere. Yeah, I very, very much sympathise with that. So, so a bit of a spoiler alert, you're still breastfeeding at six months. So even though this is a story about breastfeeding after blood loss, it ends in a positive way and it shows that you can overcome even what is a very difficult start. And there may be some people who are coming along along to this episode, for whom there wasn't a happy end. Maybe for some for some people who might have even had she had syndrome and complete poetry. Literally failure or may have had such significant blood loss that their milk never really came in, which is something that sometimes happens. So, if that is anybody's story, and you are hearing this, I am really sorry that that was your experience. And I'm sorry, that's what you went through. And, and, you know, we know how hard it is to not be able to breastfeed in the way that you want to, and you have our sympathy, if that is your story. Let's start with the beginning. So you're pregnant with lovely Lorcan. And what happened with the birth and how did things go? 

Leanne Fitzpatrick  10:30

Yeah, so he was due on the 25th of August. So a week before we I delivered him so and in that kind of point where I was due and that due date, I really was having like a very long latent Labor's overnight lots and lots of contractions. And then during the day, absolutely nothing. So just chilling out at home. I'm a big sporty person. So just lots of light bouncing on my board, lots of kind of like gentle exercise, hoping that things would move along. And by the end of that week, for the Friday, I was in such incredible agony overnight that I'd had a bit of reduced foetal movement anyway, so I've been into triage, and they had recommended that I was probably so far along in terms of my own dilation that I could probably go in for to get my membrane membrane bursts. So my waters broken. And so on the Friday morning, I woke up and I was like, I need to get this Arn. And the you probably know the term for that better than I do. But essentially getting my waters broke. Something's exactly rotting my rupturing my brain brain of some, some sort. And I really wanted to move things along because I was in such agony over that, that last kind of night of contractions, and then they petered out that I did want to move things along. So that day, I went into hospital, actually, so I live in Manchester. So I ended up going to a different hospital to the one that I'd originally chosen because they had a bed for me. And all things considered, I think that was the probably the best things that had happened that happened. And I always look back on these sorts of things and think that certain things are really just meant to be in the way the stars align, in all kinds of you know, and again, you know, feeling for anybody out there that has been through, you know, any kind of trauma or any kind of trauma related to a birth or post their birth, you know, there's those peaks and troughs, and sometimes you really do get stuck in those troughs. But for me, the way I've kind of rationalised that decision to move to a different hospital probably resulted in a really positive experience on the other side of things for me. And so I went into hospital, everything was pretty standard, they decided to I was they were happy with my four centimetres and decided to go ahead with bursting my my waters, and I got my own contraction started. So I didn't need any synthetic oxytocin or anything, I just got started naturally. And so a couple of hours in happily going away but little baby that we didn't know it was a boy or girl didn't know the genders but at them now we know who the boy so look and decided that it was gonna get in a really awkward position. And so I was trying to push them out at six to seven centimetres dilated. So that really wasn't the best of situations trying to push a baby out way too early. So that was when the epidural came in. So that was kind of very up into this point, I would say pretty much standard birth experience in terms of any kind of baby that is in a little bit of an awkward position. And the decisions that were made. And I felt really confident. And the team's hands were the kind of the decisions they were making. Though at one point, I was crying out for a C section I do distinctly remember that before they got because before the epidural went in, I was still only on gas and air and my 10s machine like everyone's like it was a lot of ego. Anyway, lots of people that will listen to you because we're I'm sure remember their own experience and the pain that goes with that so and the joy as well. So that was kind of where we were and then that was sort of roughly about four, maybe somewhere between four or 6pm on that sort of Friday, I'd gone into hospital at 11am My waters were broken at one and so roughly around four or six that that things kicked off with the epidural and I was having a quite a nice relaxing time in the bed and just waiting for everything to kind of naturally progress and so baby has been really good the whole way through my pregnancy right over the my cervix has had lovely down and in a perfect position apart from the fact that it was slightly twisted. So the hence why I was trying to push him out. But he decided to start crawling up the birth canal. He got a little bit confused, excited. And that meant that we started to have a bit of a challenge with his baseline heart rate. So and essentially there was a few calls on the emergency button just to send check what was going on. And a number of something they call an FTP, which is what they when they take a little bit of blood off the top of baby's head, just to send check his oxygen levels. And so that was sort of where we were in terms of everything. And then really where we ended up was that we moved to a cat one C section, roughly half past midnight on the Saturday morning, after waiting for me to move past nine centimetres dilated, and it just wasn't happening after an hour. And the baseline heart rate was just dropping so much that they decided to make that call.

Emma Pickett  15:42

Can I just ask you a sciency question? When you say cat one, can you explain more cat one? Sorry, just like explaining the basics. 

Leanne Fitzpatrick  15:51

Yeah so category one C sections. So that means that there's two types of I think emergency C sections. So there's a category two c section and a category one C section. And that is essentially an unplanned C section. And the two different types kind of dictate how quickly they want to get the baby out of you and the kind of procedures that have in the theatre room. So standardly with a category one, they won't let your partner come in just because they really want to get the baby out as quickly as possible. But we were fortunate that my husband could come in to the delivery theatre, or theatre or I should just say with us, so he was there during that that C section but it was very much we were very much rushed through. And for the best because Lachlan did need to get resuscitated when he was delivered. 

Emma Pickett  16:40

Okay, yeah, and you're only because of your epidural you didn't need a general anaesthetic or anything, you're awake, you know what's happening? Yeah, I'm guessing everything's a bit of a blur at this point. So asking how you're feeling is a bit of a stupid question. What are your kind of memories of those few moments of move beginning moved into theatre?

Leanne Fitzpatrick  16:56

That's a really good question. Because obviously I'm just getting over things that are for me have become a my like my normal in terms of my story. So thanks so much for kind of helping me too, because I had the epidural with the epidural got topped up, but I was I was awake for the the C section. I remember being drugged, like delivered through and at the time, I was insanely calm. And looking back on it my Lisa says to top top, my epidural had said to me, you're really calm going into theatre. And I was just kind of, I guess there was two sides of this. Firstly, I was just happy that we were getting the baby out because after a 12 hour labour, and like knowing that we weren't going to get any further, I was at the point where I was like, bit sad and quite disappointed that the vaginal delivery kind of I'd initially wanted wasn't going to be any more. But also, I just, I didn't want to put my baby at risk any any longer. So I was kind of that was all quite let the serenity of calm. The other thing that happened was in our build up to labour, my husband and I had done a number of antenatal courses. And I'll mention later, who's who those were live. And so we were ridiculously informed about all different paths that Labour could go through, right through, we'd actually even watched like a C section an emergency. So no, not an emergency section is a planned C section, just to understand through those classes. And so because I'm quite an analytical person, I think having all of that information and that knowledge ahead of what I was going into, in that right fight or flight moment of like, oh my gosh, we something really unexpected, that we didn't quite think would happen is happening, we're going through to this level of C section, this emergency situation, my body was able to kind of keep myself calm with this knowledge that I had that was knowing I'm going and be in the right hands. There's going to be lots of people in the room. But they're all of those people have different jobs to do. And they're all going to be tasked with making sure that my baby is delivered safely. And I'm I'm safe and my husband is looked after and that's their role for that. So I think there was this like overwhelming sense of calm that came with my mind. That could also be because I was on the epidural probably.

Emma Pickett  19:13

I guess we don't need to know why the calm was there. Good drugs definitely have their place. I'm glad that we're however you got there. You were in that calm state. And I hope he wouldn't mind me asking this question. But your husband wasn't benefiting from drugs at this point. Unless there's something you're not telling me. So how was he feeling? I mean, did he as he had a chance to kind of debrief some of his feelings at this moment, I guess. I'm sure you've talked about it and you don't vote for you have to tell me if it feels like a very private conversation, but I can't imagine what it feels like to watch a baby being birthed and then watch them being resuscitated worrying about you and worrying about baby at the same time. It's quite tough for a partner. How does he think back on those moments do you think?

Leanne Fitzpatrick  19:52

So the resuscitation we didn't actually find out about until after our hospital debrief and my husband knew something was up because he got the baby got lost. Welcome, got taken phrase checks twice. So the first check. And then the second check. And that was where we knew that there was something going on. They were there was essentially masking. And sort of my husband's name is Rory. But at the time when we were in the kind of the theatre room, and I remember looking up at him once they've delivered Lorcan, he was obviously ecstatic. And then kind of there was this sort of moment where post sort of retrospectively now we know, Lorcan was being taken away. It wasn't a bad like from my understanding, because ABB scores fine after they kind of resuscitated him. So we were in an okay situation with law could but the kind of the main stress, let's say, of that instance, was overwhelm and delight of the fact that we now knew we had a baby boy. And we were really excited when my husband told me later that I had actually named him when, like, we, when he was delivered, like we knew the name. But when they asked, Oh, it's a boy, does he have a name? And I said, Oh, his name is Lorcan, James. So at that point, I think, yeah, maybe the path to delivering locum was very wiggly for us at that point. But all in all, we were quite in a content state, let's say. So at that point. Rory was feeling oh, my gosh, this has been quite stressful to get here. But this is off, now. We've got babies delivered the and just needs to be kind of stitched up. And then we can, you know, go on to a slight small bit of recovery, and then off, we go home. And so at that point, everything is sort of hunky dory, not hunky dory. But as in retrospect, in comparison to then subsequently, what happens, which it because it was all so close together, I think it's hard to distinguish. The timeline of events happen very quickly after this point. Yeah. The relativity is probably just have massive impact on the historical kind of thinking about what happened to us. So that point was quite high, let's say, Yeah, I mean, I can sense from the way you're talking that we're about to come to a chapter which wasn't so so happy. And you seem really together talking about this. You mentioned you've had a hospital debrief, you feel good talking about this, this feels okay to discuss this. I'm guessing what's happening next is not easy. How do you feel about having conversations about your birth? Yeah, thanks for checking that out. So I've been really well supported, actually, by the hospital, and but everything the kind of care package and the support package I got in place I have been having talking therapy. So I am in a position where I feel comfortable talking about what happened to me and also talking about, I might come across quite factual about what happened to me, but that's just because of the way that I've kind of processed that timeline event thence. So I'm quite comfortable going on to talk about what happens next. For me, you know, I really want to advocate for the fact that there was a lot of self championing that you have to do to get that breastfeeding started afterwards. And physiologically, there's a lot going on. And that's the bit that I feel like helps me process what happened to me. Much better. That makes sense. 

Emma Pickett  23:07

Okay, so you sort of regained control by by getting the breastfeeding happening and, and finding the resources. And that was you kind of taking control of a situation where you had felt very much out of control. I'm guessing from, from what you're saying next?

Leanne Fitzpatrick  23:20

Definitely. I think that it was a big out of control feeling.

Emma Pickett  23:24

So you're in theatre. Lorcan is now okay. We're always okay. And what happens next?

Leanne Fitzpatrick  23:31

Yeah, so local was delivered at that point at 1:27am. In that Saturday morning, and the senior consultant who was performing the C section went on to kind of close up, my C section had closed everything up. And trigger warning, I'm gonna go on to talk quiet, but what may be considered quite a traumatic experience. Essentially what happened was, I went on to have at least two and a half litres of southern blood loss from my kind of birth canal. And when they went to go and explore what was happening, there was a sudden another gush of blood loss. So within a very short amount of time, I had roughly between three to four litres of blood loss. I had one major haemorrhage. And then I went on to have another two major haemorrhages. And so at this point, that was when they called for more blood to start coming to make sure that I was going to have enough blood in my body. And at the same time, they started to explore options to stop the bleeding. At this point in time, I knew something was wrong, but I was still awake. And I knew they were working on me and why I knew something was wrong was that somebody had come over to me to the top of the operating table. Law Ken and Rory had been taken out of the room and someone came to reassure me that I was an extreme unleashed safe hands and I needed to continue remaining calm and that they would they would be done as quickly as possible. So I knew something was going on

Emma Pickett  25:10

 but no one is using the word haemorrhage. No one's talking about blood loss. You didn't know 

Leanne Fitzpatrick  25:13

No one was talking about blood loss at this point. No.

Emma Pickett  25:16

I mean that that experience that amount of blood is a lot of blood. Let's be honest, for anyone asking I mean a typical C section you might lose, you know, 1000 millilitres or 1500 millilitres, but two litres plus two and a half litres plus, let's just take a moment to say thank God for blood transfusions. Thank God for blood banks and people who donate blood. Thank you. Thank you, if anyone's listening to this, and you were a donor of blood, thank you because Leon may not have been here if it wasn't for you. Those people are really really saving lives and possibly yours. I hope that's feels okay for me to say that because that transfusion was obviously crucial not only to your life, but also to your lactation, you would not have been breastfeeding Lachlan, if you hadn't have had those transfusions? Because you wouldn't, you would have had complete purity failure, even if you had survived. So here comes the blood, you having the transfusions. And you're feeling okay, were you feeling dizzy? Were you starting to feel rough? How did you feel physically?

Leanne Fitzpatrick  26:11

I was definitely shaking a lot. I reverse vividly remember absolutely shaking. And whatever the rest of the team, the initiatives, everybody else, were keeping off looking after all my other vitals, my senior consultant was looking after everything that was happening, as she says it down below, so to speak, and look making sure that she could work. So it was the whole team around me, essentially, were doing what they needed to do. And I just want to kind of second, you know, the fact that, you know, without blood donors, I would not be here today, I really would not be here. And it actually makes me sad sometimes now that I can't donate blood. But it's also one of those things that I know that my family and the people around me will because they have seen what it did, like I would not, there's no way I would have survived what I went through. And again, what happened to me in labour was extremely rare. My scenario is extremely rare, extremely rare in Western medical practice as well. And that's supported by my senior consultant went on to do a lot of research about my situation, it was just, I'm just a random blip. And there's absolutely no physiological reason that this should or would have happened. So did you have an explanation for what I'm I don't want to jump to the end. But did you have a so there's no explanation. So presumably, your placenta is removing and not closing up the blood vessels are not closing is that give us the sort of lay description of what was happening. So what was happening before I go on to why they couldn't, where I wasn't why continue to lose blood was that when the placenta was removed, and that wound site, normally, your hormones would normally just allow that to be completely clamped down. So that that that wound site that large placenta removal, which is quite a large wound site takes normally takes a long time to heal, but your body clamps down to stop the bleeding. And that's a kind of natural reaction after that placenta is removed, that did not happen. In my case, 

Emma Pickett  28:20

you would be given an injection presumably in a C section and you weren't responding to the injection.

Leanne Fitzpatrick  28:24

So they did the injection, they also went on to suture it. So which is essentially they tried to manually kind of clamp it down as well as additional levels of separate set. So I so sorry, I don't know if this is the right term, but the hormone I think, is serotonin to help with that clamping down. And then we went on to move work the use of balloon, which is essentially where they put a balloon up the canal to be able to put pressure on the wound site, which isn't closing to try and encourage it to essentially put that essentially, if you imagine you were bleeding from your arm, who put a lot of pressure on your arm, hopefully therefore your your body will react and start trying to heal that like at least stop the blood loss and stop the blood flow to that area with enough pressure. So they tried to do that with a balloon as well. So they were trying all the all the tactics, all the methods that they know that we know to try and stop that blood loss from that area. But there's no known like physiological reason why that happened to me that my body just decided to not clamp down enough at that point and then not in a bad good enough way that meant that there was only a minimal amount of blood loss. It was a substantial amount of blood loss. 

Emma Pickett  29:37

Okay, um, this is not my expertise as so we're both in this together you know more about this than I do but I'm guessing it would have been an oxytocin substitute rather than the serotonin 

Leanne Fitzpatrick  29:47

Yes, sorry that since you can do not know was expected to know all the details. You cannot be an expert in every area. Synthetic oxytocin is what it's known as, and that's what I didn't have to have when I got my Like contractions started because I could have gone. But I subsequently had it after the C section delivery to try and encourage my, my wound site to close.

Emma Pickett  30:11

Okay. Yeah, yep. So that wasn't happening. So what happens next at this point?

Leanne Fitzpatrick  30:17

so at this point, they've tried everything and a couple of things happen. I'm told that they need to put me under general anaesthetic and I know I'm continuing to lose quite a major amount of blood. I think at this point, I was close probably to having lost all of my blood, in the sense of my all of my own blood. And the amount of transfusions, they were putting in me, that was what was essentially keeping my body going in terms of blood. And it was at a point where they were going to have to make quite a drastic call. So when they put me under the general anaesthetic, someone came over to tell me that they may have to remove my womb. And at that point, that was when my resolve of calm completely lost it. And I think I remember looking at the clock, and it was 10 to three. So 2:50am At this point, so they've been going since 127, after Lukens delivery. So they've been really going for a long time to try and do everything. And they essentially said to me, I was like, please don't let them I begged with them, please don't let them take my room. I don't want to go under general anaesthetic, and they said they did need to put me under so I, because it was I was at risk of losing my life cash,

Emma Pickett  31:29

they actually said that to you the and they actually use those words. 

Leanne Fitzpatrick  31:34

Yeah, and I remember my niece's saying something along the lines of, you've got a little boy to be among to you need to cut kind of got, like trying to encourage me to go under. And I think at that point, like my resolve was gone. I mean, I was also tired

Emma Pickett  31:50

as I was gonna say, no one's gonna be able to not fall apart at that point, regardless of what they're being told, 

Leanne Fitzpatrick  31:59

Well, I just kind of accepted that that was where I was at. And I, you know, you just do I think in those, you know, you when your body's in fight or flight, you just, I mean, you're in this extreme circumstance, your body finds a way to your mind weight finds ways to cope, and I just accepted that I needed to go under the general anaesthetic. And so for me at that point, I don't remember anything until I rouse myself from my coma, actually on the same day, but about 13 hours later that day, so it was a Saturday afternoon. And so when they did put me under, that was kind of the timeline of events, so to speak, what ended up happening was they had to call another consultant who was at home at the time, and kind of theoretically did a lot of mileage very fast, quick mileage down the motorway and not going to crow number to get to the hospital in time because that severity of a decision around saving my life needed a second consultant to go ahead. And so what they did was they actually decided to take my womb out to inspect to see what had happened, took a look at the womb. And the other consultant at the time also agreed that the only kind of things that we would go on for was, it would likely be then brain damage and subsequent loss of life. So at this point, I've lost all my blood, this is I've lost all my own blood. So roughly five litres is what you have inside of you for anybody that doesn't know. So I've had a total of five litres put inside of me. And then I've gone on to have an additional two litres. So I've got like seven litres of other people's blood kind of pumped into me at this point. And they're still inspecting kind of the womb to see what can be done. And that's when they went through to my husband, who at the time is looking after little holding him this little bundle, who apparently was very calm throughout this scenario, to Central Tech as a next of kin permission to perform surgery to essentially which was a subtotal hysterectomy, which for anybody that doesn't know that it's essentially remove all of your womb, but keeping my ovaries and my cervix intact, because the only the bony problem so to speak was the womb itself that was what was causing the distress on my body and therefore all this bleeding and they needed to make the call to remove that so they could have a hope of saving my life. And that was essentially the call that my husband Rory fortunately said yes to they went on to perform that surgery and then it took a while for me to stabilise so that was where I continued to have so by this point now I've had an additional 10 I've had essentially total 10 litres of blood transfusions while they were stabilising me, and then I was put into an induced coma so that my vitals could be tracked and I med sent to You might either call it Intensive Care Unit or intensive trauma unit. And so essentially put into an induced coma and looked after it under itu, at the hospital I was at. And that was where locum was then left with my husband on postnatal. And I was in ITU in a different part of the hospital, which I later understood, but at the time, anybody that's been through blood loss, or anybody that's been through quite a major or traumatic scenario, in childbirth, there's a lot of things that you just don't understand or don't know, that's happening at the time. And it all just felt like this huge worrying. And the only reason I can talk about all these events is because I've taken the hospital, I was under the care that I had, have taken a lot of time to kind of debrief me and help me go through that timeline a lot. So I could really come to terms with what happened and be able to talk about it. And I feel really fortunate about that. But none of this is clear to anybody. So anybody listening to this thinking, wow, how does this person know all these things that happened to when I, you know, maybe gone through something similar or a different type of traumatic experience, maybe haven't had as much of an opportunity to process I'd definitely say, reach out to your hospital, reach out, see if you can get an additional debrief, you can always think there's a certain timeline that you can still go back and revisit what happened to you. And I definitely think for me, it's helped me to process that, because at the time in the midst of it, it is just a whirlwind. And you don't know if you're coming or going, you know, you've just had a baby. And now this is not the scenario you think you're going to be in at all. 

Emma Pickett  36:31

Yeah, I can only imagine the and and I'm really grateful for you for, for sharing your story. And, and it sounds like when you were talking about the decision to go to this hospital, you mean because you had the care that you had that you may not have had any other hospital? And this is the team you needed to be with? Is that what you mean?

Leanne Fitzpatrick  36:48

Yeah, I think retrospect, I'm sure the other hospital but essentially, I was opting to go to a birth centre originally. And I think if I had gone there, it would have taken a lot longer of time to get me into theatre. Whereas because I ended up going into a labour ward, where theatre was literally around the corner. I think there was a lot that just happened that was a little bit meant to be in my scenario, that sort of at least the way that I'm rationalising what happened to me. And the decisions I made up in that kind of run up to those events. Going to that hospital meant I was in a really like, secure position because I was on a labour ward rather than a birth centre, where it just meant that theatre was, you know, a hop, skip and a jump a few seconds travel on it on a hospital bed. And there was, you know, blood was already ready for me like there was all those things were already ready because I'd gone in for my membranes to be burst with this situation were just completely different, they'd taken a lot of different not to say that that wouldn't happen in a birth Centre at all. But just in my mind been a bit of a desire to lay Possibly, yeah, the delays could have really impacted what happened and certainly going on to successfully breastfeed in my in my scenario, 

Emma Pickett  38:02

I guess one of the things that's difficult is that, that what if part of your brain like like if you had given birth in a birth centre, and your placenta had behaved like this in the birth centre, when you'd have this bleed in a birth centre, that that could have been quite scary as well. I mean, there's all this sort of what ifs running around your therapy that you've talked about sounds that you've had some birth debriefing, some professional birth debriefing, and you've also had some talking therapy alongside that as well, as part of that included thinking about having had a hysterectomy and the feelings around that as well. If you don't mind me asking. 

Leanne Fitzpatrick  38:35

It has, and you know, those places or things for you to be able to explore whatever topic you want to bring related to kind of childbirth or mothering or so sometimes I've talked about the amount of sleepless nights, especially with breastfeeding, the very age at very young age when in those first few months, but it was also it's been an incredibly safe space for me to come to terms and you know, my therapist has been amazing and supportive in that of what's happened to me and I don't think for me, I'm never going to put a stop on those what ifs, it will always happen. But I think I've come to a place where I'll never accept what's happened to me, but accept that I won't necessarily fully accept what's happened to me if that. I think therapy is allowed me to do that. 

Emma Pickett  39:23

That's a good place to be. You do not have to accept what happened to you. That I noticed that awful thing you've got you've got a healthy baby, haven't Julianne Aren't you lucky? Let's just focus on Lorcan. Isn't it lovely? You've got a healthy baby. You never have to get to that place. You are allowed to look back with all sorts of feelings on when you think about your birth experience. Yes, yeah. Yeah, I'm sorry that that happened to you. I am obviously glad that you've had the support to go through it and and has already had some opportunity for some therapy as well. 

Leanne Fitzpatrick  39:54

So that is the one thing I'd say is that I'd say that partners, whether they be may more female. I think you'll get signposted as a partner rather than as the birthing person who I think there's a there was a lot of proactive care put in place for me sometimes in some scenarios because I advocated for myself to need that proactive care, in some other scenarios, it was because they recognise that the rarity of what I went through, required that but with my my husband, it's really been just signposting and other people I've spoken to, who've been through trauma as a birth person has all have also found that their, their partners have been just signposted. And I think that's quite difficult when you're in the thick of, you know, new baby with a partner who's gone through that, that you've been the person who's gone through that, watching it with both of your loved ones, you know, and maybe if you've got other children in the equation, or extended very close family as well, that you've got to like, look after, there's a lot going on for that that partner that I feel like signposting is just not enough, because actually, they're probably doing so much more and they kind of go into these, like adrenaline mode. That was what happened to like, kind of my, my husband was, he just went into this like huge adrenaline mode of like, having to do everything, almost for everybody. Not just you know, myself and your baby boy lock. And it was like, he had to be the point of contact point of communication for everybody, manage everybody manage it, almost everybody, others everyone else's feelings. And I think signposting just wasn't isn't quite enough for that that person. And so he we have a lot of great conversations together. But he's not leaned into anything that's been put on the table for him. Because unlike me, where it's kind of like, I think, kind of forced to go to the restaurant, so to speak, you know, like, he's just kind of been given the like that, here's what could be on the table for you. But you've still got to step in inside and kind of take advantage of of what is there. And I think that's a really difficult thing to do when you're in those first few months of a new baby.

Emma Pickett  42:07

Yeah, there's still time as you say, he was only six months. There's lots of time. And that may be something he feels he wants to do later on. I'm just, yeah, I'm just trying to imagine what it must be like to for him to wait for you to come out of theatre. He's got to tell people you've had a baby. And he can't say the kind of mom and baby are both Well, you know, he can't do that little cliche of everyone's well, and he's got to talk to your parents, presumably, and your family and rough, tough. But anyway, that's not I don't want to dwell too much on Rory, because he's not here to speak for himself. But I think he obviously needs our empathy as much as much as you do. 

Emma Pickett  42:43

We're just going to pause for a minute here to say that we've decided to split the fan story into two episodes. So come and join us in part two. 

Emma Pickett  42:54

Thank you for joining me today. You can find me on Instagram at Emma Pickett IBCLC and on Twitter @MakesMilk. It would be lovely if you subscribed because that helps other people to know I exist. And leaving a review would be great as well. Get in touch if you would like to join me to share your feeding or weaning journey, or if you have any ideas for topics to include in the podcast. This podcast is produced by the lovely Emily Crosby Media.