Retained Products after a Cesarean

My postpartum journey was far from plain sailing – not least because for over 4 months I had no idea what was wrong with me.

Our daughter was born on 9th October 2017 via c-section, we were told everything had gone smoothly and after a two night stay in hospital we were discharged. From then on the days and nights blurred into one as I think they do for most new parents; broken sleep isn’t know to make you feel great so I put my constant bouts of illness down to that. It was also the flu season so it wasn’t surprising that I kept getting ill. My focus was heavily on doing everything perfectly as a mum, I was also distracted by Arabella’s birthmarks with various hospital appointments. Time slipped away, it was the end of January when my husband finally instructed me to see the doctor as how I was feeling ‘couldn’t be right’.

What I’d not paid enough attention to was that I’d not wholly stopped bleeding since Arabella was born. I’d seen both the GP at 6 weeks and the Obstetrician a few weeks later and informed them both that I was still passing sizeable blood clots – the GP simply put me on a contraceptive pill and told me not to worry. I told the Obstetrician the GP had told me not to worry and she seemed to agree.

By the time I saw the GP at the end of January I was no longer bleeding – it was now a rather nasty smelling discharge that had left me extremely embarrassed. I barely wanted to tell the doctor when I sat in his office but as soon as I told him all the symptoms: feeling like I had the flu, occasional cramping, bleeding that was now discharge – he told me he would be booking an ultrasound at the hospital as he feared I may have retained products. I was shocked at the news but also a little relieved that maybe there was an actual reason I’d been feeling so crap. In truth I’d been very worried that feeling so run down was just part of being a mum and I’d forever feel this way moving forward.

Two weeks later I had the ultrasound and they confirmed there were retained products about 3cm x 3cm in size and booked me in to have a procedure to remove it later in the week.

I’ve since learnt it can be quite common for women to have retained products, albeit usually after a natural birth and it’s usually found much sooner. The procedure was explained to be straightforward – a ten minute procedure under general anaesthetic. As they checked us in for surgery in the morning, the surgeon visited each inpatient to run through their procedures and explained everything to me once more – I remember laughing and joking with him probably about how pleasant it feels for a few seconds when you’re going under from a general anaesthetic! Only myself and one other were having hysteroscopy to remove retained products, the others were there for different procedures. The other lady was 8 weeks postpartum and had her baby with her as was breastfeeding. I never produced enough milk to keep up with Arabella’s demands – at the time I was convinced there was something wrong with me. Breast was best and I’d had to combination feed from very early in her life and at 3 months postpartum my milk simply stopped coming.

My procedure was not straightforward.

I suffered a haemorrhage in surgery, lost a litre and a half of blood, required two blood transfusions and had to stay in hospital overnight. They managed to extract a tiny amount of the tissue to have it sent to the lab for a biopsy – the rest remained inside my uterus. When I initially woke from the surgery in recovery I was screaming in pain, there were six people in scrubs stood over me telling me it was ‘ok’ and to ‘calm down’, ‘you’ve lost a lot of blood’. They hooked me up to morphine and told me to press the button as much as I needed it – the next few hours remain a blur.

My friend had come with me that day, my husband stayed at home to look after our baby. I’d been in surgery and recovery much longer than expected and as my friend wasn’t family they wouldn’t tell her what was going on. She was the first person I asked for when I woke up as she would be able to contact my husband – of course she had already contacted him when she couldn’t find out what was going on, when I was in recovery he was already on the way to the hospital. I made it back up to the ward, she was waiting for me – shortly after the lead surgeon, a lady I didn’t meet before the procedure came to my bedside and informed me that there had been considerable blood loss and unfortunately ‘sometimes these things just happen’. Although hazy, I remember clearly she was wearing normal clothes and had a coffee cup in her hand.

Post Op February

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My husband arrived with Arabella shortly after, I insisted on holding her despite her grabbing at my cannula and the IV lines, I felt awful but thankful to be alive. The reality was that stark and despite the lead surgeon being quite casual upon her visit to my bedside, the surgeon who we’d met earlier in the morning came to see us and stayed for a very long time, without saying the words ‘I’m sorry’ he apologised in a way. Something went wrong during the operation and you could tell he felt quite bad about it. Forcibly, tonight would be my first night away from our daughter since she was born. I barely slept – I was in considerable pain, the morphine wasn’t enough and had already made me sick so eating was difficult. The nurse who cared for me through the night was lovely, I was grateful for her care. By the morning I was finally hungry again and ate some food, as I began to feel more myself I became very aware of the catheter and the balloon which had been put in my uterus to stem the bleeding, they’d then packed my vagina with medical gauze. It was uncomfortable to say the least. It was a Saturday and I’d have to wait for a consultant to see me and remove the medical gauze and baloon. I told my husband not to come until I knew I would be able to leave. Hours went by with no sign of  the doctors, by lunchtime I was in tears. It was all too much and I still felt dreadful.

Finally the consultant came to see me and told me she’d remove the medical gauze and balloon. Dignity flies out the window in these situations, I found myself embarrassed that I’d not shaved my legs – literally the least of my worries. As she began to remove the gauze I winced – she instructed that I press the button for morphine if I felt I needed it. I needed it. The gauze had fused to the inside of my vagina, as she pulled the gauze out – the never-ending gauze comparable to a magicians scarf – I cried, yelped and wriggled up the bed away from her, asking her to stop. She replied that it had to come out and carried on. I guess she was right, although she wasn’t experiencing the pain. The baloon being deflated and pulled out was comparably painless. Once she’d finished I pulled my legs to my chest and sobbed, tucked up in a little ball. When I’d calmed down I called my husband and he arrived an hour later, by which time I’d organised being discharged.

The recovery from the procedure was long – I’d felt ill before the procedure from the retained placenta poisoning me, now the placenta was still there causing problems and I had the added complication of getting my blood count back up. I also had an allergic reaction to the dihydrocodeine pain relief tablets – coming out in hives all over my body. Four days after surgery I still felt awful, as though I was going to pass out the entire time – being the sole charge of our baby was a struggle, thank fully she still napped quite a lot back then and she’s always been quite happy playing in her play gym. I was also bleeding a lot still – I called the gynaecology department and they asked me to go in for a check up. There was a large pocket of blood in my uterus near to the retained placenta which was causing the bleeding. The blood tests showed that my haemoglobin levels were low – they told me to eat more iron rich foods.

I was asked to attend regular internal ultrasound scans, visiting the gynaecology department almost bi-weekly for over 2 months. They also ran swabs for infections – my immune system was at war, I was put on various courses of antibiotics – due to the invasive nature of the procedure and the check ups I somehow managed to get e-coli in my nether regions! Arabella came with me to every appointment – she showed unbelievable patience. I became very pragmatic about her routine; sleeping and feeding on the clock were necessary for me to be able to function.

There appeared to be little change – my body wasn’t dealing with the placenta itself and the tissue began to calcify. I felt sick most days and doing any exercise was almost impossible – simply walking for 5 minutes led to me pouring with sweat. I missed multiple baby classes, didn’t socialise much and became a bit of a hermit. I now also recognise that I was incredibly anxious – I felt I was living in a world of uncertainty. Only now that I’m attending regular Cognitive Behavioural Therapy am I overcoming my fears.

At the end of April they repeated the same procedure – when I was checked in for surgery that morning I begun crying and didn’t really stop until just before they knocked me out. When I woke they informed me everything had gone well – and I was allowed to go home within a few hours. Apparently they don’t need to see me to check everything’s gone well but I feel much MUCH better. Seven months of suffering, I’m now doing as much as I can with Arabella to make up for lost time.

If you don’t feel quite right after your baby is born, don’t make the same mistakes as me – speak up, get checked. It’s so hard as a first time mum to know what is ‘normal’ – go with your gut.

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Operation in April which was successful.

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