Time for some crowdsourcing! A reader just emailed me with a request for information about low platelets and the risk of PPH. Here's her situation:
Hi Rixa,I'm super busy with the start of the semester. If anyone can provide information, or has dealt with low platelets personally or professionally, please help her out!
I'm a long time blog follower and have loved following all of your births. I had a homebirth two years ago - I switched to a homebirth at 40 weeks after I was risked out of a birthing center for the baby being 'too high, too big, and too much fluid.' I ended up with a wonderful positive homebirth experience (although I did push for 4 hours!!) Your blog was especially comforting while I was anxiously awaiting my son (he arrived at 42w3d).
I'm 38 weeks with #2 and everything has been great. But I just found out my platelets are low - they were 109 at 28 weeks, 90 at 37 weeks, and 83 yesterday. My CNM's have referred me to an OB, who is recommending I do a hospital birth. She has also referred me to a hematologist - who I just met with in the spirit of gathering as much info as possible. The OB was actually quite pleasant to speak with - she understands my desire for homebirth and seems very supportive of natural hospital birth. I'm just not sure at what point I should actually be thinking about a hospital birth. I have read many conflicting articles, blog posts, etc. on the subject in the past few days.
PPH is the worry - but the frustrating part is that nobody (OB or hematologist) can tell me what the actual percentages are for PPH with a low platelet vaginal unmedicated birth. The hematologist said there is no risk to the baby at birth, so the main concern is me. He wanted to prescribe steroids to increase my platelets which he says also has no risks to the baby (I disagree). The CNM's did say they felt the treatment for PPH would be the same at home as in hospital - but they are not comfortable going against the OB and hematologist recommendation for steroids/hospital birth. I have another midwife I can use (CPM), but I just want to make sure I'm being smart about the decisions.
If you wouldn't mind posting some of the questions, that would be wonderful. I would love to find out if anyone has had personal experience, and what the outcomes were.