Posted by My OB said WHAT?!?.
Jul
18
Posted by My OB said WHAT?!?.
“The Only Patient I Ever Lost Was A Redhead…”
“The only patient I ever lost was a redhead. You redheads bleed too much.” – Midwife to mother who came to the hospital at 28 weeks for vaginal bleeding.
There are 30 comments to this post.
Redheads bleed more? Seriously? I think my head is going to explode from the stupidity… not to mention the horrible timing.
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Jane Reply:
July 18th, 2011 at 10:29 am (Quote)
I’ve heard this a lot! It’s an old-wives-tale that circulates among midwives and maybe it’s even true. If you think that maybe the gene for red hair is related to a gene for slow clotting, or maybe red hair indicates the person is of Irish descent, and maybe there are some genes in those of Irish descent which lead to more friable/less stretchable skin. But there’s no *research* to back it up. (Most likely because no doctor is going to say, “Oh, you have brown hair, so we won’t worry about shooting you up with pitocin after the delivery.”)
Much more likely is that whenever a woman bleeds a lot, the midwife notes whether she’s a redhead. Since the old wives tale isn’t that ONLY redheads bleed, if the woman has brown hair, black, blonde, or no hair, the midwife doesn’t notice. But if the woman does have red hair, the midwife notes it and thinks, “Yeah, those redheads sure are bleeders!”
This is known as an “observation bias.” And the existence of observation bias is fact, not an old wive’s tale. 
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Petra Reply:
July 18th, 2011 at 11:42 am (Quote)
Actually, there is research, but it mostly doesn’t back up the notion that red heads bleed more.
A nice summary here: http://www.bmj.com/content/341/bmj.c6931.long
Redheads report more bruising, but normal coagulation: http://www.ncbi.nlm.nih.gov/pubmed/16368849
Being red-headed is not associated with increased risk of post-tonsillectomy hemorrhage: http://www.ncbi.nlm.nih.gov/pubmed/15510037
There is, however, some evidence of increased need for anesthetic among red-heads: http://www.ncbi.nlm.nih.gov/pubmed/15277908
http://www.ncbi.nlm.nih.gov/pubmed/15731586
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jenni Reply:
July 18th, 2011 at 3:40 pm (Quote)
i believe the bruising is actually because their extrememly fair skin leaves it more visible, not that they actually bruise more. my kids are something i’d call half-ginger. DD is strawberry blonde and DS is more blonde with a kiss of strawberry. i’m pretty fair myself, but brunette, DH is dark blonde with a serious ginger streak in his facial hair, his father and brother are the same. the kids both got the red!
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SarahB Reply:
July 18th, 2011 at 11:53 am (Quote)
It’s definitely true there have been no studies. When I was first told that red heads are bleeders, I asked a few of my doctors and their response was all the same “Well, there is no research but in my experience it is definitely true with a certain type of redhead and you fit that type.” Then the surgeons I have seen and the nurses in L&D and surgery have all said “Be ready to bleed.” I definitely have been a redheaded bleeder. I hemorrhage when having babies and have to stay longer for procedures that are supposed to be outpatient because they can’t get the bleeding to stop. I also have problems with anesthesia (epidural, which I did not want almost killed me) and lots of different medications which they say is all related to being a redhead and a bleeder. Observation bias is probably part of it too though! And it may just be a coincidence that I have these problems and “that” kind of red hair. My mom also had similar problems and has the same red hair.
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Mama Wrench Reply:
July 18th, 2011 at 2:36 pm (Quote)
There have been studies, whether they know about it or not — but it’s not a definitive link. Basically, redheads experience higher levels or pain and need more pain relief, without which they may experience higher blood pressure as a pain response and therefore bleed more and have more problems healing.
I’m not a bleeder, but I *do* need higher levels of pain management in general. I’m a full-on ginger, though — not just “kind of” auburn.
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Karen Reply:
July 18th, 2011 at 4:11 pm (Quote)
I am a bleeder and require crazy amounts of anesthetic/analgesia to knock me out/take care of pain. I had an ERCP and after 12mg of Versed and I don’t know how much Fentanyl I was still conscious and lucid. Even at the dentist I need about double the amount of novocaine as is typical.
I had attributed it to another condition I have in which ‘hard to anesthestize’ is a hallmark. I never put it together with my ‘redheaded bleeding tendencies’
It isn’t just gyn related bleeding either. I bruise incredibly easily, fill a bag when donating blood in a few minutes, very heavy periods etc…I am NOT anemic either. I’ve been anemic once in my life and that was after my last childbirth with a PPH.
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Sarah Dorrance-Minch Reply:
July 19th, 2011 at 7:39 pm (Quote)
I’m a bleeder. Lost crazy amounts of blood after each birth, although my periods are usually very light. I used to bruise very easily, until I started eating more lettuce (it has a lot of vitamin K).
I also have a bizarre tolerance to opiates (Dilaudid barely makes me groggy, although it does help with pain when I have a migraine) and NSAIDs have no effect on my pain whatsoever. The dentist has to give me extra Novocaine. That’s for “bad” (unwanted) pain, though. “Good” pain (accepted as a normal part of an activity, such as exercise or birth) generally gets a “meh” from me.
I don’t know how much of this is due to my strawberry hair, though. I attribute the drug tolerances to being autistic and thus having a jury-rigged neurological system.
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Kit Reply:
July 18th, 2011 at 7:10 pm (Quote)
I was told something very similar by my midwife. She insisted that I get a heploc because I was more likely to hemorrhage after birth. Thankfully I didn’t. But I do have strong reactions to pain medications and anesthetics, one of the reasons I choose to have natural births. Labor and delivery is the worst time to have a reaction to drugs!
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A nurse said the same thing to me! My hair is not even that red- just barely strawberry blonde. The nurse took one look at me and said, “Oh, you’re going to be trouble. Redheads always bleed a lot and take a long time to heal!” Umm… Thanks. I had just had my second c-section and was in the recovery room after 26 hours of labor!
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This is the reason my midwife (w/#2) and family practice doc (w/#3-5) both gave for insisting I have pitocin after the baby was out.
The FP doc has actually been fairly ‘bending’ and ‘lets’ me do most things my way… so when I feel like have to ‘give in’ on something to keep the peace this is the sort of thing I’ve been willing to give him.
I’ve figured at least pitocin *after* the baby is out isn’t going to the baby or causing massive contractions that freak me out during labor. The after pains aren’t as much of a concern to me… and I *have* bled a *bit* more than ‘usual’ after births… but no *serious* bleeds.
Of course I’m sure they would say that is *because* they gave me pit.
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Insensitive and cruel, yes, but actually based in medical fact–depending on the red. Certain red shades are caused by a gene that also means they’re more likely to bleed, have weird reactions to medications and have a lower pain threshold.
I happened to grow up with one of those redheads. They are pains
But you can’t just ASSume that and that’s a really mean thing to say to someone who’s probably already worried already!
My mom and aunt may be those kinds of redheads (I’ve got a redheaded daughter, but her pain threshold is normal/high, she reacts normally to meds and she is NOT a bleeder, so hers must not be the right gene–it takes two to make red anyway) but they’ve both had two kids (my aunt via two cesareans, and lost twins later, my mom via two vaginal births) and neither bled to death (though the anesthesia almost killed my aunt–fun times with meds reactions, NOT).
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This is mine. It is more the insensitivity of the comment and really bad timing…talking about losing patients while basically saying that I have the same risk factor isn’t exactly good bedside manner, especially when I’m already worried about unexplained vaginal bleeding (everything turned out fine).
For what it is worth, I did hemorrhage with both of my first two births. However, they both involved pitocin during labor. My first I was basically induced as I was leaking amniotic fluid and with my second, I was bullied into it by an impatient on-call doctor (at least I didn’t let him bully me into an epi). “Oddly” enough, the only birth I did not hemorrhage was my completely natural third birth. They had everything standing by for the bleeding and never needed it.
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I’m a redhead and I also bled a lot after birth. The doctor was very nice about it though and gave my body time to stop bleeding and did some natural procedures to get it to stop. After nothing worked, she explained to me what was going on and offered me a shot of pitocin in the thigh to get it to stop. I never felt like I was in danger because she stayed so calm and a few minutes after my shot, the bleeding calmed down. She handled everything the right way.
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Lindsey had this to say,
Jul 18, 2011 @ 12:14 pm (Quote)
I bled a fair amount after the birth of my first child, a daughter born with hair as orange as a crayon.
The nurse said to me “We always tend to have a problem with you redheads bleeding out”. I am a natural burnett and dye my hair auburn and told her such, apparently because I birthed a redhead I was lying and was truly a redhead, and my more than average bleeding proved it. *headdesk*
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Christina Reply:
July 18th, 2011 at 1:17 pm (Quote)
I had a nurse say just about the same thing to me after my PPH. Funny thing is my hair is definately not red, it’s dark dark brunette, almost black. I do have very pale skin and freckles so maybe she thought I dyed it? It was a very strange comment and I was too tired and anemic at the time to correct her.
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Alyson Miers Reply:
July 18th, 2011 at 1:34 pm (Quote)
Talk about forcing the facts to fit the theory. It’s not enough to assume “red-haired women generally bleed more in childbirth,” but she went as far as, “Any mother who bleeds a lot MUST be a redhead.”
Did I go to elementary school with that nurse? Was she one of those kids who assumed the red-haired kid MUST have a red-haired parent?
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Well, I used to be blonde and it got darker every year until it started going grey. I bleed. I also have trouble with overreacting to certain medications. You know that thing about general anesethia being out of your system shortly after you wake up – nope, try 2-3 days of fuzzy brain! There are a couple of things I just can’t take and several more that I only need a child dosage. Maybe next time I’m in the hair color aisle I should grab a red?
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Alyson Miers had this to say,
Jul 18, 2011 @ 1:24 pm (Quote)
The only patient she ever lost had to be something. If she’d instead lost a blonde to stroke, would she say, “Oh, you blondes with your blood pressure,” or if she lost a brunette to infection, would she say, “You brunettes need to get your immune systems together.”? The plural of anecdote is not data.
She makes it sound like all her red-haired patients got together and collectively decided to hemorrhage just for the heck of it.
Also, when a 28-week pregnant woman comes in with bleeding, that’s not the time to start comparing her to a mother who died. I also don’t care for the treating redheads like a monolith, but that’s a rant for another site.
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Because hair color has anything to do with Iron, Vitamin K, Platelet count, or anemia.
Right….
As one of my friends would say, “Wat you smokin’ and why ain’t you sharin’!”
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Another redheaded bleeder here. One midwife even said during an initial exam “I see you are a natural redhead!”
No one has ever based my treatment based on my red hair but they tended to watch me more carefully for hemorrhage which is a good thing. I do hemorrhage, even with baby actively breastfeeding within minutes of birth.
I haven’t had a birth that I didn’t need pit PP. The two times they tried a wait-and-see approach with baby nursing and fundal massage I lost a lot more blood and still needed the pit.
Even if ‘red head = bleeder’ is evidence-based the midwife in the OP is an idiot for saying what she did.
How about we resolve the situation and maybe at the next appt talk about the possible correlation between red hair and bleeding. There is never a time it would be necessary to tell one mother about another mother’s death.
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My hubby is a red-head and he bleeds like a stuck pig! Once he got hit in the nose during a football game and was bleeding so profusely, we all thought he broke it. At the hospital, they cleaned him up and nothing was wrong…they explained his hair color and very fair skin have alot to do with it.
I also had a red-headed client who had an epi during labor. It took them 4 hours and 4 doses of epidural before they turned on the lights and realized she had RED hair and that was why the epidural was failing over and over. It was re-set, with a higher dose because of her “nerves of steel”. Poor girl 
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Sarah Dorrance-Minch had this to say,
Jul 19, 2011 @ 7:43 pm (Quote)
Why, thanks for the words of cheer and support. You’re so kind. And bonus points for blaming the patient for her problem rather than providing something resembling compassionate care…
I heard a really funny joke.
Q: How do you drown a stuck-on-herself blonde nurse?
A: Glue a mirror to the bottom of a swimming pool.
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JoMarch had this to say,
Nov 10, 2011 @ 3:01 pm (Quote)
I’m away from computer so can’t post the links, but there are a few studies showing definitive correlation of these signs, carried on a gene most commonly found in people of Celtic/Gallic ethnicity. They don’t all have red hair (research Black Irish for ex) but do share these common traits including one or more of following: hemorhaging, low blood pressure, “allergies” to common meds, backwards reactions to meds, very high or low pain tolerance, sensitivity to sunlight,and more. People w/ this gene do not manifest all these signs, and do not necessarily look stereotypically “Irish”. Hospitals in Great Britain have parallel protocols for pain relief, hemorage management, etc for patients suspected w/ this gene, since those patients typically prefer to avoid opiods, narcotics, etc.
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Real comforting when someone is having bleeding. Maybe not the right time to talk about losing patients?
Apparently the redheads bleed more thing is true though. I am a redhead and almost died from blood loss with my second baby.
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