My 2nd birth ever- baptism by fire

Some first births of a new Midwife can be so teaching, so foretelling, so scary that we call them baptism by fire.
This birth proved to be mine. It didn't say that I shouldn't be a Midwife but that I was there/here for a reason, get my act together and do what I needed to do, without hesitation.

My 2nd birth without any other Midwife or doc, I had a new apprentice.

I was working with an ND. and he was confident that I could do any birth, thank goodness.
Mom and dad were both over 6 feet tall, this was their 5th baby and both were EMT's. Both very experienced in "catching babies" and having intense situations in emergencies. I'm glad at who they were. However, looking back on it, it should have been a clue for me as they spoke of many of the intense situations they had been through together in the medical field.

In her pregnancy she had told me about her placentas "being ripped out of her" and that she had "bled a bit" with each of them. This is a clue !
I spoke alot of being prepared for birth and letting it happen. They were both excited about this home birth. They had always wanted to birth at home but them being in the military always seemed to interfere with their wishes.
We discussed her options of letting the placenta detach on it's own and that it could take awhile, but that we "probably won't see a large bleed". I have learned to not be that specific anymore.

She went into labor and was going rather quickly, so I was anxious about going on a military base as they had told me home births are not allowed.
Got lost so I got flagged by an MP who gave me the right info, he noticed the bags in the back and asked me why were we going to someones house at 3 am on a military base? I told him the truth, he thought it was weird, but when he tried to delay me I asked him if he wanted to help me "catch" this baby and he let me go quickly.

Anyway, we get there, and dad helped get our stuff in their house. Oh, by the way it was in the winter so it was about 30-40 below. So once I got my glasses frost free and could hear and see that indeed she is in labor. It was then that I got introduced to their priest. My brain exploded- like why do we have a priest here? I understand wanting prayers for the birth- but it was a clue.

Mom is doing great and is now in transition, she's decided to be on the sofa couch- pulled out into a bed in the living room and that would leave any noise downstairs so we wouldn't wake up their other daughters.
All of a sudden her water bag broke and it consists of water and much blood. Baby has sounded great with the Doppler, but this is clearly an abruption and a large one! In the background I hear the priest praying VERY LOUDLY. (Let me tell you for years if I had an intense birth, my hearing would go funny and I could only hear my own thought process going on) but I also heard him. I was past scared as this was the first abruption I'd ever seen and I knew this one was bad.

Wonderfully, the baby's head came quickly as I tell mom to push, and baby just needed a bit of stimulation, so I hand baby to mom and dad and here comes a waterfall of blood. Literally like a water fountain. My brain is screaming (I am very calm at births though).
Cord goes flaccid in a matter of seconds and with all the other clues that was another huge one that just confirms the abruption and there was no more oxygen supply, however the placenta is not coming out.
Mom and dad are still talking and dad looks over and sees the continued waterfall of blood. He goes a bit pale.
All I can think of is to get that uterus shut down, so my apprentice had already drawn up pitocin and methergine, I give her instructions to give them to mom as I take my hand out of mom. I was going to do my first manual removal of this woman's placenta.
There is sticky blood everywhere in my path so I grabbed the cord and followed it up inside mom, I warned mom she would feel my hand go in her. I found the placenta (or what I thought had to be the placenta- warm mushy mound of tissue.There were lots of clots inside and I would just squeeze them out on my path up. Somehow my hands knew what they were doing, and when I reached the placenta, my hands just started to loosen the tissue from the wall. As, I did this slowly I knew I was doing the right thing because her uterus was slowly reacting to what I was doing. As I got it all out, the whole placenta slid right out and her uterus started closing down. I went all throught the uterus again making sure I didn't leave anything else in there and it was feeling cleaner and much more room now everything was out including the huge clots. I told my apprecntice and she gave the shots. That uterus was very firm now.
Now, my hearing is coming back and I continue hearing the preist and look at him and he and everyone in the room looks white. Everyone saw how much blood she lost. I didn't think to call the EMT's cause I was busy taking care of mom. I knew if I didn't do what I did I could have lost her.
There was no more bleeding, I tried to figure out how much blood she lost, but with what I came up with, she would have lost all her blood, so I knew I was off. She looked very pale but she and husband refused to go in for a transport for blood loss. Dad started an IV on her to get fluid in her and we kept her warm and monitored her vitals for the next 24 hrs. In my mind she was going to drop dead any minute, so I did what the priest did- pray and went over everything I did.
I checked her hematricrit and she was VERY low, parents still refused to go in.
So, meanwhile I had called my ND and asked him for advice. I said transport and I let him know the parents wishes. So he let me know all the homeopathics and suppliments to get in her to allow her to heal quicker. She and I did everything he told us to do. and within a week her hemoglobin was up to 9.
Her 2 week postapartum visit she came to the clinic, I couldn't believe she was up walking, let alone pink and talking and breastfeeding her baby.

Did this birth teach me, sure and alot. I learned how to look for clues that around the room, clues she's giving. Take in everything.
Was this birth dangerous? Yes, the top thing in the world that causes women to die in postpartum is bleeding to death.
It was something I was suppose to see and do, scared the you know what out of me, so I have a healthy respect for the unexpected realities of birth.
I don't think birth is dangerous, but I think people and Midwives need to know these things can happen. Rarely, but they do.
I think that she had scar tissue built up in her uterus from "ripping out other placenta's before they were ready", I'm not sure if it caused this horrendous bleed, but I do believe it played a part in it.
Could it have been a precreta, or acreta placenta, no. They usually don't bleed like this.
I just knew in my head that I had every chance of changing how things were going by getting that placenta OUT.
I didn't want to do any births for a bit, but don't you know the next time I got a call I went,