# Physiogical v managed third stage?



## SarahSausage

Hi I was hoping for a bit of input into the pros and cons for each of these. I an hoping for a natural third stage but are there disadvantages to this? Is it less likely to come away completely compared to if it is managed and I receive the injection. Also I want my baby's cord to stop pulsing before being cut and clamped so that will affect the timing of the injection also. Any advice is appreciated. Thanks.


----------



## lynnikins

i have had both, i wanted to go natural both times but due to intervention in the birth of ds1 i didnt have the chance to say no before they stuck me with the needle. i remember there being a bit of rush and tugging on the cord with ds1 to make sure it came away before the uterus contracted caus it can trap the placenta and require surgery if it doesnt come away fast enough. 

with ds2 i was firm with them and told them no injection and i got to cuddle and feed ds2 whilst the cord was still pulstating and they couldnt take him away to look at him he got checked over while feeding it was nice and DH got to clamp and cut the cord when it had stopped pulstating and after about 35 min or so i got a couple of contractions and out it popped all fine all in one peice and HUGE lol they needed a bigger bowl for it.
it was nice to have them leave us alone a bit to bond with ds2 caus ds1 i saw for all of 20 seconds before he was whisked off and cleaned and dressed and given to OH and my mum to cuddle and it was over 2 hours before i got him back for a quick cuddle before my shower


----------



## Mervs Mum

There is a in increased risk of retained placenta with the managed (injection) third stage. A physiological third stage MAY be slightly longer but not always. I've seen them vary from 10 mins to an hour plus but always a complete placenta after. Managing the third stage can help reduce PP bleeding but the risk is the uterus clamps down so fast on the placenta it can be retained fully or partially. Anecdotally women bleed more when having a natural third stage immediately after they give birth volume wise (I'm not talking PPH here) and have less ongoing bleeding (lochia) but with a managed one bleed less initially but have heavier lochia. This is purely anecdotally though. 

I've have both and I'd always have physiological. I dint see the pount if adding synthetic hormone into the system unecessarily when there are enough flying round already! There are no time scales on having the injection so you can take a wait and see approach and if bleeding looks little on the brisque side have the injection.


----------



## PeanutBean

Wish I'd read this before the weekend, might've thought harder before changing my plan at the last minute! :dohh:


----------



## claire-lou

I came on to ask this exact same question :thumbup: thanks ladies you have just confirmed what I had already decided. I just won't mention it to DH until I'm in labour and he's too afraid to argue otherwise :)


----------



## AnnaBanana9

Thank you for this! I've been considering the options. I had a managed 3rd stage with Alyssa, and am aiming to have a physiological one this time round.

PeanutBean, congratulations on Indigo's arrival! Reading your birth story now - what a beautiful name! :cloud9:

x


----------



## lozzy21

Id see how your birth goes and decide at the time. The pros and cons of both are on a par so i think that you need to take other things into consideration.


----------



## SarahSausage

lozzy21 said:


> Id see how your birth goes and decide at the time. The pros and cons of both are on a par so i think that you need to take other things into consideration.

Like what?


----------



## Mervs Mum

I don't subscribe to the 'see how it goes' school of thought. Make a decision before on how you want it to be but know that if things change and it's appropriate you cam always rethink on the day :D


----------



## chuck

Mervs Mum said:


> I don't subscribe to the 'see how it goes' school of thought.

I did until I got everything I didnt want last time...going with the flow seems to lead to accepting what you're told to do.


----------



## Mervs Mum

Ive said this elsewhere before but you dont 'try' to run the marathon - you commit to doing it, prepare and then go for it. If something crops up en route you may adjust your plans but its important to have that goal or as you say may just float along with the tide and go with who ever pulls or pushes you hardest. Commitment to your birth is key in achieving it. no one ever made their dreams come true by going with the flow and just hoping for the best!


----------



## lozzy21

SarahSausage said:


> lozzy21 said:
> 
> 
> Id see how your birth goes and decide at the time. The pros and cons of both are on a par so i think that you need to take other things into consideration.
> 
> Like what?Click to expand...

In my case i wanted a natural 3rd stage as i wanted delayed cord clamping. That couldent happen as she needed resusitating so the cord needed to be cut asap to take her to the resusitare. The reason i wanted the natural 3rd stage wasent there anymore so i then chose to have a manged 3rd stage.



Mervs Mum said:


> I don't subscribe to the 'see how it goes' school of thought. Make a decision before on how you want it to be but know that if things change and it's appropriate you cam always rethink on the day :D

I dont see the defferance in rethinking and decideing at the time lol, of course you can have a preferance but for some people if you are adamant your doing xyz but if things have to chance it can leave you with regrets and a sence of guilt.


----------



## SarahSausage

I am and have been committed to a natural third stage but wanted to know if I have overlooked any reason not to choose this. I didn't even get asked with my first-a theme that ran through the whole induced intervention based, prolonged labour and delivery. This time I am committed to a natural hypno waterbirth, if all goes to plan, and that includes the third stage too hopefully. However as they say, the best laid plans of man and mouse...


----------



## pinkclaire

This thread has been really helpful for me thank you :thumbup:


----------



## madasa

lozzy21 said:


> SarahSausage said:
> 
> 
> 
> 
> 
> lozzy21 said:
> 
> 
> Id see how your birth goes and decide at the time. The pros and cons of both are on a par so i think that you need to take other things into consideration.
> 
> Like what?Click to expand...
> 
> In my case i wanted a natural 3rd stage as i wanted delayed cord clamping. That couldent happen as she needed resusitating so the cord needed to be cut asap to take her to the resusitare. The reason i wanted the natural 3rd stage wasent there anymore so i then chose to have a manged 3rd stage.Click to expand...

Hmmmm.... This is interesting to me, because something similar happend with my first baby. What I have never understood is: his cord and placenta were not compromised, so he should still have been receiving oxygen etc. from there. He came out "needing resus" - surely that means he needs what the cord and placenta have to offer even more than a baby who comes out NOT needing resus? I could not understand why they cut the cord in order to resus him, it seemed so..... illogical. :wacko: Why not leave it intact and resus him RIGHT NEXT to me? That way he gets everything he should have from the placenta AND he gets any additional help from the staff that he might need. I still don'tget it.... 

There is an enormous difference between "going with the flow" (ie, not making a plan at all) and making a plan but being flexible about it. I know, because I have done both. Without fail, where I have planned in advance, the outcome has been better than when I have thought "oh I will just see how it goes".

The first time, I had NO plan. I also had zero control over how ANYTHING was managed. Everything was directed by the hospital staff and, frankly, it was a bloody nightmare from start to finish. 

My second baby I knew what my options were, I knew what my preferences were, and yes we did have to change plans a little on the day, but overall the experience was WONDERFUL. The only part I would change for "next time", would be a firmer "birth plan" for the part I didn't really bother with this time.... 

(Now, see if you can guess which part I neglected in my plan and decided to just "go with the flow", and which part was the bit that went Pete Tong and required us to change what we did on the day... ;) )

Most women I know spend MONTHS planning a wedding, if not years! Anything could happen, it could rain, they might become ill, guests might get drunk and get into a fight, the cake might get knocked over and spoiled, she might get a giant ZIT on her chin on the morning of the wedding.... SO much she can't control, why bother planning anything, right?

There is absolutely an element of surrender in birth. But that doesn't mean give up any hopes or preferences you may have. You stack the odds in your favour, you get your ducks in a row.... So that on the day you have the freedom and confidence to let go and surrender.... IF something crops up that requires a change of plan, you deal with that and move forward without beating yourself up over it, this is entirely different than NOT giving yourself that "safe space" in which to surrender to the birth process in the first place. :D


----------



## cherry_pie

I asked my midwife about forgoing injection and having natural 3rd stage and she seemed pretty shocked and asked why as 90% of women have it now and they encourage you to have it so you don't bleed excessively. She did say it was my decision but you might get the midwife huffing and checking their watch ass they won't want to wait around! My mum thinks the 90% of people are encouraged to have the injection to save time on their part as she never heard of such an injection when having us and to go with what I want but now I'm not so sure, what if the mw makes me feel uncomfortable about it all due to having to wait around? I don't like to think I'm going against the grain completely...now I'm afraid to ask about delayed cord clamping as that will take even more time... no one discussed these thin.vs with me as options, they are ideas I have come across from reading on here...why were they not discussed? Although these mw seems lovely I'm getting the feeling already its going to be very medically laid care...


----------



## Mervs Mum

It's not discussed because as you said it (sometimes) saves them time (and therefore staff) to give the injection and pull it out. There should be no huffing and puffing and if there is I'd remind them its not about their convenience contrary to what they my believe!


----------



## Thegirl

My midwives encouraged me to try to plan not to have the injection if everything was going well with the birth and I could always change my mind (or they could advise me to if for some reason they thought it was necessary). They took the stance that if you are having a natural home birth, why have an injection once the baby is out.


----------



## Kess

Our current plan is to have the injection on hand in case we need it, but to have a physiological third stage unless I'm bleeding too heavily or something. That's the thing, you can't change your mind after the injection, but you can change your mind the other way.

I'm really scared of a retained placenta - they have to do a D&C don't they to get it out? That'd just remind me too much of my miscarriage, and the D&C knocked me about so much then it was awful. I'll be putting Bubs to the breast pretty much straight away and hoping that helps get the placenta out. Any other tips to go natural?


----------



## silver_penny

Delayed cord clamping will help prevent a retained placenta, as well as so many other benefits. I would highly suggest it!


----------



## Freya

I have a question.... can anyone help? Or perhaps I should start a new thread (wot a hijacker I am)

Does being rh negative have any impact on wanting delayed cord clamping, and a physiological third stage? More risky?

With the potential increase in blood loss during this time, do you have to get out of the water to deliver the placenta?


----------



## Kess

silver_penny said:


> Delayed cord clamping will help prevent a retained placenta, as well as so many other benefits. I would highly suggest it!

Already planning on it! :thumbup: Glad to know it'll help prevent retained placenta - how does that work, out of interest?


----------



## Nikki_d72

Freya, sorry, not sure on the answer to that. Are you having anti-D shots after? if so then I doubt it would make any difference, as any blood crossover will be dealt with by the shot, but please check with someone more knowledgeable!

Kess, it works because the baby will have received it's full compliment of blood from the placenta, thereby making the volume of the placenta less, and easier to pass out. If it is still full of the blood that would have normally have gone to the baby, then as the uterus starts to contract down, it's like a fully-inflated ballon and can get retained in there. It also prevents the uterus contracting against it efficiently, due to it's bulk. I hope I've explained that properly, but that's roughly the jist of it!


----------



## Kess

Nikki_d72 said:


> Kess, it works because the baby will have received it's full compliment of blood from the placenta, thereby making the volume of the placenta less, and easier to pass out. If it is still full of the blood that would have normally have gone to the baby, then as the uterus starts to contract down, it's like a fully-inflated ballon and can get retained in there. It also prevents the uterus contracting against it efficiently, due to it's bulk. I hope I've explained that properly, but that's roughly the jist of it!

That's very cool. It's amazing how well everything fits together when nature is allowed to work. We had been planning on delayed cord clamping anyway for the benefits for the baby, but it's nice to know there's a benefit for me too. :thumbup:


----------



## chuck

Freya, I'm Rh - and spoke with my MW's about wanting delayed clamping and physiological 3rd stage and it was never brought up as being an issue at all. 

I didn't get it in the end due to blood loss concerns but that was a simple blood loss matter nothing to do with being Rh-.


----------



## cherry_pie

I am going to discuss delayed clamping on monday with my MW and will post any further info, I am also Rh neg and didn't even think to ask about this, thanks! The only thing about it all I don't like is the idea of having to sit in the pool (if I get to use it) for so long after I deliver with the baby still attached...p;rob full of bloody water! But I guess it is a small price to pay for the benefits of delaying the clamping...


----------



## Mervs Mum

You can get out of the pool with your baby still attached :)


----------



## NaturalMomma

If there are no complications, a physiological third stage is better. Every time an intervention is introduced you have an increased risk of complications.


----------



## NaturalMomma

Freya said:


> I have a question.... can anyone help? Or perhaps I should start a new thread (wot a hijacker I am)
> 
> Does being rh negative have any impact on wanting delayed cord clamping, and a physiological third stage? More risky?
> 
> With the potential increase in blood loss during this time, do you have to get out of the water to deliver the placenta?

No, it shouldn't be a problem. I'm RH - and never had a managed third stage, and with ds2 I had delayed cord clamping. He wasn't cut until the placenta was delivered around 20 minutes later.


----------



## moomin_troll

im going for a natural 3rd stage this time. i had a managed third stage with zane, mainly because i felt pushed into it by my mw who rushed me thru everything. i felt like crap after the injection, i was sick and had the shakes. 

im also unhappy with myself for not researching things like this before hand. but this time im more prepared. Im rh- too and ive not heard about i cant do things the way i want because of this


----------



## claire-lou

I have now had both, and would chose the physiological one again. It was all so calm this time, I was just left to it, and fed Martha while she was still attached. It felt so right :)


----------



## Mervs Mum

Nawwwwww :cloud9:


----------



## PeanutBean

Kess said:


> Our current plan is to have the injection on hand in case we need it, but to have a physiological third stage unless I'm bleeding too heavily or something. That's the thing, you can't change your mind after the injection, but you can change your mind the other way.
> 
> I'm really scared of a retained placenta - they have to do a D&C don't they to get it out? That'd just remind me too much of my miscarriage, and the D&C knocked me about so much then it was awful. I'll be putting Bubs to the breast pretty much straight away and hoping that helps get the placenta out. Any other tips to go natural?

No it's not a D&C unless there are bits. If it's a whole placenta it will be a manual removal (yes an ob's hand right into your uterus).

I planned a natural 3rd stage but was a bit in shock after the speed of delivery and couldn't face any more feeling in my uterus. We delayed clamping then I had the injection. It led to a retained placenta, the irony of which meant contractions continued for another 4 hours til I had a spinal. :( My big regret from this birth was having the injection. Maybe it would've happened anyway. Maybe my uterus was scarred from my first traumatic birth. Or maybe not. Maybe I would've had the first night with my whole family at home together. :shrug:


----------



## Kess

PeanutBean said:


> Kess said:
> 
> 
> Our current plan is to have the injection on hand in case we need it, but to have a physiological third stage unless I'm bleeding too heavily or something. That's the thing, you can't change your mind after the injection, but you can change your mind the other way.
> 
> I'm really scared of a retained placenta - they have to do a D&C don't they to get it out? That'd just remind me too much of my miscarriage, and the D&C knocked me about so much then it was awful. I'll be putting Bubs to the breast pretty much straight away and hoping that helps get the placenta out. Any other tips to go natural?
> 
> No it's not a D&C unless there are bits. If it's a whole placenta it will be a manual removal (yes an ob's hand right into your uterus).
> 
> I planned a natural 3rd stage but was a bit in shock after the speed of delivery and couldn't face any more feeling in my uterus. We delayed clamping then I had the injection. It led to a retained placenta, the irony of which meant contractions continued for another 4 hours til I had a spinal. :( My big regret from this birth was having the injection. Maybe it would've happened anyway. Maybe my uterus was scarred from my first traumatic birth. Or maybe not. Maybe I would've had the first night with my whole family at home together. :shrug:Click to expand...

I'm sorry things didn't go the way you hoped, PeanutBean. Thanks for the info. I'm really glad it's not a D&C, they screwed up my last one and I really don't want to have to go through that again.


----------



## PeanutBean

Not that it was desirable but the manual removal was really just fine. I had a spinal so felt no pain (though I did feel rummaging which was pretty weird). DH and Indigo were in theatre next to me. It took about 20 mins after the spinal and they packaged up the placenta for me to take home. Weirdly it stunk of lavender so they must have put oil on it which is something that's done in lotus birth. I had a second degree tear and bad piles which may or may not have been from the birth or the procedure - the me didn't check properly but thought I hadn't torn. :shrug: It was disappointing to transfer after a full day of labour and birth at home but there was no alternative in the end and my hospital experience was about a thousand times better than it was at my son's birth. If there are tiny fragments left over then I imagine it would be a D&C if they weren't passing on their own. I would've thought that would come later, days or weeks after birth, unless the placenta came out incomplete right after birth.


----------



## Wolfie

Thankyou everyone so much for all the info. I'm still formulating my birth plan but delayed cord clamping and a physiological third stage are the two things I am pretty adamant about. (of course, I may have to change my plans on the day, but the medical staff better give me good reasons for changing these two things)


----------



## Sooz

I had a delayed cord clamping and natural third stage and was really pleased with how it went, my placenta delivered naturally with just a couple of contractions 10 minutes after she was born. I was feeding her at the time, and DH & I cut the cord together.

Unfortunately I had to have the injection AFTER I had delivered the placenta because they suspected I was hemorraghing. One thing that no-one had warned me was the injection makes a lot of women violently sick, and I was throwing up green bile quite quickly afterwards.

It turned out the blood was actually from my third degree tear, but no-one could see that until the consultant came and examined me.


----------



## madasa

cherry_pie said:


> I asked my midwife about forgoing injection and having natural 3rd stage and she seemed pretty shocked and asked why as 90% of women have it now and *they encourage you to have it so you don't bleed excessively. *She did say it was my decision but you might get the midwife huffing and checking their watch ass they won't want to wait around! My mum thinks the 90% of people are encouraged to have the injection to save time on their part as she never heard of such an injection when having us and to go with what I want but now I'm not so sure, what if the mw makes me feel uncomfortable about it all due to having to wait around? I don't like to think I'm going against the grain completely...now I'm afraid to ask about delayed cord clamping as that will take even more time... no one discussed these thin.vs with me as options, they are ideas I have come across from reading on here...why were they not discussed? Although these mw seems lovely I'm getting the feeling already its going to be very medically laid care...

Only just saw this - I question the use of the word "excessively". If 90% of women bleed that much, IS it excessive? Or is it normal? This is yet another example of how pregnancy and birth are treated as an illness and it worries me. Why are care providers so concerned about "excessive" (ahem, normal?) blood loss? Unless you are truly haemorrhaging, what is the point? Surely you are going to lose that blood ANYWAY? Lochia lasts for weeks for most women....


----------



## aileymouse

I had a physiological 3rd stage this time round and I felt great!

With the injection I was sickand had the shakes.

This time I was just left to get on with and delivered the placenta within 15 mins.


----------



## RoxyRoo

This thread has been so helpful.

I mentioned to my midwife at my antenatal class on Tuesday that I would like delayed cord clamping and a physiological third stage. She went on to tell me about the 'risks' of this, that I would experience heavy bleeding and that if I hadn't delivered the placenta within an hour I would have to be transferred to hospital etc etc..

I'm still going for it though and this thread has given me the strength to stand my ground.

Thanks ladies :thumbup:


----------



## Kess

RoxyRoo said:


> This thread has been so helpful.
> 
> I mentioned to my midwife at my antenatal class on Tuesday that I would like delayed cord clamping and a physiological third stage. She went on to tell me about the 'risks' of this, that I would experience heavy bleeding and that if I hadn't delivered the placenta within an hour I would have to be transferred to hospital etc etc..
> 
> I'm still going for it though and this thread has given me the strength to stand my ground.
> 
> Thanks ladies :thumbup:

Good for you! I didn't bleed much at all - MW estimates 300ml - with a physiological third stage, and it was easy and painless. LO got his full complement of blood, and I just sat cuddling him on the sofa until his cord stopped pulsing, then my sister cut the cord, MW said to cough and the placenta slipped out. Why did your MW at the antenatal class say you'd have to transfer after an hour if it hadn't made an appearance yet?


----------



## RoxyRoo

Kess said:


> RoxyRoo said:
> 
> 
> This thread has been so helpful.
> 
> I mentioned to my midwife at my antenatal class on Tuesday that I would like delayed cord clamping and a physiological third stage. She went on to tell me about the 'risks' of this, that I would experience heavy bleeding and that if I hadn't delivered the placenta within an hour I would have to be transferred to hospital etc etc..
> 
> I'm still going for it though and this thread has given me the strength to stand my ground.
> 
> Thanks ladies :thumbup:
> 
> Good for you! I didn't bleed much at all - MW estimates 300ml - with a physiological third stage, and it was easy and painless. LO got his full complement of blood, and I just sat cuddling him on the sofa until his cord stopped pulsing, then my sister cut the cord, MW said to cough and the placenta slipped out. Why did your MW at the antenatal class say you'd have to transfer after an hour if it hadn't made an appearance yet?Click to expand...

I have no idea why she said that :shrug: I think they just like things done to a timeline, which is rubbish! Hopefully she won't be present when I'm in labour anyway, the other midwives I've met seem to be much more supportive of homebirths :thumbup:


----------



## moomin_troll

some mws say all kinds of crap. my mw told me if i hadnt passed the placenta after 30 mins they would give me the injection....i would of liked to see them try lol


----------



## Linzi

I got given the injection at about 15 mins... im pretty sure now thats why I had problems getting it out coz my sons came very quickly naturally.

I also bled for about a fortnight with him, and this time Im still going 4 weeks on :(

I personally would never have it again.

x


----------



## Shiv

My midwife told me last week that the combination of delayed cord clamping and then having the injection is a bad one and is more likely to lead to a retained placenta. So she has urged me to choose, either go for an all natural 3rd stage with delayed cord clamping and physiological delivery of placenta OR have the injection straight away. She urged me to go for physiological though as I want a home birth.

She did explain to me why it was a bad combination.....but I can't quite remember, it did seem to make sense at the time though!


----------



## madasa

Shiv - I waited to cut the cord and had the injection... and gess what? Retained placenta. WISH I'd known all this before....


----------



## PeanutBean

^ Me too. I wonder why that is? Wish i'd known that. :(


----------



## Shiv

ok let me try and remember what my midwife said (I thought she might be saying it just to get an easy answer out ofme but it appears she may have been ringht going by your two ladies experience)

SO once you have given birth to bubs your uterus starts to contract down. The syntometrine injection makes the placenta seperate away from the uterus wall more quickly. So if given straight away the placenta will seperate before the uterus has had a chance to clamp down too much to let it out. If you wait for the cord to stop pulsating then the uterus will have started contracting down again for however many minutes it takes for the cord to stop pulsating, so then if you give the injection to speed it up there is a chance teh uterus will have already contraced too much thus a retained placenta.
however if you leave everything to happen naturally, the uterus will slowly start to contract and expel the placenta.

I think the 5-10 minutes for teh cord to stop pulsating is just too long for some midwives to be comfortable with then giving the injection.

I have been thinking about this a lot, I had no issues having the injection with my daughter and after 90 minutes of pushing was more than ready to have it all over with. The thought of having to physically push a placenta out was too much for me. If I have a short pushing stage this time around I will go for physiological, if I have a hard time pushing again I will go for the injection straight away

That all probably made no sense - sorry!


----------



## PeanutBean

Thank you and that does make sense. I felt like that which is why having given birth I suddenly asked for the injection (after the delayed clamping). I was kind of in shock and wish very much someone had said "are you sure?" all knowing what I'd gone through to achieve the homebirth. I felt at the time like I would be happy to never ever feel my uterus ever again! Personally the delayed clamping was very important. I wish I'd known this then but I didn't bother researching it as I didn't intend to have management! There's always bloody something!


----------



## Shiv

To be honest I got on google after my midwife told me and couldn't find anything to confirm or deny what she had said. I guess my midwife must have personally had some experience of retained placenta when combining the two options and that is how she has formed her opinion, doesn't mean she is right, but has made me think twice about it!


----------



## chuck

I didnt like my managed 3rd stage, she pulled the placenta out! Bleurgh!

I wanted physiological but by the time I was transffered to hospital and had just given birth I was in no place to argue and hubby didnt stick up for me.


----------



## moomin_troll

chuck said:


> I didnt like my managed 3rd stage, she pulled the placenta out! Bleurgh!
> 
> I wanted physiological but by the time I was transffered to hospital and had just given birth I was in no place to argue and hubby didnt stick up for me.

:hugs:
ita no fun having the placenta pulled out *crosses legs* i had that done with zane


----------



## chuck

Its was the most gross feeling ever it makes me cringe thinkin about the way I could feel it kind of sucking away from my insides.

BORK


----------



## lynnikins

i hated them pulling on the placenta after Nate was born too ewww was as bad as the ventouse pulling feeling if not worse much nicer to get 30 min cuddle time with EJ then my body did the pushing to expel the placenta i just sat up a bit and it slid


----------



## chuck

I dont think it ould have been so bad if she'd warned me! I know she gave me the jab (blood loss concerns blah blah blah) but I was not expecting her to yank it out.

I was cuddling Stanley (and the shakes had kicked in too so I was concentrating on not dropping him) and yoink WTF?!?!?!?!


----------



## moomin_troll

chuck said:


> I dont think it ould have been so bad if she'd warned me! I know she gave me the jab (blood loss concerns blah blah blah) but I was not expecting her to yank it out.
> 
> I was cuddling Stanley (and the shakes had kicked in too so I was concentrating on not dropping him) and yoink WTF?!?!?!?!

thats exactly what happened to me


----------



## chuck

It was quite a shock to be honest, quite a strong/intense physical feeling and to have to without warning was rather horrible!

I wish I had said NO, or Hubby had. 

I remember it clearly she said now then Charlotte I know you wanted a physiological 3rd stage but we're still concerned about your blood loss managed would be better...whammo jab i the leg.


----------



## Linzi

My midwife tried pulling mine out at home but it wasn't ready. She snapped the cord off, and then shoved her hand off and tried getting it but she couldn't manage. It was horrible. Then I sat with the thing half in half out all the way to hospital and for about another 20 mins in the hospital. It was agony so much worse than the whole of my labour. They were threatening me with general anaesthetic when I got to hospital but I managed to push it out eventually.

It was HORRIBLE and makes me cringe when I think about it, purely why Id never have a managed 3rd stage again 

xxx


----------



## aevenstar

I had a natural third stage after reading around a bit-I figured that if I had a PPH then they could give me the jab then. Took about half an hour-much easier than actual labour and I just felt the less intervention the better. Planning on same this time round!


----------



## libbylou

Bumping this up - I was searching for a thread like this - very helpful, thanks ladies!

My midwife asked me about this at our last appointment 

I've written in my birth plan that I wanted to deliver the placenta naturally but when she brought it up and said the oxytocin shot was procedure unless the patient didn't want it...she made it sound like a good idea but from all the research I've just done and what I've read here, I think I definitely want a physiological 3rd stage and delayed cord clamping. 
I want to avoid any sort of intervention as much as possible, but if I was having PPH then I'd take the shot.


----------



## Heather M

libbylou said:


> Bumping this up - I was searching for a thread like this - very helpful, thanks ladies!
> 
> My midwife asked me about this at our last appointment
> 
> I've written in my birth plan that I wanted to deliver the placenta naturally but when she brought it up and said the oxytocin shot was procedure unless the patient didn't want it...she made it sound like a good idea but from all the research I've just done and what I've read here, I think I definitely want a physiological 3rd stage and delayed cord clamping.
> I want to avoid any sort of intervention as much as possible, but if I was having PPH then I'd take the shot.

If you're having PPH my understanding is that the MWs would be giving you the shot regardless (letting you know of course). If it takes too long for the placenta to deliver, they would also recommend doing the shot (after 20-30 minutes). Just had the discussion with my MW at my 36 week home visit :) I'm opting for physiological this time around unless issues arise. One thing my MWs have ready at any birth is the shot regardless of whether it's used or not. I had the shot with my first and was still able to have delayed cord clamping...


----------



## ZoeZo

But 20-30 minutes isn't too long is it? Who decides what is 'too' long? Textbooks?! It can take up to an hour to delivery naturally AFAIK


----------



## Mervs Mum

20-30 mins is short for a physiological 3rd stage. They might _prefer_ it out sooner to get finished up but there's no medical _need_ to rush that. I've been at births where we've 'waited' almost 2 HOURS for a placenta to be born. Not that we sat staring waiting for it to come obviously! The family were enjoying their baby while we tidied up, put fresh linen on the bed etc. and an hour passes in the blink of an eye :)


----------



## Sommerfugl

I wanted a natural third stage with my daughter. We delayed clamping and cutting of the cord until it stopped pulsating, but as it was approaching an hour and I still hadn't delivered the placenta the midwives kept saying I would need surgery to remove it if it wasn't out by the hour mark, so in the end I gave in and let them give it to me. They then pretty much yanked it out by the cord.

So I guess it is ok to leave it longer then? I'd really like to try to go for a natural third stage again, I'm sure that injection caused my afterpains to be worse than they otherwise would have been, I still had quite a lot of painful contraction type pains for hours after the birth.


----------



## Blah11

i waited an hour for my placenta. I didnt mind the wait but i was having pretty nasty contractions for the entire hour which sucked a bit. The MWs pretty much sat and stared at my vagina for the hour. Homebirths arent very common around here and i dont reckon physiological 3rd stage is either, lol.


----------

