Home birth after a retained placenta?

[bethyb]

hi ladies,
just wanted any advice really from any mums who have had a home birth after a retained placenta. I had a retained placenta with my 2dd at home and had to be transferred to hospital for a manual extraction that was pretty horrific lol but now i have been put as consultant led on this pregnancy and have to see the consultant at 20 weeks to discuss my want for a home birth.
Any of you had a retained placenta and then had a home birth and did it happen again? Any advice would be great
thanks xxx

 

[Mervs Mum]

Can I ask did you have a managed third stage or physiological? ie was the syntometrine injection administered to 'help' the placenta. The reason I ask (for other readers benefit!) is because there is an increased risk of a retained placenta with a managed third stage. The injection causes the uterus to clamp down abnormally quickly which has a sometimes desired side effect of slowing bleeding but a very undesirable sideffect of it clamping down so hard it he placenta is retained and requires manually removing.

The best way to avoid it being retained is to avoid the injection. You could also try adding some homeopathic remedies in there to encourage it to come. Obviously I haven't been to hundreds of births but in my time and talking to other doulas, retained placenta with a natural third stage is unusual. Whats required is patience. 2 hours for it to come is perfectly acceptable but sometimes women are rushed unnecessarily.

 

[Sovereign]

Can I ask did you have a managed third stage or physiological? ie was the syntometrine injection administered to 'help' the placenta. The reason I ask (for other readers benefit!) is because there is an increased risk of a retained placenta with a managed third stage. The injection causes the uterus to clamp down abnormally quickly which has a sometimes desired side effect of slowing bleeding but a very undesirable sideffect of it clamping down so hard it he placenta is retained and requires manually removing.

The best way to avoid it being retained is to avoid the injection. You could also try adding some homeopathic remedies in there to encourage it to come. Obviously I haven't been to hundreds of births but in my time and talking to other doulas, retained placenta with a natural third stage is unusual. Whats required is patience. 2 hours for it to come is perfectly acceptable but sometimes women are rushed unnecessarily.

Thats really interesting. My third stage was managed and I had a retained placenta. Will try for a natural third stage this time then I think! x

 

[xxembobxx]

I had a retained placenta with my 2nd child. It was a very quick unassisted, unplanned home birth and I was quite upset I had to go to hospital after the birth as I had to have a manual removal due to PPH.
It had never been an issue until with my last (5th) pregnancy when I wanted a planned HB. I then found myself under a consultant as I was considered at risk
The consultant concluded that as I had since had 2 more children without problem the risk was low and that due to quick labours a planned HB was probably the best option.
She did however say she wanted me to have a managed 3rd stage. I agreed but at the home visit from MW at 37 weeks I said although the consultant recommended it I would like to try for a natural 3rd stage and repeated this when MW's came out to me when I was in labour.
The HB MW's were great. They were happy to allow me a natural 3rd stage and it felt so different from my previous labours. I had never really taken notice of the 3rd stage but was fully aware this time. It lasted about half an hour and I ended up pushing the placenta out when the MW's advised me to go to the loo!
It was Merv'smum who gave me the advice about natural 3rd stage and I'm so glad. It meant the cord was not cut straight away as the MW's waited so the placenta drained a little and I got to hold the baby for those precious first moments as she was still attached
I would have had the syntometrine if the MW's had advised it and if the placenta was taking a while but it didn't take much longer to be natural. I also didn't feel like I was being rushed or taking up too much of the MW's time.
I'd definitely do it again and I don't think a retained placenta automatically means a re-occurrence but I was prepared to have to transfer and have a manual removal again. Glad to say it was not necessary and I had a lovely HB

 

[lynnikins]

it took a good 40-50 min post birth for AJ's placenta to arrive the same with EJ's and i got cuddles the whole time it was lovely vs. the mere seconds i got to hold ds1 before he was whisked off my staff at the hospital, id opt for natural anyday

 

[bethyb]

thanks for ur advice ladies, Yes its just upset me that im now classed as consultant led and not midwife led I will have to try and push my case and say how much having a home birth means to me, I really didnt like having my placenta removed (was done by a doctor and not in theatre! lol) The cord snapped off my placenta so not sure what happened but i know i had no problems once it was removed, it was just upsetting as i wanted to remain at home although not having surgery meant I got to go home! I will have to read more about a natural third stage as I wasnt aware of the issue before it happened to me! xxxx

 

[Mervs Mum]

You can decline consultant led care honey and you don't need permission to have your baby at home x

 

[Sam Pearson]

You can decline consultant led care honey and you don't need permission to have your baby at home x

^^^Yes, the above.

I also wondered about the cause of your retained placenta. Were you allowed time to try to birth the placenta naturally after the cord snapped? I mean was your placenta truely retained or once the cord snapped did the midwife just declare it a retained placenta and send you off to hospital?

I don't know much about snapped cords, it's pretty rare, but thinking about his logically the cord has nothing to do with the birth of the placenta. Once baby is born the uterus contracts and this is what causes the placenta to sheer off the wall of the uterus. Then the contractions of the uterus, which also aren't reliant on the cord but depend on hormones, do the rest of the job along with Mum pushing. An upright posiiton can help this process along nicely.

I'd imagine the main thing if a cord snaps would be that baby is breathing well since no oxygen would be available to baby from the placenta.

The best way of ensuring a cord doesn't snap is not to pull on it. I'd also hazzard a guess that the best way of making sure a placenta isn't retained is to allow the woman time to birth the placenta rather than giving her an injection to hurry things along putting the woman in a position of birthing the placenta very quickly or being in seroius trouble. I've heard of many, many lengthy third stage of labours with no problems but, of course, that can only be possible with a natural labour - no injections and no cord traction.

Happy to be corrected on any of the above.

 

[bethyb]

Well They asked me to walk around and to try and push it out but I just couldnt, im not sure whether I was too tired after labour or why my placenta didnt come then but it didnt, I only describe the next thirty mins or so as a bit of a fog as I began to feel increasingly foggy headed. I didnt have any gas or air or any pain relief so this wasnt due to the drugs but more to my placenta being trapped. They told me I had to get to the hospital within the thirty mins and the team were almost ready to take to me surgery and I asked the doctor to try and remove it as I could feel it (felt like a pair of hiking socks in my hum hum lol) They didnt say why it had snapped or if I was bleeding too heavy as I said I just wanted to get it out and the midwives were getting more and more worried.
I did have the injection so not sure if thats the reason or it was a weak placenta/cord or if it was pulled with too much force. Although I know I have the right to have baby at home, baby and of course my health and well being are paramount so not sure where to proceed from mow, thankyou all for ur imput xxxxx

 

[Sam Pearson]

I did have the injection so not sure if thats the reason or it was a weak placenta/cord or if it was pulled with too much force.

I didn't mean that the injection could have caused the cord to snap only that when you have the injection you are then on a time crunch to get the placenta out whereas with a natural birth so long as you aren't bleeding you would have had time, hours, to birth the placenta.

Is it possible to speak with the staff at your previous birth to get more details/clarification as to what occurred? That might help you decide your next move.

 

[bethyb]

yes think ur right, have midwife at in 2 weeks and then consultant in six so will have to ask more about it, sounds awful that i dont know more lol xxx