injection to deliver placenta?

[kbwebb]

at my midwife led birthing unit, they've started to not give the injection and leave the cord to stop pulsating, and then you deliver the placenta on your own.

I was planning on delayed cord clamping anyway, but i'm still undecided on the injection.. so are you having it? or not? and why? pros and cons please

 

[xdxxtx]

I didn't get any injection and delivered the placenta on my own. It released a few minutes after my baby was born, and my MW helped ease it out as I pushed. My pushes were strong, so it only took one good push to get it out with my MW's assistance. It was all over with by the time my baby's tests were done and he was ready to be held. Apparently, it can take up to an hour, but not for me. Also, I had VERY little bleeding in the weeks after delivery. I remembered watching my sister after a c-section go through dozens of gigantic pads, and I only changed mine for sanitary reasons, never because they filled up.

I will probably do the same things this time that I did last time. It was all just very easy and calm.

 

[Pixiegirllily]

I had the injection, and midwife just pushed on stomach and pulled gently. I can't remember actively pushing it out. But remember going "eww" as it slipped out xx

 

[Rah]

I'm hoping for delayed clamping but still having injection as I think the risk of bleeding is too high not to have it but thats just my thoughts
Its not something I have looked deeply into I have discussed with paeds drs who I work with and that was the general outcome so I'm going with that

 

[fionar]

I don't know that it's something they even offer here, since I don't recall it being brought up when I had my son.

That said, I think I delivered the placenta about 15-20 minutes after he was born, with no problem.

 

[xdxxtx]

I had the injection, and midwife just pushed on stomach and pulled gently. I can't remember actively pushing it out. But remember going "eww" as it slipped out xx

Yep. If you don't get the injection, you usually don't have to push.

Actually, the injection is a lot easier because, as Pixiegirllily has said, the midwife just holds the uterus in place and pulls the placenta out. Nothing involved on your part; you just get to watch! Haha. However, with the injection, you're more likely to need to go back into the hospital after being discharged... because the bleeding can get so bad.

But, it's less likely to leave any little bits of placenta behind, making the injection less risky in that sense. For this reason alone, some hospitals use the injection as standard procedure.

 

[Gamina]

OUr antenatal classes run were run at the hospital by the midwife team. They recommended delaying cord clamping to drain blood which we would like to do. They then said that they are now not recommending or pushing the injection for a number of reasons. She said that the injection does not actually speed up the process that much if the delivery has been good and that it can lead to alot more bleeding after wards. Also she said there is an increased risk with the injection that not all of the placenta will pass and they would have to intervene in removal of any lost parts to prevent infection.

In short the leaflet she gave us said

pros-

Less blood loss in recovery
Benefits for baby in delaying clamping
Cleaner removal of placenta
Less likelihood of needing operation/ intervention to stop bleeds inside

cons-

Time taken can vary afterwards
Some women are to tired to deliver without assistance after difficult labour

 

[LoraLoo]

With my last baby i had a retained placenta (they didnt give me the injection even though i asked for it) I lost so much blood i felt really poorly. I thought i was dying Everytime i moved blood poured out of me, it was up my back, all over the bed, even on the curtains. I couldnt sit up because everytime i did i almost passed out and my blood pressure dropped really low.They left me like that for 6 hours (though did put me on a drip) I was in a lot of pain too. Just as they were about to take me down to theatre to have it removed i went for a wee and out it came, pain stopped instantly.

So for the experience i went through, i will definitely be having the injection this time x

 

[xsadiex]

I didn't have it and it came out 10-15 minutes later. Had to push a few times but was alright!

 

[winegums]

I would say find out which drug they use in that birth centre to deliver the placenta before making up your mind.

Syntocinon is the most commonly used, IM injection, works within 2-4mins, stays in the system around 40-60mins. Most common side effects - nausea, vomitting, headaches,

Some units use syntometerine (more effective for stopping blood loss post birth), still IM injection, generally worse side effects - nausea, vomitting, raised BP, palpitations, arrythmia, headaches, dizzyness

Length of 3rd stage with injection is usually within 5-10mins. Naturally can be over an hour (but often about 20-30mins).

Blood loss post birth is less with the injection - however blood loss in the weeks after the birth tends to be more. With a natural 3rd stage blood loss is heavier after the birth but tends to be less in the following weeks.

I guess a disadvantage of natural 3rd stage would be if you lose over 500mls they class it as a PPH which means you may be considered 'high risk' next time. However it might be worthwhile doing some research if you plan on a physiological 3rd stage as cardiac output is increased in the last trimester, so you have up to I think it's 40% more blood pumping around ready to compensate for blood loss post birth.

Also with a managed 3rd stage you don't have to 'do' anything but with a physiological you may have to use the help of gravity by squatting etc to help the placenta out.

Oh and the other thing about the injections - it isn't common but it does happen sometimes where the drug works really quickly and the uterus clamps down before the placenta is out, meaning you will have to have it manually removed.

Just make sure whatever you decide you read up on it all first and the midwives know what you want x

 

[winegums]

There is a greater risk of retained placenta if you have the injection x

 

[murmur]

I hadn't planned on having the injection but when I hadn't delivered the placenta afterm more than an hour they gave it to me. It took nearly another hour for me to deliver the placenta. I don't know if having the injection made any difference to me delivering the placenta and I think the only reason I would have it again would be if I have another very short umbilical cord as it caused a few issues last time in trying to get good skin to skin contact and breast feeding.

I didn't realise that some areas are no longer offering the injection.

 

[weffi82]

I had it with 1st but not 2nd, I just went along with whatever midwife suggested with my 1st but educated myself better for 2nd. Won't be having it for no 3 either. Also did delayed clamp with 2nd and will do again this time.

 

[TTCBean]

Is this a UK thing? My midwife never mentioned anything about an injection to get the placenta out. We've talked about pushing the placenta out though, saying it usually takes a push or two about 20 minutes after the baby is born.

 

[winegums]

I think it's a worldwide thing but depends on your care provider - if your with an obstetrician I think they routinely use the injection in the US but may be wrong. And midwives are governed differently over there so I think they make their own decisions whereas here if you work in the NHS (the majority of midwives do) you are meant to follow your employers protocols etc. Our trust guidelines state to offer all women the injection - syntometerine if they have a high risk of PPH, syntocinon if they have had any instances of hypertension, any renal or cardiac problems

 

[mammy2oaklen]

I had the injection and delivered the placenta within 10-15 mins i dont remember having to push at all though it kind of just came out lol it felt disgusting is all i remember i will be having injection again this time it was easy and straight forward and could get on with having a bath and cuddles with my baby

 

[special_kala]

I'm not having the injection.

There is more chance of retained placenta with the jab.

 

[kbwebb]

thanks ladies
I think i'll put that I don't want the injection it seems so much more hassle, then at the time I can change my mind if i'm too tierd to push or have had a bad labour

 

[weffi82]

I had the injection and delivered the placenta within 10-15 mins i dont remember having to push at all though it kind of just came out lol it felt disgusting is all i remember i will be having injection again this time it was easy and straight forward and could get on with having a bath and cuddles with my baby

When I had injection wi 1st there was no pushin, midwife just pressed on my tummy an manoeuvred it out. When I delivered it naturally with 2nd it felt very strange, bit gross too, blergh. Hopefully will be able to deliver it in the pool this time.

 

[d_b]

I had the injection, it took like 15 min (felt like forever) and I still had to push. The doctors here wait til the placenta is delivered to do any stitches, which I needed. I couldn't imagine waiting an hour for it to come out, i'd just be anxious about the impending stitches for that entire hour. I'll prob get it next time too. Although I never thought to stand up to help it fall out, I was tired and busy staring at my baby .