Physiogical v managed third stage?

[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]

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! 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]

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.

 

[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]

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

 

[PeanutBean]

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.

 

[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?

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.

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. 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]

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