Physiogical v managed third stage?

[Kess]

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

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]

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

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?

I have no idea why she said that 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

 

[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]

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.

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]

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.