Physiogical v managed third stage?

[Heather M]

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.