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Tis just that I lost a lot of blood last time and I blame it on the cord being tugged.
The ONLY time I was ever assertive during the whole birth was when I insisted I stand up and push out the placenta myself and it came out right away and splashed cord-tugging midwife in the face!
This time I'd like the same, but without the cord-tugging midwife, - or the injection!
They left mine alone and still attached to DD as I had opted for a physiological 3rd Stage. That was until I had to back on the G&A for the contractions It was ruining my first BF experience so I told them to give me the jab and it almost flew accross the room MW fault as she had pulled it after she injected me. It was not a nice feeling to have someone pulling and I would try the same thing if I had another DC.
I think they should tell you about 3rd stage in more detail - I was quite shocked that I was still contacting so hard and having to still push.
i didn't have to push, and no contractions (sorry!)
It was taking ages though so the lovely MW suggested I tried bf-ing again and I did and out it popped, no effort on my part but it scared the life out of me!
no-one went anywhere near my nether regions, dd was born in the pool so the MW just caught her, then I shuffled across to the loo and the placenta came out there
maybe i was just lucky but no-one else needed to get involved!
'cos if you had a proper pph then they will recommend you have the injection. Just pre-warning you that they may try and scare you into it. Of course its still your choice and you can say you don't want it unless you start bleeding heavily and they think you need it - if you think that sounds ok?
Perhaps you should ask to discuss what happened last time so that you can get the facts about what actually happened and that will help to inform your decision.
I am not saying you are wrong or anything, but at that stage of the proceedings it is difficult to know exactly what is going on, and it would be good if your midwife got your old notes and you had a debrifing session.
Oh good God, what are you all talking about? Is this the bit when the placenta is delivered? Is it hideous? What is physiological 3rd stage? Do they cover this at NCT?
Thanks 3littlefrogs, but I've been debriefed to death!
There wasn't anything in my notes about the 3rd stage, - or about the fundal pressure for that matter !!
I would be happy for my midwife to have a copy of my notes (at a different hospital), but I'm worried that they'll find out about the bleeding and cancel my homebirth.
A physiological 3rd stage is where it is delivered naturally, and managed 3rd stage is where they give you an injection to contract the uterus to speed up delivery.
I probably did Stripey, - but they estimated my bloodloss inaccurately at 500ml. When I read my notes, there was an entry two days later that said on reflection it would have been 750ml but could have been more as the bed was soaked.
I'm pleased I found out, because I had no symapthy with c/sectioners who whinged that it took them 4 weeks to be able to walk properly, when it took me just as long if not longer!
Physiological 3rd stage is the best option. Had two myself, very gentle and a lot more normal from my pov. Very little bleeding either time. And I should say that it can cause bleeding- it's barbaric as far as I'm concerned.
Aside: I know someone who waited 7 hours for the placenta to come out during a home birth... Finally appeared just as independent midwife was starting to mutter about hospital.
Starlight, you had a really long labour last time if I remember correctly, this was almost certainly the reason for the pph. If the mw had given you the jab it is routine to pull on the cord, normally a quick tug and it is out. If she hasn't given you the jab then no pulling should happen as it is a risk factor for a pph. You would have almost certainly had the jab if you had had a long labour, unless you specifically requested not to. Lots of women don't notice it as it is often given immediately after the birth when they are being amazed at their new baby.
You don't have to go in to hospital if you don't want to, (how can you have been on mn this long and not know that! ) it would be much safer to let your midwives know about the blood loss so that they can be prepared. If you really don't want to have the jab then you could have a physiological third stage with recourse to the injection if your bleeding is more than would be expected. It can be given at any time, before or after the placenta has been delivered.
Yes I can guess that your birth plan is not going to be too concise either! The midwife will be too busy reading it while you just get on with having the baby!
You can put in your birth plan that you'd like to wait and see, if they decide that you had a pph last time for example: I would like a physiological third stage, however, if I suffer excessive bleeding at any point prior to the delivery of the placenta, I will consent to oxytocics after taking advice from my caregivers. That would make it clear that you are not being cussed, you've thought about it and you are aware that it's possible to have a wait and see approach
Maxbear I don't think it was that long - 17 hours from start to finish, - but I was in pain right from the start and pushed for 3 hours. (Ive been going on about it for 17 months, - so perhaps that is the long part you remember )
I feel that the pushing stage was mis-managed and it ended in fundal pressure by an unaccompanied SHO, followed by 15 mins trying to deliver the placenta naturally (As was in my birth plan) and the insistance of the mw to give the injection as I was takign to long apparently - which I agreed to. She then pulled hard on the cord.
I felt this is why I lost so much blood, and is one of the reasons I'm going for a homebirth this time.
Thats right, Its all coming back to me now, I think it was the long second stage that I was remembering. 17 hours is quite a long time to be in established labour, but not excessively long of course.
Thanks for the advice though Maxbear. The cord was being tugged before I was given the injection. Although I was in a mlu, when the m/ws read that it was going to be physiological 3rd stage they did both look at each other as if not entirely sure what it meant, - but I could have imagined that!
Maxbear - Twasn't established I don't think. But don't really understand these finer points.
Waters broke at 3am - contractions every 3 mins for 1 min, - extremely painful 2 hours later, - went in at 10am and was 2cm screaming for epidural. Never came. Was 3 cm at 12pm, and began pushing at 4:30pm - til 7:30pm.
But contractions never lasted for more than 30 seconds from as soon as I arrived in hospital, and at the second stage were only 15 seconds long.
So my notes said, - but not sure how mw knew this! Very clever people!
Thank you! Mine is in Oct 08, so I'll be falling over myself to find out by that stage! All of the notes about the delivery of my DD are "written in retrospect", so also bloody useless. Did you ever complain to the hospital? I never found the energy what with the scar issues and the DD-not-sleeping issues. I felt that they would just say that DD was showing some signs of distress or something anyway, and make me feel even worse.
I didn't complain, - the super super head made it very clear that I couldn't do, without exactly saying anything I could use against her!
Basically she said that I had misunderstood, that the SHO was probably just rubbing my tummy hard and fundal pressure is not a recognised obstretic procdure so wouldn't be written in my notes, - whatever THAT means.
She also told me that there is no point in dragging my mw into it, because it was so long ago now she wouldn't remember. (I don't belive this as MN midwives say tis sooo rare to see).
justhavingamoan Nope, - I'm currently doulaless, - but it is my own fault at the moment. I've just got back from hols and haven't followed up a couple of potentials!
Ahh, - I see *Stripey', - so hopefully the risk of pph in my case was likely to be, as I expected, down to the mismanagement of it, and a proper homebirth with limited intervention shouldn't be a problem!?
Oh no, hope you find one. I am meeting a couple this weekend, both seem really great, I am going to book asap though as I here both of the ones I am seeing can get booked v quickly. I hope you find one.
The problem is although you had 2 things happen which can increase the risk of you having a ph there is no way of telling if it did actually cause the pph or if you would have had one anyway.
Now if it would have happened anyway then you are at an increased risk of having another.
I had a long and difficult first stage in the MLU (large OP baby) and pushed for two hours but DD was stuck. So I was transferred to the CLU. My birth plan was no instrumental delivery ("natural" or CS) but I was bullied into ventouse. The politics between the MLU and CLU were obviously very bad, there was definitely a feeling of "yet another one that the MLU can't cope with, score one to us" and "silly woman think that they can do the Mother Earth natural stuff, but they can't really cope". You get the picture.
Basically the consultant was never going to stop arguing with me until I signed the consent form, and I had been strapped down onto my back and was in agony. I used my last bit of strength to insist that I did not want an episiotomy (I had only agreed to ventouse because I knew that you didn't need an epi) and that if I tore that he would sew me up (I had grilled him on his experience).
You can probably guess that he gave me a huge episiotomy (almost the whole length of my vagina) without my knowledge or consent, lied to me about it ("just a small tear"), and then left the SHO to do the repair. I am still having problems with the scar and pregnancy has made them worse.
I also had a bleed after an assisted delivery (ventouse then forceps)I was given the injection and the cord shapped whilst they pulled on it - and they then had to remove the placenta manually - (cue losts of stitches and a nasty painful scar)
In my notes it says I only lost 300ml but my blood count was at 8 and I was offered a transfusion - I refused and got back to normal myself.
I am CONVINCED I lost more blood than this (TMI it was everywhere!!)
I am unsure what to say about the third stage next time.
I am obsessing about it and getting quite anxious.
Starlight - I'm having a bit of a wrangle with my consultant over the 3rd stage as I also had a PPH last time. Like you, I think it was due to particular circumstances at the time rather than anything that will be repeated. (in my case, too much walking between post natal ward and SCBU).
She's put on the "alert" page of my notes that she'd like me to have a managed 3rd stage, but really I would prefer to wait and see. THe PPH last time was 12 hours after delivery so although offically a "primary" PPH it was after I'd left the delivery room, and I have no idea given that time lag what would have happened if I hadn't had the injection.
I have had a lovely healthy, happy pregnancy (now 37 weeks) and just want to be left alone during labour!
The MWs were lovely - it was the OBs that I had an issue with! My CMW is on a mission to keep me away from OBs. I would like there to be some kind of procedure though, so that if a woman has a lot of problems post-birth that that information gets back to the medical professionals that were attending. I naively hope that it would cause them some time to reflect and knock down the God-complex a bit.
PS I also think that there was a bit of "fudging" about my blood loss as in my notes it's recorded as just under the limit for needing a transfusion, but I can remember the blood loss being a big deal and doctors coming in to peer at my bits when I was BFing DD.
LOL Gem! I think experience helps, - but you can't possibly be accurate at estimating - it's an 'estimate'!.
Dunno why they decided 2 days later that I lost an additional 250ml or more. Dunno what the cut off for transfusion is. They just gave me massive iron tablets which I obviously wasn't going to take given the amount of stitches....doh!!!
It was ruining my first BF experience so I told them to give me the jab and it almost flew accross the room 
MW fault as she had pulled it after she injected me. It was not a nice feeling to have someone pulling and I would try the same thing if I had another DC.
!!
) it would be much safer to let your midwives know about the blood loss so that they can be prepared. If you really don't want to have the jab then you could have a physiological third stage with recourse to the injection if your bleeding is more than would be expected. It can be given at any time, before or after the placenta has been delivered. 
)
.
