Delivery of placenta

[Stefka]

I was just reading through another thread and noticed that a couple of people said not to get the injection to speed up the delivery of the placenta but they didn't say why this was. Just wondered why this is a bad thing.

[CatIsSleepy]

If you have the injection there is a very short window of time during which the placenta must be delivered before the cervix closes up and it's too late. That's what happened to me and it meant I then had to go into theatre, have a spinal, and have the placenta manually removed.
Not what you want after you've just given birth!

[Spillage21]

There are a few situations where an injection would be recommended, i.e. where the uterus may have trouble contracting down and therefore difficulty in stopping bleeding.

But for a normal labour in a healthy woman I don't think evidence supports the need for the injection. Your body does all the necessary stuff to expel the placenta and control bleeding (and you can help by keeping upright, skin-to-skin with baby, breastfeeding). Blood loss is reckoned to be slightly more without the injection (but nothing that most women can't handle), although research is suggesting that in the postnatal period, there may not be much difference.

[Stefka]

Thanks - I never knew any of that - first baby so all info is useful!

[Beauregard]

I have experienced both sides of delivery of the placenta.
With dd1 i was offered the injection and i thought what the hell it will be quicker.
With dd2 as i had such shock with the rapid delivery they suggested a physiological 3rd stage esp as was at home.
The only difference was it took a bit longer and i felt further contractions so was a bit painful.

[Miaou]

The flip side of it is ... I didn't have the injection with my third and wasn't able to deliver the placenta myself (didn't need surgery but needed to be transferred to a bigger hospital so that they could pull on the cord). Now that may or may not have been caused/hindered by me not having had the injection, no-one is sure; but to be on the safe side I had the injection for my fourth and had no problems (same as with my first two).

[Miaou]

Oh God yes the contractions!!

I had a two hour ambulance ride contracting all the way

[puffylovett]

i opted for a physioloigical 3rd stage as i wanted a natural labour and didn't see why i should be given an injection to speed things up. At the time i thoght it was because childbirth can be a conveyor belt and it's done for their convenience to speed things along. I know now that there are risks.

Anyway, it delivered itself about 5 mins after baby with only 1 contraction - all v quick. I was then known as the only person in my hospital who'd had a physiolofical 3rd stage recently (my midwife had never performed one) so people kept popping in to say wow !! V funny

[Lilliput]

It can also sometimes make you sick or dizzy. You really don't want to feel pukey when gazing lovingly at you newborn baby.

[Drinkypops]

I had the injection, but ended up the same as CatisSleepy and having the placenta removed in theatre. I'm not sure if that was to do with the injection though.

[Lilliput]

Sorry I meant the injection can

[BonyM]

I had a natural home birth so opted not to have the injection, but after 45mins there was still no sign of the placenta and I was in a lot of pain. At this point the midwives suggested I have the injection, which I agreed to and when they delivered the placenta they found that a lot of blood had built up behind it, hence the pain. This was a post-partum haemorrage - potentially life-threatening so I had to be taken to hospital for observation.

I was completely fine but wished I'd opted for the injection straight away, thereby avoiding all the worry and the hospital visit.

A PPH is rare though - I guess I was just unlucky.

[Eaglebird]

When do you get the injection? Is it after you've delivered the baby, or while the baby is being delivered, after the head has crowned?
Just wondering. I'm currently 29+2 weeks and am thinking about what to put in my birth plan. I'd rather the cord wasn't cut until it has stopped pulsating. Same with the injection. Are these reasonable things to put in a birth plan, or would they be considered strange? I guess I'd rather the cord/placenta were left alone until they've 'finished doing their job', so to speak.

[Dinosaur]

Hello Stefka,

Like CatIsSleepy, with my second DS I ended up having to go to theatre for manual removal of placenta. Was gutted as had managed completely drug-free labour and delivery.

Didn't have the injection with DS3 and the placenta was delivered within 10 minutes. You can always have the injection after the placenta has been delivered if you or MW is worried about bleeding.

[Wilkie]

I had injection as wanted it all over with quick as poss. Plus had had an epi so the midwife did her thing (pressing on uterus and pulling on cord) and it came straight out.

I asked to have a good look at it and she explained what all the bits had done. Very interesting.

[NotADragonOfSoup]

Didn't notice any difference apart from time with having it and not having it TBH. Didn't have it with DD and stayed in the birth pool to deliver the placenta. Didn't have any painful contractions at all.

[mumtodd]

Hi I also had a drug free delivery and ended up under general anaesthetic in theatre for manual removal of placenta. DD was born very quickly and afterwards did not feel any further contractions to deliver the placenta. Midwife pulled on the cord and the cord came away so only option was theatre. I was in such a haze about the whole thing that I am not sure when (or even if) I had the injection. I just wanted to be with dd and dh and it was taking forever. Baby latched on straight away and everything but still nothing. I feel a bit cheated about it really because I had such a great delivery it really ruined it for me.

[Dinosaur]

It's really odd, isn't it, how some women have problems delivering placenta if they don't have the injection - and others, like me, have problems if they do have it. Makes it a very hard one to call if it's your first baby.

[feetheart]

I had the injection with DD and it was fine but with DS I wanted to deliver placenta naturally - curiosity possibly!!
It did take 50 mins but I don't remember feeling any contractions, it just slithered out when it was ready! However I was at home, nursing my gorgeous boy after a fantastic delivery and I really didn't care how long it took. Only regret is that I wanted a completely physiological 3rd stage (cord pulsing etc!) but midwife hadn't understood and clamped the cord before I had even turned round. Not a big deal but if that is what you want make sure you let the mw know.

[mumtodd]

The midwife i had was great - they didn't rush things at all but it was going on longer than they usually wait and i was so impatient to get cleaned up and into a nice bed to cuddle dd tgat i would have agreed to anything. Although in my case i think they were worried when the cord came away.

[TheQueenOfQuotes]

I opted not to have the injection with DS3 - and still felt the same after I'd had him, however after 50 minutes there was still no sign of it and I was getting fed up of waiting (wanted to be stiched up and go home LOL) so decided to have it anyhow - was deliverd within 5 minutes. I did have contractios - but very mild (or maybe they just felt mild as I'd had very strong and close together ones while actually in labour )

[marmitemad]

mumtodd - I had a similar experience to you, drug free delivery (against the odds and expectations of everyone) and a physiological third stage which was wonderful as dd could not be taken away from me (I had requested this in my birth plan barring any emergencies).

But after 60 mins without contractions despite pushing, I had the injection which didn't help which then led to panic stations in case my cervix was closing so the dr attempted manual removal (awful, awful experience- don't let this happen to you) which also didn't work so was then wheeled off to theatre for 2 hours although I had a spinal so was awake the whole time.

Apparently it is quite likely that the placenta would still have failed to appear even if I had had the injection immediately, I would just have gone to theatre earlier so while it was quite traumatic I would still go for physiological next time as I treasure that special time we had together and the knowledge that it hopefully eased dd's first few hours in this world.

[Klaw]

It's important to empty your bladder regular in labour as if it is full just after birth it will prevent the uterus from contracting down and so a PPH becomes a bigger risk.

It is also important to note that a physiological Third Stage can be planned if there are not interventions in the labour. If, however, you've had induction or augmentation etc, then you must have a managed Third Stage.

here's a link which may help you to make informed decisions about your 3rd Stage

[mumtodd]

marmitemad Your experience sounds very similar to mine except that when there was no sign of the placenta delivering a lovely doctor who didn't speak much English appeared, held up a HUGE hand, smiled at me and said 'too sore, much better in theatre' and strolled off. I could only imagine what he was going to do with that hand if I didn't agree to theatre. I was under full anaesthetic so no idea what happened after I went under. I am actually thinking of requesting my medical records because it still feels strange to me that I had a procedure that I know nothing about.

[mumtodd]

Klaw, thanks for the information. It is something I would like to avoid if possible if I have another baby. Feels very disappointing to have the labour and birth you want and for things to then go out of control.

[TheQueenOfQuotes]

mumtodd - I had the "perfect" labour and birth - went EXACTLY as my birth plan/my hopes.....I really wanted a natural 3rd stage - but it didn't happen - but you know what? It doesn't bother me one bit, I think because everything else had gone pretty much "text book" (which I'm still stunned about 11 weeks later LOL) the fact that, in the end, my 3rd stage wasn't as I planned I didn't care (and still don't)