I had with first as the midwife cocked up my labour and it turned into an emergency (shoulder dystocia) - it was all very hectic but I remember it hurting a bit. With second no injection and it just slopped out easily about 20 mins after birth when ds2 had latched on. I wouldn't bother unless medical reason/traumatic birth.

The resaon why I put not in second birth plan unless was haemorhaging or something was that after nightmare medicalized first birth with monitoring, prodding, poking and jabbing I had a real strong urge to be left the f* alone in labour unless medically dangerous for the baby and I must say, I was lucky enough it worked out that way and it was a much less unpleasnat and traumatic experience.

I can't remember if I had it with dd, but I didn't with ds, very relaxed birth, I had read up about it, then whilst waiting I got impatient, but the midwife just encouraged me to wait, so it was all fine in the end... have to say I found the after pains quite shocking with ds compared to with dd, I wasn't prepared for them, esp after a fairly easy birth.

I had it with my first (hospital)birth which led to much hauling on the cord and pressure tactics (verbal/emotional and physical!) due to the inevitable panic of the midwife followed by inevitable bloodloss.

I didn't have it with my following three (home)births. Physiological 3rd stages (waited for cord to stop pulsating) and each placenta schlooped out in it's own good time, no trauma (emotional or physical), not much difference in length of stage, a shorter time if anything and less bleeding by far. All apart from the final one which took an hour but critically, it was an hour of chilling out and baby cuddling/feeding; all good!

Are you planning to breastfeed Picante? Your body will release oxytocin upon latching on if so, if not a similar hormonal response can be acheived by skin to skin snuggling.

Oxytocin closes down the womb, expelling the placenta and shutting all blood vessels as it goes. Syntometrine (the injection) is merely a synthesised version of the same chemical and not necessarily better! Not least because it necessitates a time limit for expulsion which is what often creates the panic that leads to intervention.

I had a natural third stage with DD after I had the injection with DS. It was fine, and much nicer than the horrible yanking that the doctor was doing after the injection <boak>.

I had an infection with 'retained products' after the injection so was keen for a natural 3rd stage with DD.

It took about 30 mins, including waiting for the cord to stop pulsing and then a few pushes and out it came. I got to have a good look at it too! I thoroughly recommend it if you haven't seen it before.

However, I also had the same womb infection after DD so it looks like that's just the way I'm built!

One of the consultants told me something cheery while I was spaced out with 40 degree temp because of infection, on a drip in the hospital.... apparently I'd be dead if this had happened to me 100 years ago.... nice....

if you at home this time, so you dont need any injections - just take your time

I did have the injection with both of mine, but I still retained some placenta and membranes with my 2nd.

Didn't come out until 10 days later. Fortunately I had had some antibiotics for something else or I would have had a dreadful infection. As it was, I felt very dizzy and strange when it finally "fell out".

Just gave birth to DD2 on tues and thanks to advise on this thread had a natural 3rd stage. I used gravity and coughing to help shift the placenta and really thankful to people sharing their experience as otherwise would never have known to ask.
I had the injection last time with DD1 and when the MW had applied tension to the cord it felt like my insides were being pulled inside out, really unpleasant sensation. This time the MW asked if she could try abit of tension and even though she was really gentle was the same horrible sensation so I asked if I could sit up, and after squatting very unceremoniously over the bucket and coughing it came out. Not my most glamorous hour but so much better than the very brutal tugging feelings so definitely the best decision for me. I thought it wouldn’t have been that uncommon but after it had been delivered the MW who has been a community MW for the last 2yrs after working in the hospitals said that was her first natural 3rd stage she’d done, which surprised me.

First time (home birth) I did have it as I was bleeding a fair bit. By no means was it straight away though so I'd guess the cord had stopped pulsating but don't really know. The placenta just came out after a few minutes with no interference fro, the midwives.

Second home birth I wasn't going to have it but after a while when nothing happened (was only about 10 mins I think so was obviously too impatient) I asked for the jab. Midwife said it wasn't worth it by so didn't have it. It tok hardly any time to come out and was still cuddling/feeding my newborn when it did.

Oh yes, and if you do go for natural 3rd stage put in your birth plan that the midwives should not tug on the cord or try to pull the placenta out as this is contra-indicated.

I think it is best to wait and see how you feel. As I understand it once they have given you the injection the placenta must come out within a specified time or they will take you in to surgery, and there is no requirement that you have the injection straight away so give it a while and see how you feel.

I did not have the injection as I wanted a natural, unclamped third stage. BF'd DD while waiting for placenta and DH cut the cord once it was out.

Hope it all goes well

I had a very fast unplanned home birth with Ds, Had the injection but retained the placenta and had to go in to hospital to have it surgically removed. Wasnt alllowed a homebirth second time around for other reasons but went for a "natural" 3rd stage as Id read the injection can (bizarrely) sometimes cause retention. Didnt have any problems delivering the palcenta without it.

Maxbear - print this off for her
Physiological third stage should not stress her out - she just needs to learn more about it which is part of her respibility to keep up to date!

I didn't have it with either of mine, placenta came out after 20 mins with the first, ten with the second. I have much less bleeding in the first few weeks and less afterpains than I expected. I did however lose 500ml blood second time around and felt knackered for about two weeks, will probably have another physiological third stage if I have a homebirth or an easy hospital birth this time, but will be with the same midwife, so if it is going to cause her too much stress will go for the injection. Kinda feel that if she is going to put herself on call for me, I don't want to stress her out any more than I have to!

mrsradders - what a pity the cord was cut to get your DD2 breathing. When the cord is still pulsating, the baby is still getting oxygen from the blood supply. Better to stimulate the baby to breathe while still attached.

It is also not good practice not to give the injection if the cord has been clamped and cut while pulsating as it intereferes with the natural process of placental separation which can increase the risk of haemorrhage.

i had it with hospital birth of DD1 and i had a retained placenta :-( (spinal theatre aaarrgghhh total nightmare) was terrified of the same happening again when i was having DD2 so went for homebirth and the midwives were happy to go for a natural third stage, unfortunatly couldn't wait for cord to stop pulsating or for daddy to cut it as she needed some help to start breathing, but with some tummy massaging from fab midwife and very gentle tugging (very thin cord!!) i delivered it myself probably 20-30 mins later i think..did experience crampy type pains....needless to say i not looking forward to the delivery of DD3 in sept!!!!

3 babies, never had it. Much to the disgust of the midwife with DS1.

Thanks all - that's been really helpful. I think I'll give it 20 min or so and see what happens.

Jaundice is associated more with having the jab than not, you'll be glad to know.

Duchesse - my son was jaundiced. He didn't have the cord cut till it stopped pulsating.

Physiological third stage is a natural thing if the first and second stages are without intervention. The cord should stop pulsating before it is cut. The cord can actually be left unclamped till the the placenta is out.

If you have an epidural again, or other intervention, you could ask for syntocinon as the injection for the third stage. It does not make you sick. That is what we use all the time now. It is syntometrine, another injection, that does make you sick often.

Should also say I had no noticeable contractions to get them out. They just appeared painlessly a few minutes after the baby.

I didn't have it! Twice. Was no different for me than having it (which I did first time), so would always opt for not having. Placentas took about 2-3 mins to emerge in each case.

Son had jaundice which I'm not convinced is not caused by cutting the cord while it's still pulsating, as they have to if you have the jab.

Just to clarify, I wasn't trying to push the placenta out for a whole hour. I was just sitting around feeding the baby and chatting, but there came a point where the midwives said 'you really should try to push out the placenta now' and so I did, and it came out.

I had the injection with ds1 (in hospital) and I swear the midwife bruised me while doing it as that area hurt for months afterwards. I remember asking other mums in my postnatal group if their thighs still hurt from the injection and they were all quite surprised.

The main reason I chose to have the injection first time was that I reckoned I'd be so tired I would just want the placenta out as fast as possible rather than hanging around waiting for it.

Ds2 and ds3 were born at home so the hanging around didn't really matter. Both times it took about an hour, but I had to concentrate on pushing it out, it didn't just slip out on its own.

My midwives brought a kind of bedpan thing to sit on. I am surprised other midwives weren't as helpful.

I didn't make a decision until I was actually at the 3rd stage. Certainly with my third birth I recall the 3rd stage as being worse than the labour, and asked for the injection after about 20mins. I think it was bad because I was lying down on my back. I've no idea why I ended up in that position, having just given birth upright in a birthing pool!

You don't need to chose beforehand, see how it feels when you're actually doing it, then choose.

I didn't have it. Was no big deal at all - didn't feel more than very gentle contractions (pain free) and after about half an hour of cuddling ds, I just held a sanitary pad supplied by the mv over the front of my fanjo, as I didn't have much vaginal muscle tone at the time. Was the same amount of effort as a very easy crap. It was big, but so was fanjo after a baby had exited out of it, and the placenta (unlike tha baby) was slippery and foldable!

My son had serious feeding problems later and got rather unwell. Natural third stage was very comforting to me on that basis - I felt I'd given him a little extra boost.

I'll do the same thing next time, with the same reservation - that if the labour is worse, and the 3rd stage hurts, I'll change my mind and ask for the jab. But there's no harm in giving it a go. You can reconsider on the day if need be.

I couldn't imagine wanting to push again after he was out. Injection, placenta out in 4 minutes, was very relieved.

had it first two times, hardly noticed placenta being delivered, couldn't have it with dc3 as I had pre-eclampsia and hideously high BP, delivering the placenta took ages, was very painful and heaps of pulling and tugging by MW. Bleeding afterwards looked like my internal organs were falling out <sorry> Given the choice I would most certainly have it.

All three homebirths, first time had managed third stage, difficult placenta delivery but came eventually. Physiological second and third times, but primary PPH on both occasions (pretty minor after DD2 but heavier bleed with DD3).

Fourth not planned, but would probably opt for managed given my history, though I would like to wait for the cord to stop pulsating first as well.

i had it the first 2 times. first was a hospital birth, second was a homebirth.

didn't have it for the third because the midwives turned up so late, and by the time they were there and figured out what was going on i was delivering it anyway.

22 minutes after the birth i believe

I had decided not to have one when DS3 was born (natural all throgh) - however after 45 minutes of waiting and feeding him I got bored and asked for the injection so they could starting sorting me out to go home

I did with ds1 but didn't with ds2 - 3rd stage was alot longer (1.5hrs) than 1st + 2nd stage combined (under 15 mins). MW seemed totally unbothered, but she was only there for about the last 45 mins of 3rd stage.

I had a home birth 10 weeks ago with DD2. I put in my birth plan that I wanted a natural 3rd stage, but that if nothing had happened after 20 mins that I wanted the injection. I specified that I wanted the cord to stop pulsating. The midwife was happy to leave the option open. As it turned out, we realised that 40 mins had gone by since the birth and the placenta still hadn't budged despite feeding DD and sitting and pushing on the loo (no contractions) and MW and I decided injection was best. I was happy with this decision as it was out within 5 mins and I could then really get down to enjoying my new baby.

First birth in hospitl; Gassed up and out of it, vaguely recall busy midwives saying "You'll need to go to theatre if we don't inject..." no doubt because natural placenta removal can take from 10 mins to n hour...no time, no resources, injection does it in minutes!

Second birth at home, no injection, placenta out naturally after some hard pushing in about 10 minutes.

Natural 3rd stage at home for dcs #3 and #4.

Made sure the midwife knew exactly what I wanted as had discussed it fully with her beforehand. She was extremely experienced so was very happy to do so, even encouraged me to do it.

I didn't have the injection and i managed to deliver the placenta in an hour (think that was my time limit before they would intervene and give me the inj. anyway)

It made no diff to the baby unfortunately as they cut the cord immediately anyway to get her under the resuscitaire. so that was a shame, i think i would need to be more clear about it being for baby's benefit and if they were planning to do that (which they probably were as she was a little early) then i would rather have had the injection than sit in a pool of blood for an hour having contractions. to be honest it all distracted me from cuddling her and i ended up passing her to my husband so that i could push the damned thing out!!

on balance i would go without the injection again if it meant that the baby would get the extra blood

To give a different viewpoint, I had a homebirth and did have the injection. The midwife was in fact quite keen to stick to my birth plan which said I wanted to try a natural third stage, but after waiting 20mins or so I just wanted it over and done with so I could get up off floor, was trying to bf dd propped up against the ball I had been draped over for giving birth and wasn't comfortable. I got the injection and it came out within a couple of minutes. I was glad to get comfy and focus on getting dd bfeeding.

It's all glamour, glamour, glamour isn't it?!

I didnt have it either time, with dd it took a while, cord wasnt cut and i was bfing her until placenta came, a good 45 min i think

with ds i was actually going to have it (fast labour not in comfy position) but he was delivered by paramedics, they cut the cord but werent allowed to give me the injection until a mw arrived, placenta came within 10 min and mw didnt arrive so i didnt have it

I have a lovely image there ILike - thanks!

Well you've pretty much convinced me so I shall make sure my doula knows what I want and see how it goes!

If you are having a homebirth and a natural 3rd stage, it's worth having a spare bucket. If the placenta is just sitting at the opening of your vagina but not coming out, sitting on a bucket like you would sit on the loo and giving your pelvic floor a little squeeze will have it plopping out in no time!

I had it with DS1 and was as sick as a dog. I didn't have it with DS2 (home birth) and was not sick and it did not hurt one little bit. No contractions, I just coughed and out it plopped into our old washing up bowl (can you believe the midwives didn't bring anything with them? I thought it would be standard) It did take 40 minutes though and I was getting a bit bored of waiting before it decided to make its appearance.

Homebirth for DD and I chose not to have it.

Midwives just told me to cough about 20 mins after she was born, and I did, and it was out. Hardly noticed it.

However you need to make it very clear to the midwife/s that this is your intention and make sure they are confident with it. I had the somewhat unsettling experience of one midwife leaning over me as DD'd shoulders were emerging to stage whisper to the other "Ooooh, physiological 3rd stages always make me so nervous"

I had ds2 and ds3 at home and didnt have it either time. MW was itching to give it me with ds3 but i refused - it didnt take long and i went through a natural birth - didnt want any drugs.

I would have changed my mind if it had taken longer - just make sure mw knows your wishes cos ds3 she was coming at me with needle

I had a natural 3rd stage, it took about 45 minutes to come out. I didn't have any contractions to expel the placenta, it made its way out and a bit gravity helped.

Something like 10% of the baby's blood volume is in the cord, so to clamp and cut before it has stopped pulsing will deny the baby a certain volume of blood.

Found info! Research was done not long before DS was born, may be more recent that backs it up. www.dailymail.co.uk/health/article-462477/Waiting-minutes-cut-cord-babies-health-boost.html

Ah yes, the pulsating cord - how important / useful is this? Is that the main reason most of you didn't have the injection?

Oh this reminds me of a bizarre battle we had with MW when DS was born. I wanted natural 3rd stage, but said if circumstances meant intervention was required, I wanted the cord to stop pulsing before I got injection and cord was clamped and cut (there had been recent research to show that even this extra time helped get iron to the baby's blood supply). We had a change of shift during labour, and 2nd midwife towards end of labour kept asking DH whether he was sure about this etc. Obviously a stressful time for DH anyway, who was trying to keep me cool/hydrated (I wasn't really up to the conversation at all!). In the end she clamped the cord, said 'look it's stopped pulsating' (no kidding!) and then got DH to cut it. . Still annoys me!

I just waited to see how the labour went. In both three was an indication to have it, so I did. But had thre not been, I wouldn't have. Iyswim.

I didn't for dc4
much more relaxed final stage
no pain
no afterpains to speak of
less bleeding

wish I had done it with the others

I had it for the first two - didn't have for third (homebirth) but then MW had to come round acouple of hours later and give it to me quick as I keeled over.

Ended up in hospital on day 5 with an infection in a tiny bit of retained placenta and the consultant told me that if I had another baby, the I should have the injection.

So I would have it if I had another one but I don't think it's unusual not to have it

I had planned not to have it for my first but the midwives said basically 'you've had so much intervention anyway you will need it' - no idea how true that was but it came out easily. With my second dc I had just gas and air and the placenta came out naturally within 5 minutes or so.

I had it for both hospital births but not for my homebirth. TBH, I didn't notice much difference other than timewise. Certainly no pain or anything other than a slithering feeling (why can't birth be like that??)

Natrual 1st and 2nd stage, why not a natural 3rd stage?

I didn't bother. In normal circumstances it's not necessary. I even have a history of slow blood-clotting so thought I might but the midwife said, 'let's just give it a moment' and everything was fine. I also had a homebirth.
TBH I wouldn't sweat about deciding now. Just see how you feel. Your midwife will have it with her and you can decide based on circumstances. It's not once of those decisions which you absolutely HAVE to make in advance.

I think it made me sick last time. I also had an epidural last time so had no sensation of the placenta coming out anyway.

I'm planning a homebirth this time and really have no clue - what helped you decide whether to have the injection or not?