Manual removal of placenta, pregnant again and terrified!

(42 Posts)
nunnie Sun 02-May-10 14:13:15

I went to all my ante-natal classes. Spent a lot of time with consultants regarding previous biopsy surgery on my cervix and a large cyst on my ovary. I was informed my labour may be quicker than 'average' first timer as my cervix is shorter than 'normal' due to the biopsy.

My labour was quick and relatively pain free (no pain relief as all), and DD was born in under 3 hours.

After she was born, my placenta didn't want to come away, they tried tugging and pulling, I tried BF (which was the only time I got to hold my baby girl and only for about 10 mins), the a drip and more pushing and pulling gas and air neeeded by this time as the pain was unbearable and making me vomit. Decided it wasn't coming away and I was whisked off to surgery given a spinal and treated to more embarrasing, degrading vaginal intrusion.
During the surgery all I could think about was my baby girl and how terrible I felt that I didn't even know her eye or hair colour.

My ante-natal classes didn't cover a full placenta being retained only partial. I wasn't aware until it happened to me that is was even possible, so wasn't prepared for it in the slightest.
Now I know and am pregnant again I have researched it and have found out as it happened in last pregnancy it is more likely it will happen again. Now I can be prepared but I don't know how, how do I prepare for it. I cant imagine being whisked away from yet another baby and being degraded in that way again, just the thought of it makes me want to cry sad.

Sorry if long just needed to vent, I don't like my hubby to know I am petrified as it means discussing what happened in theatre and I am too embarrased to discuss it with him.

FabIsGoingToGetFit Sun 02-May-10 14:15:51

I had a retained placenta because the bloody midwife pulled the cord and it snapped.

I had to have it removed in theatre too but next time around i managed to get it out, I had the jab even though I didn't want too.

Try not to worry.

nunnie Sun 02-May-10 14:21:06

Thank you I am really trying to think of the positives like having the baby, but this is like an ugly shadow that is lurking and won't allow me to just think of happy thoughts angry.

Mine was stuck to the lining of my womb didn't want to unstick.

Naughty heavy handed midwife, poor you.

FabIsGoingToGetFit Sun 02-May-10 14:24:57

Please don't let it spoil your time with the baby as it won't change anything and could make things worse.

starynight Sun 02-May-10 14:44:42

I had my first retained placenta due to a late miscarrige with twins got put to sleep for removal as was already in a bad way. Had dd last may and placenta was retained again although im told thet were not conected. it was the most awful thing ive experianced doctor tugging while i was on gas and air that didnt work so was taken to surgery for a spinal didnt. get to hold dd till next morning as i was numb could not move. I no how you feel dp would like to start trying so there not too far apart in age but im really scared of having it happen again just thinking about it makes me feel sick:

There is a higher chance of it happening agai but ive also heard alot of storys from ladies on here who had no problems second time round.
Have you spoken to your mw to see if theres anything while in labour that may help it along? im not sure what exactly but i have been told not to have that little injection after babys born see if things happen on there own first.

When my time comes im going to ask that if this happens again then i want to be put to sleep for removal as this was a much better experiance than having docs yanking for an hour then the spinal.

Hope all goes well for you and try not to read to much searching on internet think the stuff you find on there worrie you more.

starynight Sun 02-May-10 14:48:08

Sorry about my typing im using my phone its a pain lol

nunnie Sun 02-May-10 15:00:18

I did ask the mw and she said yeah there is a high risk of it happening again but it may not.
Have read about not having the jab, so am going to discuss it with her at another appointment.
The spinal didn't worry me too much apart from the annoying numbness for 6 hours afterwards, it was the being awake and knowing what he was doing that made me feel so degraded to be honest.

I am seeing a consultant in a few weeks about my cervix so I may get some information of him.

Thank you for your reply starynight x

nunnie Sun 02-May-10 15:01:09

Starynight, sorry for your loss x

WickedWitchSouthWest Sun 02-May-10 15:54:24

Starynight, that so sad, I'm sorry.

nunnie I'm another who had a short labour with dc1 and retained placenta. 5 hours of tugging, pushing and pumping full of drugs before I could go to theatre to have it removed It was a vile experience and one I wasn't prepared for either. But don't beat yourself up about losing time with your dd. My dh says although it was frightening, he really treasured those few hours where he could have skin to skin and learn to change her nappy etc.

I'm 32 wks with dc2 and much better prepared this time. Having done alot of reading (I thought this was useful) I'm going to ask to have a more natural third stage, with the option of the syntometrine jab after 20 mins if the placenta hasn't come away on it's own. At least that way I've given it a good go, and then the MPR procedure isn't going to be such a shock either since we've been through it before.

If it's any help, my mw says that there is an increased chance I'll have it again, however where the placenta implants and how deeply is entirely up to chance - it's nothing physiological or anything we have done 'wrong', it's just plain old bad luck.

Fingers crossed for you (and me!) that this time goes more smoothly.

nunnie Sun 02-May-10 16:20:15

Think I will discuss the natural third stage when I see my midwife again, seems to be the consensus on most of what I've read.
Fingers crossed for you wicked, and being prepared does make a difference.

My dh said the same about the time he had with Freya, he said he didn't put her down once and the MW was great she kept coming in and informing him how it was going and seeing if he was okay, and he got tea and toast so he was happy.

As it's nothing we have done wrong there is nothing we can do to prevent it which is what saddens me the most, I just don't want it again, but if needs must, I can't walk around with it hanging from my .... so it has to come out so how.

x

HarderToKidnap Sun 02-May-10 17:04:39

Fab, in defence of your midwife, a cord that is properly implanted and/or not abnormally friable will not break from being pulled on. You can practically hang off a normal cord and it won't snap. A snapped cord means your cord was either skinny and unusually breakable or implanted strangely, neither of which your midwife could possibly know until she has pulled on it, at which time of course, it will break! And traction on the cord is a normal part of a managed third stage so if you are having a managed third stage there is no way round it.

suwoo Sun 02-May-10 17:08:59

You might not want to, and sorry if I am making an inappropriate suggestion, but have you considered a C section?

I had (part) retained placenta and PPH with DC1 and had to have surgery under GA to remove it and a blood transfusion.

I had c sections with my subsequent pregnancies, predominantly due to this and my 3rd degree prolapse which was also caused by my vaginal delivery.

mears Sun 02-May-10 17:14:20

nunnie - it is worth trying a natural third stage first and delaying any injection. I have seen many women deliver their placentas with no problem after retaining one before. If you are unlucky and do retain your placenta, you could ask for a general anaesthetic instead of a spinal since the experience of being awake traumatised you before. You could discuss that with your consultant and/or an anaesthetist at one of your clinic visits. That can be arranged and may alleviate some of your anxiety?

starynight Sun 02-May-10 17:38:08

yep it was the being awake part that got me to. first time round when i went to sleep was so much easier it never botherd me when i became pregnant again untill it happend. so much easier too being able to get up and see to baby afterwards.

WickedWitchSouthWest Sun 02-May-10 21:49:31

I hadn't realised that you could ask for a GA. Being awake was pretty unpleasant and the whole reason for avoiding a spinal/epidural was due to my low blood pressure so I ended up being pumped full of adreneline to keep my pressure up, the spinal, the synto AND pethidine coz I was going a bit mad from the shock, not to mention all the anti-b's and pain relief afterwards.

The link I posted before, I've taken the text and used it in my birth plan. Dh can still cut the cord, but not still it stops pulsating.

It's a risk it could happen again, not that it will, that's what I keep telling myself!

Good luck

mears Sun 02-May-10 21:53:53

You can ask. The anaesthetist will usually advise a spinal unless there is heavy bleeding, in which case a general is usually the better option. This is why it is good to have a discussion with an anaesthetist at the clinic which is then kept in the notes. In nunnie's case, I would be really surprised if an anaesthetist did not agree that a GA would be a better option.

lumpasmelly Mon 03-May-10 19:07:41

I had a retained placenta with both a miscarriage and then with ds2. Horrible experience as resulted in pph during the removal and then again a couple of months later, not to mention two uterine infections. Second pph involved ambulances in the middle of the night and then a d & c as it turns out they hadn't got it all out. This time I had a c-section......after two posterior labours and instrumental deliveries I was also well over the whole "natural birth" thing...best decision I ever made. Turns out placenta was stuck again (like before it had grown into the lining of the uterus) but as I had a section they could make sure to get it all out before bleeding got too bad. If you are great at natural birth then I can understand not wanting to have a section as there is a chance that you could have a great both and no placental problems.....as I wasn't, the choice was easier. If it was an issue with placenta stuck too deeply (like me) then check to see where the placenta is this time - mine was in the same place so alarm bells were ringing in my mind quite early on!

nunnie Mon 03-May-10 20:15:22

Thank you for all the advice ladies. I am going to discuss natural third stage with MW at next appointment and I will also ask if it's possible to have a GA if it happens again. I didn't have a PPH afterwards or any physical problems so not sure if they will allow it soley on the psychological affect can only ask I suppose.
Don't want to request a c-section soley because I didn't suffer anything other than psychological problems and the birth was quick and relatively easy.
I feel like such a fraud, moaning because I felt degraded and embarrased, but had no medical issues afterwards.
All I can think about is the way I felt lying there infront of my husband having people try to pull something out of me while I was vomiting with the pain and then sitting on a theatre bed whilst haing the spinal with this thing hanging from me. Then more vaginal intrusion from a male surgeon whilst seven people stood around the bed. I didn't ever want to think about it again, but now I am pregnant that is all I can think about, I cry at least once a day, I am snappy, I am agitated, I can hardly sleep.

Sorry just feeling so sad and angry today, needed to vent x

nunnie Mon 03-May-10 20:39:20

I should say most of the feelings I am having can be written off as normal pregnancy symptoms, and with having a toddler too I am more tired than last time. This may all be adding to my anxiety I suppose, or my anxiety could be adding to them confused I just feel useless , I don't even have control over myself angry.

Lovethesea Mon 03-May-10 21:18:12

Did you have any midwife supervision/psychology support post birth? Have you been through your notes with someone?

I am currently seeing the maternity psychologist for some support as I head towards my second birth (elcs) after DD's traumatic arrival 17 months ago (emergency rotational forceps in theatre due to OT position and fetal distress). I am finding it really useful to be able to air my feelings to someone neutral.

Might help with the anxiety and planning your next birth - and I would be concerned about the daily crying and stress affecting you and possibly triggering off ante-natal depression, or post-natal even.

nunnie Tue 04-May-10 07:40:18

I saw the midwife for a a couple of weeks, then the health visitor but neither of us mentioned the labour. The visits were mainly to check on Freya and ask about my general health. I did suffer from PND after the birth as I found BF very difficult and got infection after infection, and was told not to stop as it was the healthiest start for my baby. So I felt guilty and thought I was failing my baby just thinking about stopping. After being prescribed medication for PND, I decided I wouldn't take them and would stop BF as I felt that was the major cause of me not being able to enjoy my baby. I stopped BF and after a week or so my mood lifted and I began enjoying my baby and being a mother, so I never felt the need to take the tablets and never did. My mood has been fine until now really. I think some of the crying is due to the tiredness and insomnia. The 2nd trimester was the best when I was pregnant last time, so now I am into that I am hoping my 'normal' pregnancy symptoms will fade so I can concentrate on being happy that I am pregnant again, and try to avoid thinking about how he/she will enter this world, and focus on what it will be like once s(he) is here.

Thank you again for all your advice and help, hope you had a nice BH weekend.

sweetkitty Tue 04-May-10 07:56:59

I was 5 minutes away from the spinal and theatre myseldf with DD1, I know what you mean about it totally taking away those first few precious hours and I didn't have to go in the end as they managed to tug it out. Poor you no wonder you are anxious and worried.

Anyway I have went on to have 2 normal deliveries, both with physiological third stages. The difference, for me, was amazing. DD2 was born, placed on me and left to have her first BF before the cord was cut, it was a lot more natural and calm rather than having catheters inserted/hanging off the bed dripping into a bed pan etc. The placenta came away itself about 20 mins later. I had the same thing with DD3.

I know the injection has a place and has no doubt saved lives but I don't get this massive need to interfere with a natural process afterall women have been delivering placentas for an age without injections.

I hope things go better for you this time x

hazygirl Tue 04-May-10 08:04:02

i had a retained placenta with my ds, but didnt with next birth,so hopefully you will be same,good luck

BlauerEngel Tue 04-May-10 08:21:27

Like hazygirl, I had a retained placenta first time but not the second time.

I had a very quick labour too - interesting if there's a connection. I also have endometriosis, and the doctor thought that might have been connected - adhesions preventing it come away.

I'm shocked about WickedWitch having to wait 5 hours with all that tugging! My midwives worked out after 45 minutes that the placenta wasn't budging, once the bfing hadn't worked. It was an annoyance more than anything else - I had given birth in a midwife-led birth centre so had to be transferred to hospital by ambulance.

I had an automatic GA - didn't know a spinal was an option until I read this here. From what you've all been saying, it was the best option though, not the least traumatic. LOL at your DHs bonding with their babies, mine went off to get a post-birth curry, but DD was sleeping anyway.

The general meant that I could stand up relatively quickly afterwards. I had to stay in hospital a minimum of 4 hours afterwards for legal reasons, but we buggered off home then at 2am. It was a good feeling.

With DC2 it was a different midwife, and the placenta wasn't coming again, but she was very experienced and gave a tug in the right spot, and it came away complete. I was sooo relieved.

Wishing you all the best for it. It can work the second time, but do ask for a GA if it doesn't.

nunnie Tue 04-May-10 10:31:29

Interesting I also have endometreosis or had it and it was treated, didn't know there could be a connection.
It's is suprising how different hospitals work, I didn't know GA was an option was only offered a spinal. Because of that I had to stay in 2 days, 4 hours would have been lovely grin. Think GA is looking like it might be a preferred option for me now if it happens again. It is nice to see there are occasions where it doesn't though makes me feel a little more relaxed. Definatly requesting not to have the injection this time and hopefully it will come away naturally and all this worry will have been for nothing.

Thank you ladies.

lumpasmelly Tue 04-May-10 19:00:48

I have endometriosis too so beginning to see a patten here....wonder if there is a link? I asked about getting a ga for the placental removal in case i decided to attempt a vaginal delivery. Consultant was not willing to do this for recovery reasons (longer stay in hospital, longer time to bond with/feed baby, but said they could give me something to ensure I was "out of it". Different policies at different hospitals I suppose.

nunnie Tue 04-May-10 21:00:57

I wasn't offered it as an option either, I am persuming I will get the same response. I had to stay in for at least 2 days anyway, so I am guessing that a GA won't require a longer recovery time. As all my previous ga's I've been sent home same day. I will request it and see the response but not hopeful it will be a nice yes of course you can!

There may well be a link between endometreosis and retained placenta, but I suppose we can't change that and just have to hope it doesn't happen again.

elvislives Tue 04-May-10 21:12:07

I had a retained placenta first time round. They had just got to the stage of "preparing theatre" when it finally came away.

I subsequently had another 3 vaginal deliveries and didn't have the problem with any of them. They didn't tell me it was more likely (which I'm pleased about)

greenbeanie Wed 05-May-10 11:15:48

I Had a retained placenta with my first delivery which was manually removed in the delivery room as I had had an epidural. It was without a doubt the most traumatic part of the whole labour.

I was very anxious about my second delivery and after a lot of reading felt that having syntometrine may have contributed to it, there is a slightly higher risk of retained placenta with a managed 3rd stage. 2nd time round I had a physiological 3rd stage, managed with no medication, just breastfeeding baby until the placenta came away naturally. It took about 40 minutes but there was far less blood loss and it was less traumatic to say the least.

It might be worth talking to your midwife about the possibility of a physiological 3rd stage as it might make a difference.

nunnie Wed 05-May-10 11:49:51

Thank you greenbeanie, reading the responses on here I will definatley be requesting that I don't have the injection when I next see my midwife and I will get her to add it to my birthing plan, as I don't have access to my notes they are kept in the hospital.

greenbeanie Wed 05-May-10 16:33:06

There is a really good leaflet published by AIMS on having a physiological 3rd stage that might be well worth reading just to give you enough information to answer the doubts that might be put forward by your midwife or consultant.

One of the key parts of having a physiological 3rd stage is having as little intervention and drugs as possible so that your hormones fully control labour and the separation of your placenta. I just had gas and air. The cord also must not be cut until it has stopped pulsating.
Good luck.

suiledonne Wed 05-May-10 18:24:25

nunnie I don't have time to read all the posts but just wanted to say I had a retained placenta on dd1. I had a very fast labour - 4 hours from first twinge to delivery - no pain relief at all, not even G&A and then the stupid placenta would not deliver.

Mine was removed under general anaesthetic. I don't I was really given an option on that but reading some of these I am glad I was knocked out for it.

I had dd2 2 and a half years later and delivered the placenta with no problems so it is not a given that you will retain again.

I was lucky in that it became apparent quite quickly that there was a problem so didn't have to hang around for hours before theatre but I remembered being very frustrated and just wanting it over.

I breastfed dd while the midwife was dealing with the placenta so i had time to hold her and i do like to think about the lovely bonding experience it was for dh to take care of her in her first hours

BUT I also remember being terrified something would go wrong in theatre and i would never get to see my baby again.

She is 4 tomorrow by the way so all of this is on my mind today as i think back to 4 years ago.

Best of luck with whatever you decide to do.

nunnie Wed 05-May-10 19:36:05

Thank you suiledonne, there does seem to be a link with quick labours as well. Wish GA would have been a option for me but it wasn't offered. Really hoping if it happens again I have the strength to tell them I was it done under general.

Did you have a managed 3rd stage with dd2?

suiledonne Wed 05-May-10 20:21:11

Would you believe I don't know what happened with the third stage on dd2. The whole thing was so fast - under 2 hours from the first twinge this time and she was born with only a couple of pushes.

I was occupied feeding dd2 and the midwife said the placenta had delivered. I said that was good after the problems I had before and the midwife was shock like this as apparently she should have been told. I suppose she didn't have time to read my notes as I arrived at the hospital ready to push.

I am a bit embarrassed to admit that I don't know if I had the injection either time.

hellymelly Wed 05-May-10 20:27:57

I was also going to suggest a possible section,you sound really traumatised by the previous experience and maybe a calm elective c-section would be an option,I would talk to your consultant about how you feel.I found mine very easy to talk to,kind and sympathetic.

nunnie Wed 05-May-10 20:39:55

Don't be embarrassed I don't remember having the injection first time my DH told me I did but I was watching another midwife whilst she was weighing and checking DD over.

Am going to speak to consultant think I am booked in to see him on the 10th of this month about my cervix. If I can have GA then I will go with that option as apose to c-section just for recovery aspect. If GA not and option then I think c-section is next on my list as I am truly petrified and really don't think I can go through it again sad.

hellymelly Wed 05-May-10 22:41:18

Well a c-section is harder to recover from and more risky but I've had two and they weren't too dreadful,in particular the second one,because I'd planned for it (was trying for a vbac which didn't work,but had prepared myself for a c-section)and it was calm and I felt really looked after ,it was a lovely birth even though it wasn't the vaginal birth I'd hoped for. I would think a c-section with an epidural would be easier to recover from than a GA.Possibly safer too?

nunnie Thu 06-May-10 09:46:18

I have had GA's before and have been up and about within a couple of hours, and home before 24 hours. I have never had a c-section and wouldn't know what to expect so would be equally as worried about having that without looking at other options first.
I don't think after reading that even if I request a c-section I will be given one on the NHS to be honest and I can't afford private.
Maybe I will be one of the lucky ones and my placenta will detatch this time, if I do a psycological 3rd stage. If it doesn't then my only option is a manual and then it will be either awake or out cold.

suwoo Fri 07-May-10 12:08:18

I think you will be allowed to have one on the NHS, especially if you get a good midwife or consultant behind you.

I have had 2 electives after my retention of products, PPH and GA. I came home earlier with both of them and was 100x more well than I was after my vaginal delivery. I wouldn't change those deliveries for any risk of my first birth experience happening again.

nunnie Fri 07-May-10 12:23:42

I may feel different about a C-section if I had had a PPH. But as my feelings are just because I was awake and knew what was happening which made me feel humiliated and degraded. I would feel a fraud for just asking for a c-section , that might not make sense to anoyone else I just don't feel I suffered enough to request one.

suwoo Fri 07-May-10 13:58:12

I can see where you are coming from but I think most people would agree that what you went through was terrible and would certainly render you eligible for a c section. I am so glad that my removal of products was under GA, but as I was already unconcious from the blood loss, there was no other option. sad

nunnie Mon 10-May-10 15:49:45

Spoke to MW and Consultant regarding GA, and they seem happy with that choice, have to go back at 36 weeks after thinking it over fully and ask any questions that will have arisen in that time, but all sounded promising.

Spoke about natural 3rd stage and was advised that as my placenta got stuck to the lining of my womb, the injection would not have made a difference and that I should think about having it as they will be able to ascertain early on if the placenta is stuck and deal with it promptly.

Have left me to think about this and discuss with community midwife and finalise or chat to consultant about it again at 36 week appointment.

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