Anyone had second baby after manual removal of placenta first time and how was it?

[yellowflowers]

I had a manual removal of the (whole) placenta in theatre after my first baby. Apparently there is an increased chance of this happening again - I wondered whether anyone here has had this twice or whether they had a normal delivery of the placenta a second time after a manual removal the first time.

[NorthLondonDoulas]

I havn't personally had this experience but one of my ladies, had her placenta manually removed after her first labour and i was with her again for the birth of her second baby and all was fine, no complications at all - so fingers crossed you will have the same too. Good luck.x

[nunnie]

I had a full removal in theatre with my 1st and spent my wntire pregnancy with number 2 worried it would happen again, was told there was increased risk because mine had got stuck to scar tissue and not locked by cervix.
However I never got to find out with DS because I ended up having an EMCS due to him being brow. I am currently 28 weeks with number 3 and planning a VBAC so hoping 3rd time lucky and I will get a fully natural birth including placenta.
Hopefully your 2nd will be straighforward and a fully natural birth.

[Beveridge]

I had forceps and manual removal of placenta 2 years ago with DD and unfortunately the placenta stuck this time round with DS too.


Consultant midwife I saw during my pregnancy with DS to see if I could be considered for a homebirth said it was unlikely that I would have the same problem again as although having a RP once makes it twice as likely it will happen to you again, the general risk is 5% so that only makes it a 10% chance for you.

However, I recall the sonographer commenting I had a heart-shaped uterus at my scan and having googled a bit, it would appear that this puts me at a higher risk so fingers crossed for you.

[idlevice]

Does anyone know what the reason for the increased risk of a subsequent RP is? Does it physically alter the uterus somehow? I can't see why it would increase, not just remain the same.

I had one with first DS & preg again now. It is a worry, as I had removal under GA & 24hrs in ICU after. I think first one was due to tired out uterus after ridiculous labour (long, augmented & back-to-back).

[nunnie]

I was an increased risk because mine was stuck to scar tissue, which would still be there in subsequent pregnacies thus making it likely it will attatch to it again.

I think if the placenta is trapped in the cervix (so it has detatched from the wall but not coming out of the cervix) the risk is reduced as there is an option to avoid the injection, however if stuck to lining then the injection doesn't alter the outcome.

I am pregnant again and have added more scar tissue into the mix so think I am still a risk of it happening again, but will have to wait and see.

[blossominlondon]

Yellowflower,
I had manual removal of placenta in theatre with baby nr 1, although I had the Syntometrine (orso) injection.

Baby nr 2 I worried for that to happen again too, but it all went fine and history didn't repeat itself!
I wasn't allowed a natural 3rd phase, but delivery of placenta was again 'managed'= injection of Syntometrine (orso) after baby was born).

Now waiting for my 3rd delivery and positive after-birth!

Good luck to you anyway!

[yellowflowers]

thank you all. I'm not pregnant about it - just thinking about the next one (lo is 7mo) and trying to get head round last time because at the time the manual removal was okay mostly because I was elated at having my baby and off my tits on morphine I think but I subsequently have found it traumatic, initially because the whole image of a doctor with hand up me like a cow, but recently that has subsided and the main problem is that I wasn;t with my baby for a couple of hours while I was in theatre and recovering, and at the time I didn't even think about this and we have bonded really well but I am now so upset she didn;t have her mummy straight away, even though she was with and held by her daddy the whole time.

[Glitterybits]

yellow I am 37 weeks along with number 2 after a full manual removal with my DS. Whilst I'm not worried about another MROP, I am worried about a repeat performance of the endless cord tugging they did trying to get it out last time (without giving me any pain relief), before they eventually gave in and took me to theatre! I also had the syntometrine injection after delivery, despite my request not to have it (that injection hurts way more than anything has any right to at that point!) and it didn't do a bloody thing. I do recall them saying "that's a weird one!" after removal, so I'm guessing it was welded on quite well somewhere! I know what you mean about the lack of immediate bonding. Retained placentas can also have an impact on your milk coming in. I had issues with bfing as a result.

This time around I have an anterior placenta, so it'll be interesting to see if it happens again, because it's in a very different place. I suspect there may well be scar tissue left behind by my last removal, as it took me a while to get pg again and I often wonder if this is because the scar tissue made it difficult for the fertilised egg to attach to my womb lining. Unfortunately, I'm still classed as high risk for it happening again which affects my birth plans. I'll probably not be allowed to have a birth centre delivery this time around which is a bummer. I'll come back and let you know how I get on in a little while! One bonus to consider is that, should you need any stitches, it's possibly better to have them done by the consultant at the same time as the removal. I felt a lot more reassured by that than the prospect of the cack-handed midwives I had stitching me up!

[yellowflowers]

Yes please do let me know. Also congratulations and good luck.

Yes I had my stitches in theatre after the removal. A bonus I guess.

I had massive problems breastfeeding too and had to mix feed from about day 3. Found it very upsetting at time though I find it good now as my dd will take any food at any temp from bottle or breast and I am watching friends with babies who were exclusively breast fed really struggle trying to move their babies to the bottle.

[idlevice]

Oh it swings & roundabouts on the bonding & bf-ing. I had no probs bf-ing even with two drips in each hand, but then at 5 weeks I had to have a D&C as there was still something left inside so babe had to go onto a bottle (of expressed milk) & luckily from then on he was ok with the odd expressed bottle. Everyone seems to be different.

Agree the tugging on the cord by the midwife is horrendous! I am considering a C-section for this second baby if there are any other indicators it may not be straightforward.

OP, do you think you might have some form of post-traumatic stress/depression after your experience? If you haven't already "made peace" with it it may be worth talking to someone.

[PrincessOfWails]

Ask me in a few days time - I'm in latent labour with my second!
First time round it was a hellish manual removal - it didn't come out with the thingy injection, and the cord snapped. It was properly stuck.
It is my ambition to push it out now!

[Glitterybits]

Ooh Princess that sounds terrible! Best of luck with it all this time around!

idlevice it always baffles me as to why they tug on the cord, when it's clearly stuck and the main reason for getting on with manual removal quickly is due to the concern about blood loss. Surely yanking on it provokes a greater risk for haemorrhage? After both midwives and two people in theatre had pulled on it until I thought my guts were going to pop out, I managed to stop them by saying, 'sorry to be a wuss, but I will have to kick the next person who tries pulling that cord. I'd rather give birth again!'

[PrincessOfWails]

Thanks Glittery!
I agree, though - the midwife was very annoyed with herself when the cord snapped - she swore! - because it had been textbook up to then. She explained that the cord is thinner in parts, I vaguely think she compared it to perforations on a postage stamp. But if it's fairly easy to snap it, and she wasn't using her foot as an anchor on the bed or anything when she was tugging at mine - then you'd think it's best to accept that the placenta isn't coming out, and that's that.
It wasn't at all serious in my case - but a colossal mess. Think hosepipe of blood. You'd think they'd want to avoid the abbatoir situation! (And I'd have been furious if that had happened at a home birth - you'd have to redecorate an entire room, soft furnishing and wallpaper and all.)

[yellowflowers]

Good luck Princessofwails. Hope baby comes soon. Come back and tell us...

[Earwiggy]

I'm puzzled about the high risk attitude and preventing homebirths/birth centre births, as surely in the unlikely event it happens again you will be blue lighted into hospital in short order. My RP was removed three hours after I gave birth as the ward was busy and 2 EMCS happened. Nobody seemed worried about me loosing blood during this wait.

[idlevice]

3 hrs seems ages! I had a friend who was blue-lighted for a RP after homebirth & they didn't have enough time to give any pain relief when she got to hospital (they said) & went straight for the manual removal, most grim. That was about an hour after babe was out. With mine, it was about 45mins & the ob himself wheeled me to theatre as they didn't want to wait for a porter & they wouldn't entertain any of my questions about procedure. I assume they must have some guideline for the timing.

The risk of bleeding can be massive tho - you could loose up to half a litre in a minute as the arteries are so large. That for me rules out home birth even if I was low risk just in case.

[GotArt]

I had normal delivery of placenta with second, six weeks ago... just plopped out, easy peasy.

[INeedALieIn]

I had 2x manual removals.

just a quick question. Is there a link between manual removal and really heavy periods? I also have a history of really heavy periods, horriffic if I'm honest, and have had a few 'D and C's', scans, merina.

I've always presumed the Manual removal and heavy periods were related, does anybody with more knowledge than me know?

[yellowflowers]

I just found this which us helpful

www.babycentre.co.uk/pregnancy/labourandbirth/labourcomplications/retainedplacenta/

[Tenebrist]

I had a manual removal with DD1 after a quick birth in a birth centre (ie no pain relief and no doctor, but great midwife support). It wasn't terribly traumatic, given that I had a healthy baby, and in fact I discharged myself 4 hours after the removal when DH, baby and me went home by taxi at 2am, 7 hours after the birth. Great decision (not in the UK, and the midwife came to check on me and the baby every day for a week, so entirely safe).

Second pregnancy, and birth in a different birth centre because we'd moved house. Birth even quicker and easier than DD1, experienced midwife (who knew about the previous history) gave one good tug and it all came out. I was sooooo grateful - we were at home 3 hours after the birth as a consequence. It was a fairly sharp tug, but hey, I'd just been through a birth with no pain relief and was still somewhat stoned on the adrenalin.

I have endometriosis and one midwife did posit the idea that the retained placenta was caused by endometrial tissue/scarring.

Best of luck with it all!

[Earwiggy]

Tene - you were home quick after manual removal, I had a spinal epi before mine which took 6 hours to wear off. Was completely numb waist down before that, wasn't going anywhere!

[kindlekid]

I had MROP under general anaesthetic after dd1. There was no sign of it delivering and then the cord snapped with all the tugging.

Second time round the placenta delivered intact without me even being aware of it.

[PrincessOfWails]

Well, it worked - it came out with no problems.

[fairy1978]

Hi, I had a retained placenta with first child and 18 months later had a homebirth for second. Midwife wasn't worried at all. I am now 40 + 4 with 3rd and planning my 2nd homebirth! Good luck x

[HauntedLittleLunatic]

I had retained placenta first time - but was prem which can apparently make it more likely. Was still firmly anchored to wall of uterus happy to do its job for another 3m.

Second time no synto - just plopped out.