When is the cord cut?

[MacNcheese87]

Hello,
I've given birth twice before, but the 3rd stage is a little hazy for me. Both times I have had a managed 3rd stage. I can't remember the first at all, and the second was 7 years ago.

I'm currently 35 weeks pregnant and looking into my birth plan. I'm planning a home birth (second one) and plan to give birth in the pool. All I can remember from my last birth was being rushed out of the pool, laying naked on my sofa, having the injection and the placenta coming out very easily. I have no recollection of where baby was during this time, or when the cord was cut.

So my main question. In a standard managed third stage, baby is born, injection is given and then what? Is the cord clamped and cut, baby taken away for weighing/assessing/whatever, and then the placenta delivered? Or is the placenta delivered whilst you're holding your baby and cord cut afterwards?

I know with a physiological third stage, the cord isn't cut until the placenta is out/stopped pulsating, but with a managed third stage, is the baby always taken away from you before delivering the placenta?

I would like cuddles and not to feel rushed with this one. I don't want to immediately have to leave the pool, hand the baby to someone else, deliver the placenta and then get to see her.

If none of this makes sense, I do apologise.

[Intransige]

You don't have to have the injection straight away. I know with a physiological third stage they do sometimes give the injection if the placenta hasn't appeared after a while, so I see no reason why the injection would need to be immediate in a managed third stage. Unless you're at risk of a PPH for some reason, but then I don't think they would want you in the pool?

[MacNcheese87]

I've read that they won't allow you to deliver the placenta in the pool. "Won't allow" but I can understand the reasoning behind it. It's hard to judge blood loss in water. I don't mind waiting in the pool for 5 minutes and then getting out to do the injection.

But if this is possible, will they cut the cord before the placenta is out? I don't think I want a completely physiological third stage, but I don't want to feel rushed either. Half way would be nice! I'm going to speak to my midwife next week but I'm not sure what the standard practice would be.

[Tubbyinthehottub]

My DS was born in the pool and I remember the plug being pulled out straight away so all the water went away but I was still in the pool when I delivered the placenta and when the cord was cut. I don't think I had the baby with me at this stage though, not sure. I wasn't bothered to be honest

[Intransige]

I had a physiological third stage twice. The cord was clamped both times before the placenta was delivered. When I got up to try and deliver the placenta I just handed the baby to someone then once the placenta had fallen out they handed the baby back. I assume you could do the same thing, but with the injection to speed things up after the cord is clamped?

[WantToGoingTo]

I had an unplanned managed 3rd stage. I had a water birth, they let me stay in pool after baby was born and cord was cut when it stopped pulsating, after about 20 minutes. They then let me stay in pool waiting for placenta to be born. After 45 minutes it hadn't come and no sign and they were concerned about blood loss (I had started bleeding before baby was born; they were initially worried it was the placenta though later turned out to be internal tearing). So at that point I was hoicked out the pool and taken to a bed where they gave me the injection and I birthed the placenta. Baby was taken for weighing when I got out the pool as I also required extensive stitching once the placenta had been born.

So basically, I think even with a managed third stage you can still do delayed cord clamping and have baby cuddles etc and then get out of pool and have the injection. I think the max time limit for physiological third stage is 45 minutes; would you be happy if you accidentally had a physiological third stage?