Third stage management- do you go natural or for the injection?

[Smurfy23]

Am 36 weeks and hoping to have a home birth. Met with midwife last week who was asking about my birth plan and asked if I wanted the placenta to come out naturally or to have the injection. With dd1 she was an epidural baby so it was all managed and had the injection.

I genuinely have no opinions on this whatsoever- has anyone got any good advice either way?! Not sure me saying "I dont mind!" was what she wanted to hear!

[WeShouldBeFriends]

I preferred natural unless there's excessive bleeding. Higher chance of retained placenta otherwise.

[DramaAlpaca]

I had a home birth with my third baby & opted for the injection. Just to get it all over & done with quickly, really. Like you I didn't have much of an opinion on it either way, so just went with it when the midwife suggested it.

[Countrylifeornot]

I had the injection, wanted it all over so I could enjoy the baby (and have the bloody stitches)

[waddleandtoddle]

Had natural 3rd stage. Baby is straight to you, which was important to me when in hospital so it wasn't baby went straight to weighing and stats taking. Meant to be good for ensuring all blood from placenta goes to baby. Other half still cut the cord, just fifteen mins after the birth. Can't remember any pain with pushing the placenta out. I'd do it again in a heartbeat. I liked the slower pace.

[daphine2004]

Only gas and air for the labour. When it came to that stage we talked about it and the midwife suggested not to have it as I’d not really had any intervention, so I went with her advice.

I think you just get guided by advice and do what’s best for you at the time.

[JuneSpoon]

I had only gas and air so didn't want intervention at that stage. The midwife was a bit and said of the placenta wasn't out in x amount of time they'd have to inject me. anyway , it came out by itself, no problem, no pain quite quickly. I think the midwife might have pulled the cord a bit.

Why add synthetic hormones to your body when it's doing its own thing with natural hormones was my reason

[missmouse101]

Natural. Was great, left to its own devices. Came away fine.

[Cuppa12345]

I wrote in my birth plan that I wanted a natural third stage but by the end I was spent and needed stitches and was offered and accepted the injection as it felt right in the moment. You can always change your mind, so prob easier to say natural and then see how you feel

[20viona]

I had the injection and it didn't work As i had a retained placenta. This resulted in a trip to theatre for a spinal block after being rummaged around inside for an hour 🤦🏼‍♀️ with only gas and air. It was truly horrendous I wouldn't wish it on anyone.

[Blastandtroph]

Why don't you decide at the time? You can opt for active management (the injection) at any point and if your placenta hasn't come away usually after an hour, they'd recommend the injection at that point anyway.

[Smurfy23]

Thanks all- this has been really helpful. Wasnt really too sure about the pros and cons either way. Think I'll go for natural as pp have said and then can always change my mind if necessary

[Bluebelltulip]

I opted for it as I was told it reduces the risk of pph. 1st birth I had the injection but still had a pph, was advised that I needed 2nd time due to previous pph but it came out before they had chance to inject me.

[ThePolishWombat]

I had DC2 at home and will be doing the same with DC3 in a few weeks.
I wanted a natural third stage, but said if the placenta hadn’t delivered on it’s own within an hour, then I’d opt for the injection.
Turns out I waited about 45 mins, but then just felt really sweaty and gross and wanted to shower, so I asked for the injection and it was over within a couple of minutes.
I’ll probably do the same again - wait an hour, and if it’s still not made it’s appearance, I’ll have the injection again.

[Russell19]

If you have had a home birth, no drugs etc. then it makes sense to not have the injection unless needed.

[Missillusioned]

I've had homebirths both with and without the injection.
One issue with the injection is it can make some people sick, but if you've had it before and that wasn't an issue then I wouldn't worry about it.

I did find the birth with the injection slightly better. I got fed up of waiting around for the placenta and just wanted to get cleaned up right away. I was sitting on a plastic sheet on the floor and didn't feel like moving until the placenta was out, but as we waited, all the blood etc on the sheet was going cold and I was sitting on cold congealed yuk!

I just wanted to get straight in the bath at that point, not wait around. Neither method hurt.

[Fortheloveofscience]

Due date buddy! I’m not going to have the injection unless I have more intervention than I’m hoping for or there’s any suggestion that I might be at higher risk of a PPH. Not totally set against it (and would far rather have active management than a bleed!), but there are reported side effects of high blood pressure, headaches and nausea so if I can manage without it I’d like to.

[ZenNudist]

I had no drugs until after birth with ds1. Then delivered him and then said delayed cord clamping but they said no we need to deliver placenta and get you stitched up (as bad tear but didnt tell me). It was fine and i got g&a while they stitched.

Second time was home birth and they said " going to give you the injection and get this over with" i agreed it was fine.

Risk with injection of retained placenta, risk without injection is more blood loss if you have a tear so anemia possibly post partum haemorrhage but that like the retained placenta risk is just really unlucky.

[soundsystem]

I've said natural third stage each time, unless the midwives think that it would be better to have the injection for some reason.

First birth I had the injection as was bleeding more than was ideal. 2nd birth delivered the placenta naturally after about 45 minutes. Will see what happens this time!

[FenellaMaxwell]

Went for delayed cord clamping then injection.

[lljkk]

I've had twice injection twice natural.
I guess with no-jab you get longer for it to come out before they move to surgically extract it. There ends up being a lower risk of intervention with no jab, if I understand correctly.

[Hollywhiskey]

I planned for natural with my first baby. The midwife teaching the hypnobirthing course suggested going for natural unless you are advised otherwise - if you opt natural and Feb placenta doesn't come away in whatever time the guidelines say then you can have managed. If you go managed first they wait less time for the placenta to come away and if it doesn't there's nowhere else to go except straight to theatre.
As it happened I had a major bleed with the placenta not coming away so they just gave me the injection straight away as I needed it.
I'm currently 39 weeks with my second and if I was allowed I'd do the same again but they said I have to have managed third stage this time because of the bleeding. It's a bit more worrying because I don't want to have to go in the operating theatre.

[FairfaxHigh]

I did one of each! DS1 - hospital, had the injection. No issues/complications but did find placenta coming out painful and uncomfortable. DS2 - home birth. Hadn't really decided either way, but MW suggested seeing what happened. Very straightforward physiological third stage as feeding him post birth. Much easier but no idea if that was because it was second baby, much easier labour, more chilled generally than due to not having the injection.

Good luck whatever you decide.

[BarleyG]

When I arrived at hospital with my first I was 9cm dilated and wasn’t able to communicate clearly enough to give consent for the injection - also I’d never heard of it. The placenta ended up stuck and I had a bleed, then I continued to bleed for 14 weeks postpartum. The only thing in my birth plan now is give me the bloody injection!