Natural third stage

[GinaFordAteMyBaby]

I had DD at the end of 2007 and with a bit of a fight I ended up doing the whole thing naturally. At the 3rd stage I didn't have the injection to help deliver the placenta as I wanted to do things naturally, which the midwife didn't seem to happy with. In the end she didn't seem to have a lot of patience and wasn't happy with me moving into what I though was a better position and pulled on the placenta despite my reluctance. I haemorrhaged, lost quite a lot of blood and ended up having a blood transfusion and being stuck in hospital for 4 days.

I have always put the haemorrhaging down to the midwife's intervention and can't help feeling it would have been a different story had nature been allowed to take it's course. I am now pregnant again and had my booking in with the midwife today. We discussed what happened last time and this midwife said it is necessary for the midwife to pull on the placenta and urged me to have the injection this time round. I have to see a consultant and I feel like they're going to try and push me into something I don't want to do just because it's the way they're used to doing things. Or am I just being stubborn? I was wondering if anyone knew anything about this and whether you should manipulate the placenta in a natural third stage or whether I've been blaming the midwife for something that wasn't her fault.

[LynetteScavo]

I don't speak as anyone who has any medical qualifications, but I had a natural 3rd stage iwth my 3rd baby (midwife was very happy with this), and the placenta came out with no pulling, while I was feeding DD.

I imagine nature designed the placenta to come away with out any pulling most of the time.

[liahgen]

sometimes it is neccasary to apply gentle traction to the cord to help it come away. This however should not have been done if you were having a third stage.

Have you seen your notes? Wouldn't hurt to have a look maybe, see what it says at the time.

Noone can force you to have a procedure that you are not happy with.

[SixSpot]

I had a natural third stage with DS3 - I was very keen to have this as I had to have manual removal of placenta in theatre with spinal block after DS2!

I was very lucky in that a Dutch midwife delivered DS3 and as natural third stage is the norm in the Netherlands, she knew exactly what she was doing and it was fine - very quick and i certainly don't recall any tugging. I bled what seemed like quite a bit to me but no-one else was concerned about it so it can't ahve been that much!

[mersmam]

As far as I am aware with a natural 3rd stage the midwife should leave your placenta alone! Sounds like you had a nasty midwife... I've given birth three times and always had natural third stages (Never allowing anyone to touch the cord or placenta til it was out!) and I've never had any problems. The first time it took an hour but I had a great midwife who didn't mind. The second time the midwife was itching to intervene after 10 minutes but I ignored her and the placenta came soon afterwards. 3rd time it was easy peasy, came out in less than 10 mins with minimal pushing. The key thing is to get the baby to your breast straight away - the sucking reflex makes your uterus contract and expels the placenta. I would definitely recommend a natural 3rd stage!

[mersmam]

GinaFord - I had huge dilema about this before my second birth and eventually decided against the injection - and I think I made the right decision!

[GinaFordAteMyBaby]

I don't have my notes from the last time, but I think I might try and get them. I went through them after the birth as I was considering making a complaint against the midwife but in the end I never got round to it. I'm not sure I'd trust the notes anyway as the midwife didn't take any action when I lost the blood and then they kind of went into emergency mode when they swapped shifts and the new midwife came and had a look at me. I wouldn't describe the pulling as gentle traction, I can remember feeling the pull inside me.

Starlight - this sounds a lot like my situation. I came across a lot of amazing midwives at the hospital, but the one I ended up with for the delivery was just awful. She wasn't supportive at all, didn't look at my birth plan and seemed indignant that I didn't want the episiostomy she thought was necessary even though in the end I didn't tear at all. I was a bit scared the first time round and having got through it all with a bit of a fight I just didn't have the will to put up much of a fight when she started pulling at the placenta. She even pushed me back down on to the bed when I tried to get up on my knees as I thought gravity would help speed things up. This time round I feel a lot more confident about my own body and ability to just get on with it myself and would like a home birth if we can get a new house before I'm due.

I think I just feel like I want to get everything clear beforehand with the midwives and consultant not so that I have approval as such, but so I feel like I'm going to be more in control this time round and it's clear how I'd like things to go if there are no complications.

[liahgen]

omg, ather pushing you.

Have a look at this

here

[GinaFordAteMyBaby]

Thanks everyone. I've done LOTS of reading since I posted and am feel confident about my choice and that I have enough information to convince anyone I'm making an informed decision. I particularly liked this one.

I had a look at the birth plan in my maternity record last night and the issue is covered with the rather brilliantly phrased "Do I want an injection to reduce the risk of heavy bleeding immediately after the birth?". Not trying to push you in any direction there then.

[Astarte]

If you have the injection then the m/w could use controlled cord traction.
If it's a natural 3rd stage, they shouldn't be anywhere near you and pulling on the cord before the placenta has properly detached will cause you to haemhorrage. It was her fault!

How long did she leave you to deliver the placenta? A natural 3rd stage can be longer than the jab, maybe she wasn't experienced in a natural 3rd stage. Putting the baby to the breast can help to speed up a slow 3rd stage.

[GinaFordAteMyBaby]

The most annoying thing is that this all took place in the home birth centre at the hospital and I don't think the midwife had any business being there as she seemed to want to intervene wherever possible. I've requested my medical notes but it's all a bit hazy now and I don't remember how long it took, although I know it certainly wasn't an excessive amount of time. But I think it was slowed down by the fact that I was told to sit/lie back down on the bed when I tried to get upright, which surely has got to be the worst position to try and deliver a placenta from. I'm determined to have things the way I want them this time round barring any complications.

[liahgen]

I hope it works out for you Gina. You know far more now, and i'm sure are more confident in your choices.

Good luck. x

[Lulumama]

seems to me if you had been allowed to get into a better position and not been literally pushed around, you would have had a far better experience. i would still consider bring your treatment to the attention of the Head of midwifery

am sure that you will have a far more positive experience second time.

[Qally]

I had a natural third stage. No pulling at all - but I had to use a maternity pad to apply pressure to the perineum to get the placenta out, because I had very little muscle tone at the time! I gave birth in an MLBU and they were completely supportive.

The midwife not only didn't pull, she very urgently told my mother hold to the baby down closer to me when I was getting out of the birthing pool, placenta still inside, because she was going to tug on the cord otherwise.

It was completely painless, too. Gentle contractions, but absolutely no pain.

[thumbwitch]

I had the injection straight after DS was born and the MW did "reel" the placenta out, but there was no tugging and it was out about 3 mins after DS.

I don't know about any bleeding - I had been without MW intervention for all but the last 5 mins of my stage 2 labour (being left alone as a non-progressing induction, suddenly progressed and DH had to run for a MW when I felt DS crowning).

Because I was v. overdue, I had been taking lots of raspberry leaf tea and tablets (see my blog if you're interested) and although it did nothing to induce labour, it has been suggested it can improve and expedite stages 2 and 3 labour, which I would say it did for me.

[wabbit]

Gina - I asked for natural third stage with ds... my second baby

the time between ds's birth to the end of the 3rd stage was 45 minutes for me, the 2 midwives present had never been present at a natural 3rd stage before but were wonderful and supportive and very patient and, as it's a much less urgent process than the second stage and I felt that gravity and a better pushing position were definitely needed they let me crouch/kneel on the bed... breastfeeding before going into the third stage and during helps strenghthen the (comparatively) mild contractions but pushing was utterly necessary for me - the labour was long though because of a first stage complication... and I'd been transfered from my lovely home birth to hospital.

If I were to have another - I would want to experience the calm, measured pace of a natural third stage again...

because of the long time it took the midwives let dd cut the chord before the end of the third stage, they allowed the chord to stop pulsing and then felt it was time... I'd have to read more about this if I were to have another baby.

hope this long ramble helps!

[showmeyourpuku]

Hi Gina - I love your name too!
No-one should be anywhere near touching the cord if you haven't had the ecbolic (the injection to make it come). No 'gentle' tugging, touching, pulling, yanking, fiddling (or however it's called) should be done by anyone except yourself.

And if you have had the injection then they need to get the placenta out before the cervix closes (which is one of the things the ecbolic does) so they usually need to pull at the same time as 'gaurding' your uterus with their other hand. This is so your uterus doesn't come out if your placenta doesn't detach.

I have waited an hour and a half for a placenta with no probs - and it is recommended to wait at least 20 mins.

It's your body and no-one can tell you what to do, demand that you are heard, and don't go near anyone who looks like a 'tugger' (partners excluded of course! )

[GinaFordAteMyBaby]

Starlight - maybe? I was at St Thomas. I transferred there as I thought I was more likely to get the natural birth that I wanted. In retrospect I don't think it matters where you are so much as who you get but there you go.

I am thinking of complaining even though it is over a year ago as I'm obviously still not over it and even if they can't take any action with regards to the midwife they can maybe look at their training. I was pretty clued up last time and read enough to know what I wanted but obviously not enough. This time I will be STRONG and make sure everyone knows what I want before it comes to crunch time or maybe just lock myself in my bathroom and get on with it! My husband often says he could have done a better job than the midwife we got last time so maybe I'll let him have a go!

Hopefully I will be back with a story of a lovely, peaceful bith (fingers crossed)...

[GinaFordAteMyBaby]

Or birth.

[BabyStarlightsMum]

Gina People travel up to 3 hours to give birth in the Edgeware birth centre.

My birth story

My husband thinks it might be worth having another baby just to have a night there again.

My first was at the mlu at chase farm

[CatIsSleepy]

interesting thread!
am keen to try for a physiological third stage this time as I had the same problem as SixSpot (retained placenta after having the injection) but when I spoke to the midwife I saw initially she was pretty discouraging...she mentioned the possibility of more blood loss etc...but having read this, think I'll try again!

good luck GF

[EdwardCullenCanBiteMe]

I haven't read all the replies, sorry. I had a natural 3rd stage with my last 3 children. There was no traction of the cord, and it took on average of an hour or so each time. I fed baby lots and let nature take its course.
Generally left alone nature does what it is designed to do.

You can specify that there is to be no traction, and if it was me, without being ill, I would be declining consultant care and having midwife only care.
HTH