PPH first labour - advised for have injection for placenta this time. good or bad?

[Littlerayofsunshine]

Consultant has put on my notes to have the injection to deliver the placenta this time as I had a PPH 1000mls after giving birth to DD. I gave birth to the placenta fine, and within good time. it was classed as "ragged" placenta though :s and I then haemmoraged 2 hrs after giving birth.

I had a natural birth, fast & waters didnt break until her head came out, so the haemmorage was due to a bunch of reasons i think. but they thought some of the placenta as still in. (after internal, it showed there wasnt anything left in) I had to have a drip to stop the bleed.

I was also anaemic at the time of birth (stupid drs for not telling me)

if I have the jab this time, what are the chances of retained placenta?

I don't know the stats on retained placenta but...

I chose not to have the injection for my first two deliveries. For my first, it didn't take too long to deliver the placenta, but I bled a fair amount, and was anaemic. For the second, the placenta came out intact but it took ages and I lost a lot of blood and was anaemic and it was not good (collapsed in the shower a few hours after birth).

For my third delivery, I had the injection. I was amazed how quickly the placenta was delivered. I really couldn't believe it - given how long it had taken before - it was seconds, I think. And I didn't bleed horribly, and didn't have to cope with anaemia on top of everything else, and thought why on earth didn't I do that the first two times.

The reason I didn't was my fear of having a retained placenta (oddly because I was worried I might need an epidural if this happened and that's the thing that scared me.)

But what I'm trying to say was that the injection made the birth a much more positive experience.

With my first, I had the jab. The MWs said "Cough, please" so I coughed and it flopped out of me. With my second, my placenta wouldn't budge, even after a second shot. I think the chance of a retained placenta is slightly higher with the injection.

Why not try for a natural 3rd stage and see how it goes? If they have concerns on the day THEN have it? Unless it's an emergency situation, there are other things you can try for the blood loss or a placenta that isn't coming before having the injection.

I had the injection after each of my 9 babies. Placenta came away quite quickly each time.
I haven't had a retained placenta or pph.
I think the injection has to be given quite promptly after the baby is delivered. If it's delayed, I think that's when there is a risk of retained placenta. Maybe check up on that.

I know it is anecdotal, but I got the injection immediately that my baby was born and STILL had retained placenta. It MIGHT have something to do with whether or not the cord is clmaped early or left to pulsate.... I am not sure if there has been any research done on this, just heard from quite a few ladies that they had this problem and they had chosen to avoid early clamping....

In which case, it is a case of weighing up the risks, bearing in mind that there can be up to 50% of the baby's blood volume in the placenta at birth....

I had RP & 3000ml PPH with DS1 despite having the injection, with DS2 I had the injection & placenta was out within minutes. I also had syntocinon drip after delivery to help prevent a PPH but still lost 1000ml second time around. I think it's very difficult to predict as the the circumstances of each labour & delivery are so different, but obviously the medics will take the most conservative option.

I was definitely anaemic with the second pregnancy & had to have an IV iron transfusion, despite everyone being hyper-aware of it due to the massive bleed with first delivery. Ironically if you are anaemic you are more likely to bleed & then the body is less able to cope with the blood loss too. So definitely keep an eye on your iron levels: haemoglobin & ferritin, the latter is not usually done unless iron studies are asked for on the blood test, rather than the more common full blood count (FBC). Also you could consider taking vit K supplements near the end as they are supposed to help with blood clotting.

i didn't want the injection, but i had a quite traumatic delivery, so chose (in the "didn't have much choice" way) to have it.

don't regret it at all.
i also had PPH, so really, i had to.

the placenta was delivered within a couple of minutes, with no help from me and it felt very odd (just a plop of warm stuff onto the bed)

I'm down to have an IV access this time just incase. And
They want to give me the jab for placenta. I just really hope I don't have to be
Rushed off again if they think some of the placenta is stuck.
It wasn't the last time, I know its best to check but that completely
Put a negative on our great labour.

Dr has put me on 2iron tablets a day now. and going to monitor.
That's the thing that's making me question it all, is that I delievered
The placenta naturally within 20mins I think? Just took it easy fed baby and it just happened
In its own time. Maybe it was the speed of getting DD out (fast) which contributed to the PPH.

Obviously what's safe for baby & me is most important, I just don't want to have it
If its going to make me have RP and PPH. Pot luck I guess