can anybody share their experience of a physiological third stage?

[whenskiesaregrey]

That's it really. Hoping for a home water birth and considering natural third stage. First labour was induced in hospital, so had the jab with no complications. Would like to try this labour with no pain relief other than g&a and water.

Any experiences, positive or negative welcome!

I'm also thinking of a natural third stage with my second due in 3 weeks. I had the injection first time round and my BP, already a bit high, shot up and the MW said the injection could have caused the rise, ended up on tablets which I had to fight to get taken off. Turns out I had mild undiagnosed pre-eclampsia, so as I've so far (fingers crossed) managed to avoid high BP think I'll pass on the injection too.
Re the vit k I'm sure I once read somewhere that the baby would have in the olden days got this from any poo you did while pushing! Not sure how true this is though!

it makes sense in the context of a natural home birth with no drugs. it also gives you time to just be with your baby holding him/her and waiting, no hurry , no tugging on the placenta, which can be a bonus if labour is quick, the physiological third stage gives you time to catch your breath rather than rushing the last part of the birth

I had a natural 3rd stage it only took 5 mins and I barley noticed tho did have to give a small push.

OP regarding the jaundice, I had a natural 3rd stage with dc4 and baby was also at risk of jaundice due to my antibodies(rhesus neg). In the event she did get jaundice but was under the treatment levels. It did take about 20 mins to deliver the placenta in the end and I found it slightly painful. Then the cord was clamped. The only thing I would add is make sure if you are rhesus neg that they do manage to get a tiny amount of cord blood to send for blood typing( if rhesus neg you may need an anti-D jab). They forgot with me and so had to take blood directly from baby to send for blood typing. HTH

I've had two - very uneventful. Placenta just slipped out after 10 minutes.

I had one. MWs were a bit clueless about it (later found out they'd been surreptitiously tugging the cord ) but all was five. I didn't really push, just a couple of times after about 30mins and it plopped out.

Thanks again for all these.

maccie I'm not rhesus-neg, but I have other antibodies which no-one can really tell me anything about. They are at very low levels, and hadn't raised between booking in and 28 week bloods, but, like you said, they would like to take some cord blood. I have asked the midwife to write it in my book, but I would like to include it in my birth plan too. Do you know how that would interfere with delayed cord clamping? If we wait for the cord to stop pulsing, will there be enough to get a good sample?

Also very interesting to hear those that say the placenta just seemed to slip out. Midwife mentioned an occasion where a lady had given birth on a beanbag. Then they were waiting around for the placenta, and midwife had a suspicion the placenta had been delivered, but because of the position the lady was in, it was just sitting there. So she got her to stand up, and it fell out!

i had one for ds4, had him in the pool and just stayed in the pool cuddling and nursing him until the placenta delivered, it didnt take long buti was suprised at just how painful the contractions were to deliver the placenta, i didnt have to push it out it just plopped out into the water and the midwife scooped it up. we waited till then to clamp the cord etc, ds4 didnt have much jaundice but my babies born when i did have the injection did! so thats a bit odd!

anyway it was lovely and was my plan for no 5, but i ended up with syntocin drip so needed the injection, still a a lovely natural active birth tho with just gas and air :)

OP, re the delayed clamping, no not in my case. The cord finished pulsating and was then clamped and cut. the mw then said, "its a good job your not rhesus neg as there's not a drop left", when examining the cord and placenta. (my birth was a bit of a rush in the end and no one had time to read my notes).

I would assume that if they were aware of the need to take a cord sample that they could delay clamping for a while but not until it has fully stopped pulsating. That way baby can receive most of its full blood supply back into its body and leave a small amount remaining in the cord.

Your own mw should be able to advise if this is possible or how they would accommodate your wish for natural third stage and the need for a cord sample to be taken. It would also probably need to be discussed with the midwife on the day, as well as written in your birth plan, to make sure she is aware of the need for the right timings.

I've had three natural third stages (three babies so haven't tried the other way), I had to wait longest the third time because I was absolutely done in: I needed a bit of chocolate before I could do it ;)

I had a natural third stage with DD2 at the midwife's suggestion when I told her I wasn't bothered either way (natural, average length labour, gas and air only). It took quite a while and was quite difficult. The midwife got me sitting on the loo (with a bowl underneath) to try and push it out as apparently that is a better position but I was just not getting any more contractions - or at least none with any power. It was getting to the point where they wanted to give me the jab when I finally managed to get it out.

Although to be fair, I hadn't had to do any real pushing to get DD out as she came out on the first powerful urge to push.

There was no janudice but I did pass 2 or 3 rather large clots and bled for about 6-8 weeks after the birth.

This compared to DD1 with whom I had the jab, got the placenta out really quickly, no blood clots, bled for only about 3 weeks but she did have jaundice.

Despite seemingly having a worse time with the natural third stage, I would choose it again.

Why would you choose it again Claire if you had a more difficult time?

Thank you for all these, I value them all.

For my first (long labour) it just came straight out, nothing to do.

For my second (short birth) the afterpains were awful, but the placenta was out really quickly too.

TBH I don't see when there would have been time to give me a jab, as soon as I was out of the birth pool and on a bed the placenta was out both times.

Didn't cut the cord immediately, so don't know if that makes a difference.

i think it could well have happened anyway yes from what i have read about it warren but am sure someone more knowledgable and with links will come along shortly!

btw i had a HUGE placenta with ds4, he was also huge 10lb 13oz! and the midwife got the other midwives and drs to come and look as they had never seen a placenta so huge! i am only little myself so no idea how ds4 and the placenta all fitted in tbh! :)

I've done it both times, it seemed to take ages the 1st time and I ended up feeling quite despondent about it, mw suggested giving dd a feed as it does something hormonal apparently, sure enough it plopped out immediately after she started to feed. 2nd time it felt more like delivering a 2nd baby!! But woul still choose it if I had no.3, I am scared of drugs and things and i felt more in control this way

I planned a physiological third stage with my first baby. She was born at home in a birth pool after 8hours of contractions. I got out of the pool for the 3rd stage. The cord stopped pulsating after about 15 or 20 minutes and my DH cut the cord. The midwives started encouraging me to push the placenta out. I stood up and squatted over a bowl but nothing happened. Did the squatting/pushing a few more times and all I managed to squeeze out was a wee into the bowl . After about 45 minutes I'd had enough pushing and the midwives were getting twitchy so I asked for the injection. After that I just did what I was told and the mw had the placenta out within 5 minutes using cord traction.
I didnt enjoy that bit at all and this time I will be happy to accept the injection at an earlier point once the cord has stopped pulsating. I have also heard that the cord shouldn't be cut during a physiological third stage until the placenta is out although that sounds a bit impractical to me.

Youngest DD was waterbirth at home in January. Cord not clamped until it stopped pulsating, and natural 3rd stage, with placenta delivered while still in the pool. No vit k administered either. DD latched on shortly after birth, and has been very healthy. No jaundice.
Dd1 was also natural third stage at home. But had shot in hospital with DD2. Didn't make me sick but shot must have hit a nerve or something as leg in that area was numb in one spot, painful in another for 6+ months. I would choose a natural 3rd stage if at all possible.

I had a managed 3rd stage with DC1 and natural with 2 and 3. I much preferred the natural 3rd stage and was was adamant I didn't want syntometrin with DC3. 3rd stage took much longer with the syntometrin and they had to push and pull to get the placenta out. It was pretty stressful too as they were pretty clearly looking at the clock and were talking about theatre etc, With DC2 and 3 it just fell out with a tiny push after a couple of minutes.

Had one with first baby and it took ages, was painful, and I was bleeding quite a lot.

Had the injection with my second, still took about 15 mins (longer than the second stage!) but much better ime.

Will have injection with this one too I think. The third stage is actually my least favourite stage

All home births (not water) btw

Was very quick and I didn't even feel it.
But afterwards I started bleeding (pph) and had to have an injection to stop that.

Had physiological third stage for both babies (both home birth)

1st time DS's cord was v short (he didn't get past my belly button) so ended up cutting and clamping so that I could give first feed. Had no injection and placenta was delivered after about 20 mins. I'd stopped feeling any contractions and we were discussing whether to have the injection. MW gave a very gentle pull on the cord and the placenta slid out immediately.

2nd time much longer cord so fed DD while we waited for placenta to appear. Again no injection. It was a little undignified, I can remember squatting on a kidney dish and trying to hold and feed a newborn! Can't remember how long it took but wasn't too long.

whenskiesaregrey

I don't know how to explain it really. I am a massive wimp when it comes to being in pain, being ill etc. In this house, it is me that gets 'man flu' and DH just carries on.

However, when it comes to childbirth, I have managed both times to give birth without any pain relief stronger than gas and air - this is partly down to being very lucky with no pregnancy complications and by the book labours, and also being very very very lucky in that G&A has the most amazing anaesthetic affect on me.

I am incredibly proud of myself for this and am in awe that my body knows what it is doing to the extent that I can curl up on a bed, puffing away on G&A for a few hours and get a baby at the end of it (I don't go in for 'active labour').

With DD1 I didn't really do much research about birth other than learning what would actually happen to my body. I was and still am very much of the impression that birth is something that is impossible to plan for - you can state your ideal, but there is no point in getting hung up on it because anything can happen. I am very much from the take it all as it comes school.

They offered me a jab to get the placenta out, I was holding my new born daughter and had better things to think about than asking for the ins and outs of the benefits of the jab vs a natural third stage (I don't event think I knew it was called the third stage). I just said "Yeah, whatever"

With DD2, I learnt a bit more about 'natural birth' (knowing now that I could do it) and made a lot more assertions about wanting to have DD2 places straight on me and to feed her before she was taken off to be weighed etc, but still didn't really pay much attention to the third stage - just assumed it would be the same as the first time. When the midwife asked if I wanted to do it naturally or have the jab I told her I had the jab last time and I didn't mind having it this time. She suggested that as my birth had been so natural, maybe I should try to deliver the placenta without the jab. Again, I wasn't really bothered either way - was more interested in DD, so just went along with her suggestion.

In hindsight, she was a fab midwife and just let me labour how I wanted to - she didn't even give me any internals. I loved the whole experience and how natural it was - so even though the third stage was more difficult, I would do it again.

Sorry for the mammoth post and I am not sure I have even answered your question but hey ho.

Thanks Claire that's very useful. Your midwife sounds very similar to mine (I think).