Retained placenta/ managed third stage/ questions...

[HulainHawaii]

Bear with me - at 39 weeks I'm easily confused!

Just back from the midwife where we discussed 3rd stage - managed or otherwise!

I have family history of retained/ ruptured placenta (great grandmother, grandmother, mum, aunt) -

I asked my NCT rep for advice who suggested that a natural third stage would seem best.

But just asked my midwife, who said that managed third stage with injection (syntocinon?) would be best.

Who do I believe?

I'd prefer to go for the natural option but.....

Any advice out there?

HulainHawaii, the injection, as far as I've been told, replicates hormones already present in your body to speed the third stage up dramatically. So if there is so much history of problems expelling the placenta within your family then I would go for this option just to have a bit of extra help. In my experience, NCT generally prefer natural options where possible based on their training and principles, whereas your midwife will be making the decision most appriorate for you and your medical history. This might explain the completely opposite advice. Hope this helps.

As I understand it, the injection reduces the chances of PPH, but slightly increases them of retained placenta. This is because it causes the uterus to clamp down more quickly, so less risk of PPH, but if the placenta has failed to detach, greater chance of it being retained.

If you have a family history of both ruptured placenta (which presumably results in high blood loss?) and also retained placenta, I would guess it is therefore a difficult call? Sorry, I'm not quite familiar with the terminology of ruptured placenta. I do know that if you are at high risk for a PPH, the injection is recommended.

I had a managed third stage but I was induced, so I don't know whether this is an influencing factor?
I did end up with a retained placenta though and had a manual removal as a result.
I think I would perhaps try and go natural and see what happens?
Best of luck with everything!

I was induced ( drip ) and had ventouse delivery. I had the injection but the placenta wasn't passed so ended up with manual removal. I must admit I thought it was the norm to have the injection? Though there was so much going on and so many things being explained to me that I had to give my consent to that I may have forgotten or got confused! I don't know if it's relevant but it turns out that they didn't get all the placenta out as last week ( 4 weeks post partum ) I ended up back in hospital with an infection and had to have drugs to help me pass what was left!

Oh forgot to mention apparently I have an oddly shaped uterus which could have been a factor in why the placenta was retained, it may not have been due to the injection. All turned out well in the end though, good luck with everything!

I had 3 natural births (2 at home), and in all 3 cases I needed to have an injection for the 3rd stage.

The contractions during the 3rd stage were very strong and painful, but had little/no effect, so the injection was a relief.

I felt that, once the babies were born, the need to be drug free was less important than the need to bond and enjoy their first hour, which was not possible during those horrible contractions!

The placentas all just slipped out immediately after the injections, like magic!

The injection causes the cervix to close quickly so if the placenta has not completely detatched it will be retained.