Managed third stage-not sure what to do this time!

[newtonupontheheath]

DC1 I had the injection to assist in the delivery of the placenta. I didn't really research the pros and cons, and just went with what was expected/advised by mw.

DC2 I went for a natural third stage after some (small amount of) research. Also thought as I had no pain relief with dc1, it was a bit of a "cop out" to have "help" with the placenta. In reality, it took an hour and was bloody knackering. Labour was only 2 hours so to add 1/3 on again just for the placenta seemed like ages!!

Now pregnant with dc3 and can't decide what to do for the best. Hoping for a third home birth, expecting another quick labour (ignoring the stuff about awkward third babies!) but just cannot decide what to do about the placenta.

Interested to hear other people's experiences

I had a managed third stage with dd1 in hosp. (Had wanted a natural but for various reasons went for managed). Home birth with dd2 and a natural third stage planed but placenta didn't come so after an hour they gave me the injection and it eventually came. It was quite scary and I couldn't 'settle' in that time as I had the shakes so badly and couldn't feed dd and generally felt dreadful.
I would opt for a managed third stage next time if I were to have another based on my experience.

Thanks rosey. I found the natural stage really tiring as contractions were quiet strong and I couldn't settle (in my living room, so perched on the edge of the sofa) with DD trying to feed etc.

I think I'm veering that way but wondering whether the benefits out weigh the hours worth of "work" I'm confused!

Hi. I went for the IM synto for all 3 of my DCs. I would definitely go for managed 3rd stage. It would be such a shame to miss any of those amazing precious moments with your newborn worrying about your placenta or even increasing your chance of a postpartum haemorrhage. It's not a huge intervention and I barely noticed it, and it in no way made my births feel less natural. Good luck.

I couldn't have the injection because my birth plan stated that the cord must not be cut until the placenta had been delivered.

I was in no rush anyway. Why do we have to treat birth like some sort of efficient factory-like process instead of an unhurried lovely and enjoyable process for the mother and baby?

I didn't like the insistence of the midwife that I should have a shower afterwards and wish I hadn't been made to feel it was expected. I wanted the baby to smell me, not some chemically version of flowers.

You might look up Michel Odent (v influential obstetrician, brought in water births and one of the pioneers of lateral ceaserians).

His view is natural third stage works best if there is no disturbing of the mother and baby from the birth of the baby until the placenta is delivered. So no touching the baby, no talking, no photos etc etc. just respecting and enabling the mother to be in the moment (all this assumes everything has gone well, a good midwife should be able to know this from quiet observation). Like wise no cord cutting, clamping etc.

Vice versa, he suggests that almost all 'the birth was great but then...' Complications are caused by disturbing the mother and baby bonding, which disturbs the hormone cocktail which delivers the placenta most swiftly and easily.

So if you want to go for it, maybe research that and include those kind of requests in your birth plan? Could enable a much easier natural,third dotage this time, if that is what you'd like.

Just to be clear, no touching the baby by another but the mother, that should be. Likewise he'd say fathers should also stay quiet and respectful and at a distance until the placenta is delivered: the birth is not complete until then.

Wait until after the placenta delivery for photos, passing the baby around, calling family, etc.

My instinct was to get up and move around but the mw insisted I lie down. As soon as j got up and moved around it came.

'His view is natural third stage works best if there is no disturbing of the mother and baby from the birth of the baby until the placenta is delivered. So no touching the baby, no talking, no photos etc etc. just respecting and enabling the mother to be in the moment'

Yes. I had two births exactly like this. No touching me or baby. I delivered baby myself, we clung on to each other not caring about the placenta stuff. No cord clamping, just cuddling in the pool, a feed with one, pool kept warm, placenta came out clean and with no visible blood loss each time, then detatched from baby.

I had managed for DD1 (instrumental and epidural).

DD2 tried for natural, but after an hour there were no contractions. She had arrived a bit suddenly and maybe the adrenalin rush was disruptive as people piled into the room. The homebirth MW started worrying about retained placenta and I wanted to get on with enjoying my baby, so I had the jab. I did have delayed clamping.

DS was natural. He was born in the pool. We stayed together for I think about 20 minutes, maybe longer. Then the MW cut the cord and I concentrated on delivering the placenta. I was trying to stay in the pool, but in the end I had to stand up (still in the pool. They held out a tray to avoid a big splash!!). Eventually the MW said to me "You can push with everything you've got. It doesn't have bones!". I did, and it came. It took about an hour in total, but didn't feel that long. During the time I was dealing with the placenta, DH was having first cuddles.

Thanks, I will have a look at the research mentioned.

I did have a fairly calm third stage with DD (dc2) but I couldn't get comfortable... It had been a quick labour in my living room and whilst prepped for the birth, there wasn't really much of a "bed" so I settled on the edge of the sofa. MW was fab, it was the contractions that were painful and made me unable to relax. That's why I think I'd prefer a managed third stage... But I do like the idea of a natural one...

This is the only part of my birth plan I need to agree (with myself) on, everything else I know what I want. Even DH thought it was "painful ad uncomfortable" delivering the placenta and he saw me give birth twice with no pain relief-yet that's the bit he remembers thinking "ouch" about