What is the longest physiological third stage anyone had?

[mears]

This is a question for those of you who had physiological third stages. My personal cut-off as a midwife is 2 hours, when I would give the syntometrine injection (unless woman objected ofcourse). We were all fed up waiting for a placenta the other night and I gave the injection after waiting 2 hours after a lovely waterbirth. Any experiences anyone?

Is that after the cord was cut? I nearly had a natural 3rd stage with dd2 who was born so quickly they only just managed to catch her, never mind give me an injection. But after about 10 mins they got all panicked 'cos they said the cord was breaking and gave me an injection anyway.

(Sorry, not answering your question, just curious. The injection seems to be so routine.)

I was so busy contemplating my baby that I don't remember when the placenta was delivered, the beauties of epidural I guess.

I honestly can't remember the placenta being delivered in either case, with DD now 6, I had a failed epidural, and the thing that I remember is that they chucked it without testing it, coz between water breaking and giving birth was 48 hours. And we both ended up on anti biotics coz we had infections.

With DS, no pain relief, had had a shot of diamorphine, but it wore off about half an hour before pushing and I decided to grin and bear it, so was pretty shaky and couldn't stop my teeth chattering after he was born, don't remember placenta being delivered!

I had a lovely waterbirth as you may remember mears and I waited ages for my placenta. about an hour in the pool and then another hour or so out of it drinking champagne! Certainly over two hours I think although I could check my notes if you wanted. What was interesting was I had no blood loss at the birth (really - the pool was as clean as a whistle), and my midwife was expecting the blood to come with the placenta, and it plopped out clean as a whistle as well. I didn't lose any blood at all, it was amazing. She thought because my 2nd stage was so long it just had very efficiently contracted the blood vessels down.

Thanks for info. Princesspeahead - the mum got fed up and frankly so did I because my shift was finishing and I knew that I was well outwith the protocol already (!). I would love to have waited out of interest, but I couldn't have the mum doing something that she hadn't planned for. We all felt cheated because it was such a lovely waterbirth.
Physiological 3rd stage is when labour has been antural with no pain relief, and the injection has not been given. Most women do not actually remember the injection being given when you ask them next time around. What they do remember is the vomiting.......that is usually because of the injection.

I had 3 out of 4 with a physiological 3rd stage (wasn't aware I had a choice with my first ), and I don't think they took more than about 20 mins to arrive afterwards. I also waited until the umbilical cord had stopped pulsating before it was cut.

I don't know if this is of interest Mears, but I have a friend who's (3) physiological third stages have ranged from 10 minutes to an hour and a half. She opted for a totally hands off approach with the hour and a half one, and it came out after the midwife present suggested she squat! She described it as 'falling out' and that it may have been detatched for some time, but as she was semi-recumbent prior to squatting, gravity hadn't been on her side.
I'm quite interested in this at present as I'm aiming for a physiological third stage too. I've been given the impression that the time 'allowed' for delivery of the placenta will be dependant mainly on the experience and experiences of the midwifes present. I haven't been given a specific allowance according to protocol, but have no doubt that one exists . I hardly dare ask!

Mears, does the injection cause vomiting immediately or hours later? Interested because I spent the day after ds was born mostly hanging over a bowl... have also heard that gas and air has that effect too (and I must have drained the hospital's supplies . Maybe things to avoid next time... but when the midwife asked, frankly I couldn't have given two hoots either way, had just met my ds for the first time and nothing else really mattered. Would have been nice to have more time with him the next day though, instead of feeling so ill.

edam - usually the vomiting soon after the delivery. Ofetn skin-to-skin contact has to be interrupted because the mum is being sick. For some women that may carry on I suppose.

Thanks for the replies - I think that normal is a huge range and is difficult to legislate for. I think 2 hours is quite liberal but I do know it can take longer than that. I think if there is no active bleeding then it doesn't matter, but hospital and homebirth protocols tend to be quite tight.

mears, I opted for a physiological third stage with our third because the placenta was torn after our second was born (following injection and lots of tugging ) It took 2 hours and 17 minutes according to my notes. I would have opted for the injection after about 1 1/2 hours as I was feeling exhausted and tired of waiting... I just wanted to get on with getting to know ds2 and having breakfast with dh and our older 2...

Not sure that it is the same thing but following a medical termination of 16 week twin pregnancy (missed-miscarriage), I was allowed to go over 3 hours waiting for the placenta and I ended up losing far too much blood. (Hb dropped from 12.5 to 7.1) I was terrified as the room began to swim around me and I was being asked if I would prefer an general anesthetic or a spinal... As my BP dropped to 60/30 the consultant opted to manually remove the placenta following a jab and the drip.
Wish I could had begged for the jab earlier in the process.

I've just read this thread - I had no idea it could take that long! I had no injection and it happened about 10 mins after baby came out. I hadn't really given it much thought .....maybe I'll read up some more before it's time to do it again!
mit x

Mears, not exactly on the subject, but I had Misoprostol tablet for my 3rd stage, rather than Syntometrin, because I didn't want to vomit. My two were born at UCH, I have never heard of any other hospital offering Misoprostol, have you?

I shook so badly afterwards that I couldn't speak properly - shaking is one of the side-effects of Misoprostol, but far preferable, IMO, to vomitting. Shaking didn't bother me in any case, because I was lying down being stitched and sucking away on the g&a!