MROP without pain relief?

[Numero2]

Just wondering if anyone else has been through a similar situation.

So I had a straightforward birth with my first with just gas and air. I was then given the injection for my placenta. I pushed and the midwife pulled on the cord for quite some time but the cord snapped. The doctor was called and I heard the midwife tell him that it wasn't budging.

Without any explanation, he told me to take the gas and air out and then proceeded to put his arm inside me and pull my placenta out, while pushing hard on my stomach and asking me to push too. It was excruiating. I could feel a ripping sensation right up high in my uterus. My husband tells me his whole forearm was inside me which I can quite believe as it was so intensely painful, even more so than the labour / delivery itself.

Now, fortunately, it worked. Both myself and my baby were fine, and I am now pregnant with my 2nd, so I guess no harm done. BUT, when I mentioned this to a doctor at an appointment during my current pregnancy, she claims that the notes say that it was not a MROP and that the placenta was partially in the vagina and the doctor just put his hand inside and applied gentle pressure to remove it.

I have arranged for a Birth Afterthoughts meeting next month so I hope I will find out a bit more then, but before I go I was interested to hear any similar stories or thoughts on this matter?

Does this sound like it was a MROP but out of surgery and without pain relief and recorded wrongly in the notes? Or is it possible I am a total wuss and it was simply gentle pressure and a hand (not full arm!!) removing a placenta that was half way out already??

I had the exact same thing with my first baby born last week. Placenta had detached but was stuck in my vagina and the doctor applied pressure on my stomach and used 3 fingers to help the placenta out. It was awfully painful (worse than labour in my opinion) but they did warn me to say this beforehand and that if the placenta had genuinely not detached yet then theatre and a spinal would have been the only option.
Congratulations on your second pregnancy!

If it hadn't have detached they would have done it in theatre. Sometimes the cervix starts to close before the placenta has gone through, so it may have been stretching of the cervix to get it through that you felt.

Thank you both for your replies.

I suppose I'm just a bit confused as to why in my case the doctor needed to insert his entire hand AND forearm to remove the placenta if it was supposedly in the vagina according to my notes? Honestly, it was brutal - my husband was shocked.

First timer mentions 3 fingers (which I am sure was still very painful) and I understand Overagains point about the cervix closing but still...something doesn't seem right to me.

This happened to me, utterly horrific.

Would you mind sharing some of the details?

It was exactly the same as what happened to you op, only the doctor couldn't remove it so another doctor intervened and took me off to theatre. There must have been more than 20 people there, it was horrific. I'm sorry you had this experience.

Most people don't believe me when I say this happened.Nice guidelines say this shouldn't be attempted without any anaesthetic. I opted for a natural third stage with the next birth and everything was fine.

I also think my midwife cocked up. Nice guidelines say that midwives should check for signs the placenta has separated before they start using gentle traction. They claimed my umbilical cord was weak and had snapped!

entire hand AND forearm to remove the placenta if it was supposedly in the vagina according to my notes

I had mine manually removed it theatre as it hadn't come away, his entire arm, up to his shoulder was in me. Like when they artificially inseminate cows (and he had the long blue glove to go with the cow image). At the time I was amazed at how much of him was inside me! So I can fully image them needing a forearm to get to the cervix.

That sounds awful OverAgain. But...before / during labour the midwife can reach the cervix with just 1 or 2 fingers?

DisrespectfulDodo - strangely my midwife actually commented on how unusally thick my cord was and yet it still snapped so I think like you say it is a case of the placenta having not yet detached.

That's interesting that you say you went for a natural third stage 2nd time around - the consultant I saw told me I should go for a managed third stage again. I'm not sure what is for the best really but definitely won't be allowing any doctor to attempt that again without pain relief!!!

Numero2 actually it was fine as I had spinal block so fell asleep. Was the least worst part of my labour!

There are times when the midwife can't reach the cervix because it's too high (for example if you go for a sweep pre labour) and your cervix goes high again once it starts to close. Plus if it was only partly through the cervix the Dr might have needed to put more of his hand through to ensure the placenta didn't break as he pulled it out, as that would have been bad.

Obviously not saying these were reasons (I was there!) just that these are possible causes for what happened.

I had the placenta removed manually not in theatre with stomach compression and I felt the doctor's hand inside but it didn't hurt and I didn't have any pain relief, so I don't know if it had come away but wouldn't come out? They didn't offer anything just said if this didn't work I would need surgery and a spinal. I remember pushing with all my might!