Vomiting in labour - third stage

[Santatizer]

I had an EMCS for my last pregnancy (14 years ago!) due to malpresentation - baby was undiagnosed breech. I had antiemetics prior to the section due to phobia of vomiting. This time, I am keen to try a VBAC (though not 100% decided!) and have already asked my midwife if I can have antiemetics - all good. I am especially worried about transition and particularly the third stage - I have read a few vomit horror stories about syntometrine / syntococin. I will be making sure antiemetics stay topped up (or asking DH too!) but I am still worried. Has anyone had active management of third stage and not experienced nausea and vomiting? I know lots of people say they were sick in labour and didn't care, even those with a phobia, but I know I definitely will care and that it will cause such significant anxiety that it could really impede things, since being as relaxed as possible is important, and make it a traumatic experience. Any positive experiences would be really appreciated.

Thanks for all your replies. I can't deal with the long-standing emetophobia (which is much better than it once was) in the 7.5 weeks I have left unfortunately. Those of you who have had antiemetics in labour or those who obviously work in the field, information about which antiemetics are most effective in labour and for ergometrine would be really helpful. At this point, comments about what ISN'T effective and the pointlessness of trying to prevent vomiting in labour aren't helpful at all. I realise already that there may be an eventuality where it happens but in terms of my own mental preparation, positive and constructive advice only please and thank you.

I didn’t have my vbac in the Uk but was under the impression that you wouldn’t get syntocin for a vbac due to pressure on scar. I am open to correction but I always thought vbac needed to be spontaneous, or as close to it as possible. I used acupuncture, gentle birth etc and stayed at home as long as possible so ended up with a great experience as opposed to horrific EMCS first time

I have had strong anti-emetics that worked

Can’t remember the name, sorry, but they DO exist. Can you ask a gastroenterologist? I had to see one during pregnancy

Ondansetron is the tits in terms of anti emetics. Cyclazine is decent but can have side effects of making you feel super wonky when given IV. Stemetil isn’t bad but really ondansetron is the business.

I understand your fear of vomiting, OP. I wasn't sick in either of my labours, but I chose to have a natural 3rd stage (no injection) in both - so it's worth knowing that's an option. You have to be ready to take the injection if the midwife/Dr thinks it's taking too long for the placenta to deliver naturally though.

Just to reassure you I had the injection and no issues at all - not sure exactly what drug was used though.

I did in my second labour but it was a long difficult birth of a big baby with no contractions as they had died off and it was a case of push like mad or crash section. The pushing was so strenuous it caused it though.

I wasn't sick in either labour.

I remember in labour 1 feeling a bit queezy when I first had gas and air but that went very quickly.

I have the same fear & wasn't sick in labour and didn't feel sick at any point either. It may be worth making sure your midwife knows you want anti-emetics in advance & checking the hospital is aware of that too.

It was in my birth plan about my phobia & wanting anti sickness drugs, however I didn't really take it any further than that. I arrived at hospital 7cm & asked for anti sickness medicine before I had gas & air but they just said oh we'll see how you get on first. As I was so far gone I just had the gas & air anyway but if that's a deal breaker to you then might be worth stressing that point with them so they don't try & talk you out of it on the day, or at least you're prepared either way. I'd decided I didn't want the injection to deliver the placenta for the same reason but again on the day was told I needed it. That was also totally fine and I had no side effects. A friend also had the injection with no sickness either so hope that helps a bit.

Sorry I misread the OP and thought you were having a CS this time round. With a VB then a physiological third stage is an option but be aware that in the event of heavy bleeding or augmentation of Labour using the drip etc it may not be the safest choice.

I was insanely nauseous throughout my labour. Terribly, terribly nauseous. Anti-nausea meds did nothing to help.

But despite all that nausea, I did not vomit.

Not sure whether this will help, but I hope it does!

I have emetaphobia but didn't ask for anti-emetics for labour (I've had them for surgery, early pregnancy nausea and tummy bugs though). I wasn't sick. I refused pethidine partly due to it causing sickness. I was careful with the gas and air: if the room started to spin I took a break from it - the effects wear off instantly. I had a syntocin drip, epidural and a managed third stage. None of that caused any nausea. I'm aiming for less intervention this time but will still have a managed third stage.

I had HG for the first half of my pregnancy. I vomited in early labour a few times when I was between 2 and 4cm dilated. The hospital gave me an antiemetic when I arrived as I vomited quote a few times upon arrival. Once that kicked in I had no nausea or vomiting at all, and I had diamorphine - which was given with an antiemetic, and I had more oral antiemetics later in the labour too I think it was around the time I started to push. I had active third stage and no nausea or vomiting. So regular antiemetics are possible and can mean zero symptoms once they're administered, that's what my experience was.