Physiological third stage...remind me why this is a good idea please...

[tassisssss]

felt strongly about this last time, but the placenta took ages to deliver and midwives seemed very anxious and i ended up back on gas and air being catheterised and them tugging the placenta out...

felt anything but natural after a v straight forward, active/natural labour.

worth doing the same again? or should i just have the injection, cut the cord straight away and get out of there asap?

any thoughts?

Syntocin can cause massive cramping of the uterus which means the umbilical cord has to be cut prematurely (before it's stopped pulsing). There is a third way which is to have syntocin after 15 minutes once the cord has stopped pulsing anyway I think.

Oh and syntocin can cause bad headaches too.

I asked for a phsyiological third stage with DS3, I'd had 2 awful deliveries with my first 2 and was determined that my 3rd was going to be as "natural" as possible (forgoing the constant monitoring etc that was expected as it was a VBAC). Labour and birth went exactly to plan (if a little quicker than expected) and I was initially quite happy to let DS3 suckle on the breast and wait for the placenta to come of it's own accord.

I have to confess though, after nearly 50 minutes and it showing no sign of coming on it's own I just told them to give me the injection as I wanted to get stitched up (only a tiny tear), cleaned up and home. Placenta was delivered about 5 minutes after that......

Have no regrets.

I've always had syntocinon (3 children) but last time I felt very agitated and twittery after the delivery. I assumed it was the stress of a v fast 2nd stage or the abs I'd had for GBS, but a midwife recently told me that it can be a side effect of syntocinon.

This time (33 weeks pregnant) I'm keen on letting the cord stop pulsing. I've been advised to have syntocinon as I had a PPH last time, but hopefully will have it after 15 mins or so.

well my placenta didn't deliver fast enough with the injection....so had to have it removed manually

i don't recommend it!
will request physiological third stage next time

I found this and this helpful when deciding what I was going to do

mw's can nowadays be rather impatient about placenta delievery.....sigh!

as far as I know, if you had a natural birth with minimal drugs then usually it's very safe for a physiological stage, but it can take longer then modern m/w's are comfortable with....however, unless there is a severe bloodloss, I believe there isn't actually a problem.

If you had lots of drugs, it may well be necessary to avoid a physiological 3. stage, but I believe you can always ask for a trial and go from there....

however, I believe that tugging on Plaenta is very bad and outdated practice...but I am not a midwife and I have not done any recent reading on childbirth!

Oh, yes, and also, the injections can cause more problems if placenta is not delivered in a certain timeframe....

thanks to everyone who's replied. that's all been very helpful. will discuss with dh (at some point!) and make a plan...

the bleeding/lochia went on for 6 weeks with injection/ managed placenta.
with my first two, had physiological placental delivery and bled for around 6-8 days properly and then scant!

I had a physiological 3rd stage even though I asked for the injection. I suspect they didn't have any syntocin (it was a small birthing unit). Or it could be the mw was v keen on natural birth. It took about an hour, and I experienced quite strong contractions, but eventually produced a massive placenta. Photographs show me looking as white as the sheet, as I had heavy blood loss and had been borderline anaemic at the end of pregnancy.

Glad to learn I avoided possible bad headaches and vomiting

One of the big advantgs of a true physiological is that baby continues to get all the iron rich and o2 rich blood from you, not to mention all the other goodies you're giving them. There's heaps of research supporting cutting the cord after the placenta is born for these reasons. But also because it can decrease the amount of blood loss for yourself.

There's no reason you have to lie around waiting for it to come if it takes a little while. Sometimes getting up and having a shower is all you need

Don't let ayone pull on it ever unless they are suporting your uterus at your pubic bone and you've had synto. It's really, really dangerous practice and should never be done by anyone, no matter how experienced they are or what they say.

I've had women take an hour and a half to birth their placenta. As long as the bleeding is ok and you're feeling well, there's no hurry. If it's going to get stuck and you need a manual removal no amount of tugging will get it out.

Good luck, go with your body

Mary Wollstonecraft (the first feminist) died because her placenta was manually extracted in 1797.

mine was an hour and a half (after a 15 min labour). MW arrived about an hour after the birth and wasn't at all worried about placenta (actually I was more concerned about it than her). In the end I sat on the toilet and did some bearing down (MW saying to push when I contracted - but I wasn't contracting) and she had a very gentle tug - interesting to read that you shouldn't do that.

Interesting that some mw's allow you an hour and a half.

1st time it came in 10mins or so with no assistance.
2nd time it took about 50 mins
3rd time after 50 mins the m/w's were getting a little anxious, I was cold and a bit fed up and just wanted to get cleaned up, so had the injection. Bad trip- 2hours of vomiting and major shaking. It was ghastly. Having said that, I was glad to be rid of my placenta, it was a little reluctant to shift even with help from the injection. I read somewhere that you are more likley to 'hold' onto the placenta the more pregnancies you have had.
With hindsight, I guess I had the best of both, dd2 got to get all the benefits before the cord was cut, and the placenta came out in one piece. However, if I do it all again, I would try and get something to counteract the nausea on standby just in case I had the injection again.

dd- had a rough labour (her heartbeat dropped to practically nothing and there was a bit of a rush to deliver) and forgot to tell them i wanted a physiological 3rd stage and the midwife injected me while i was watching dd be resusitated. placenta was delivered naturally but i had a PPH, retained partial placenta (unnoticed by medical staff) and lochia for 6+ weeks

ds- remembered to write birthplan had a natural 3rd stage, 30 mins or so til it came out, no further contractions; it just slid out, no PPH and lochia for less than 2 weeks then a bit of mild spotting but a pantyliner did after week one. not only that but i made the student midwifes day as she'd never seen one before and all the other students were really jealous of her, lol. was nice that she enjoyed it as she was a godsend throughout the labour rubbing my back and bossing dp about

thanks all, loads of great information there!