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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Delivering the placenta

29 replies

mckenzie · 04/02/2005 11:52

I'm 37 weeks pg with baby No 2 and planning a home water birth. 2 of the midwives from the team that i am under came to our house today to give it the okay and we had a chat about how things will go. Apparently, the guidelines at the moment are that I will NOT be able to deliver the placenta in the water. I will have to get out once baby is born and either wait for it to happen naturally of have the drug (cant remember what it's called) to bring it on straight away.

2 questions please.

Is this rule the same for all NHS hospitals?

How long is it likely to take if I wait and let it happen naturally (I know breastfeeding can help so I will certainly be trying to get baby to feed asap)?

TIA.

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Blu · 04/02/2005 11:58

mckenzie - sorry, I can't answer your question, but from what I remember from being in the pool, I would have thought it would be much easier to put your darling baby to your breast by getting out.

otto · 04/02/2005 12:22

I don't know the answer re birth pools, but I delivered the placenta naturally and I don't think it took longer than 15 minutes from the birth of ds to the delivery of the placenta.

nailpolish · 04/02/2005 12:26

is the reason you like you to get out not a prevention of infection one?

in both my cases, when my dd's were born they latched on within 10mins of being delivered. i had a contraction sort of feeling, and the midwife was there to deliver the placenta. i hardly even noticed, apart from the contraction feelings (they were mild)

hth

nailpolish · 04/02/2005 12:26

the reason they like you to get out

sorry!

collision · 04/02/2005 12:30

Ds2 was born 12 weeks ago in water. I latched him on in thw water straight away and we kept him in the water for about 15 mins. I then got out to dlliver the placenta. It didnt hurt at all and I didnt think to ask why it wasnt delivered in water. Ask to have a look at it though as it is fascinating.

JoD · 04/02/2005 18:15

Have just attended a waterbirth evening at the local hospital, where the mw said that the placenta COULD be delivered in the water (although I have read elsewhere that it is often preferred that the third stage is outside of the water - not sure why). Mw also said that they would allow up to an hour for the natural delivery of the placenta. Good luck!

Original poster

mckenzie · 04/02/2005 19:56

thanks very much for all these replies.
15 mins to an hour is manageable I think, I was juts concerned it might take hours.
And according to my MW, the reason they have this ruling (and apparently it is under discussion at the moment and may well be changed in the near future) is because of the risk of air bubbles going back up inside (or at least that was my understanding of the brief explanation anyway!!)

OP posts:

4kids · 04/02/2005 21:35

Ihad a unplanned homebirth & i had to deliver placenta naturally it took about 15 mins but hurt like hell worse than giving birth {contractions that is} but everyones different .

pupuce · 04/02/2005 21:54

MWs who don't like to deliver placenta in water it is often because they don't have the experience and they may feel they can't easily estimate blood losss.
I am sure Mears delivers placenta in water.
Natural 3rd stage can take from no time to hours. there are ways of encouraging it to come quickly. I'll e-mail those tomorrow.... too tired now.

My view on this is if you had NO drug in labour then give a natural 3rd stage a chance (why would you suddenly need drugs?).... if it takes too long you can always the syntometrine later.

dinosaur · 05/02/2005 16:13

mckenzie,

I really wanted to deliver the placenta naturally when I had DS3. The reason I was so keen to try was that after DS2 was born, I had the injection of syntometrine and the placenta got stuck. This meant that after a very quick and completely drug free labour and delivery, I then had to go to threatre, have a spinal block and have the placenta removed manually.

It was not difficult to persuade the hospital to let me have a go at a natural third stage - I just had to agree that if there was a lot of bleeding, I would have the injection. In fact, I had a brilliant Dutch midwife who was very experienced at doing natural third stages, and she delivered the placenta in about 10 minutes. The bleeding was pretty heavy afterwards, although nobody seemed particularly concerned about it, so I did have an injection of syntomatrine at that stage.

HTH

cazzybabs · 05/02/2005 16:50

My dd2 is now 4 months old and with her i had a natural 3rd stage. I tried to stay in the pool snd deliver it there, but after 10 minutes I got out because i was simply too tired to stay in. and trying to bf was nigh impossible..for me it took about 30 minutes and it was really painful. I can still remember it now (unlike the actual birth)- it was a wierd pain. I am glad i have experienced it but for dd1 i had the injection and i don't remember the placenta bit at all.

pupuce · 05/02/2005 17:34

The pain you guys report feeling is after pains, it isn't specific to delivering the placenta and it is much more common in subsequent births.

Ways of encouraging a quick 3rd stage.... well it's a difficult thing to do in hospital but the mother should feel warm (often an extra blanket on shoulders) and NO EXTERNAL stimulation, no non-esssential talking, let mother and baby bond... BF will come naturally there is no point on shoving boob in baby's mouth. The less intervention and stimulation, the better.
Often in hospital this doesn't happen as there is a lot of commotion... much more possible in a home birth, just let the MW know what you want and to respect your privacy right after the birth.

Original poster

mckenzie · 05/02/2005 18:42

thanks very much all and especially for your tips Pupuce. I'd left it with the midwfie on friday that if I'd got that far with no pian relief then i would like to continue and have a natural third stage and I would definitely be cuddling etc the baby if not suite feeding yet. I'm having the birthing pool set up in the back of our kitchen where the dining table currently is as we have amtico on the floor so no worries about carpet and it's a part of the house that I'm particulary fond of (leads into the garden).
Should I bring down my feeding chair from the nursery for sitting on do you think when i get out of the pool or should I prepare the lounge and sofa (ie lots of plastic sheets etc) for me to go and sit there quietly away from the pool while await the delivery of the placenta?

TIA for any more advice.

OP posts:

Eva3 · 05/02/2005 19:26

This is very interesting... I have had problems delivering the placenta with both my children and am concerned thir time around, for obvious reasons. My DD1 was breech and a c-section and the placenta took a surprisingly long time to remove - it was all "sticky and in bits". My DD2 was a natural birth, no pain relief until the 2nd stage when she turned and got stuck, and I had to have an epidural, had a vontouse delivery and then had to have the placenta manually removed. What could be the cause of this placental problem, are some women prone to it? My mother had to have the placenta manually removed when she had me... could there be a genetic link..? Has there been research into that, I wonder?

pupuce · 05/02/2005 22:46

I don't know Eva3 - but it is worth invesitagiating!

mears · 06/02/2005 17:47

Eva3 - you would have been given an injection for the placenta second time around and doctors are not good at waiting for signs of separation so often manually remove thge placenta when there is a good epidural in place. The placenta is often manually removed at C/S and they sometimes come out in bits.

mckenzie - it is possible to deliver your placenta in the pool - I often do it. It used to be thought that there was a risk of water embolism (bubbles of water entering your body) however that was a theoretical risk that has never actually happened. We are doing a waterbirth audit at the moment and the third stage has lasted between 10mins and 2 hours. I would tend to say that if the placenta has not delivered physiologically after 30 mins you may want to get out of the pool, mainly because you start to get cold. Better to be nice and warm. Breastfeeding encourages placenta to deliver. At homebirth often the injection is given after an hour. Sometimes it is given earlier if there is heavy bleeding.

Original poster

mckenzie · 06/02/2005 20:15

thanks Mears. My mw is saying though that I'm not 'allowed' to stay in the water for third stage.

OP posts:

pupuce · 06/02/2005 22:00

Will she get you out LOL....
Do what you feel is right at that time... I woud NOT worry about this at the moment.

mears · 07/02/2005 00:09

mckenzie - there is nothing more infuriating than a midwife telling you you are 'not allowed'. The role of the midwife is to give you information to make an informed choice. The information she has given you is actually incorrect. However, even if it was correct it is your choice whether you stay in the water or not. She cannot make you come out. In this instance, if a woman is determined on a course of action that the midwife disagrees with them she should contact her Supervisor of midwives for support to carry out the woman's wishes.

mears · 07/02/2005 00:11

midwivesrules

The bottom of page 18 details what I have said in my last post. It is up to you to decide what you want to do.

bobbybob · 07/02/2005 01:39

I'm sure that I would have been allowed to stay in water for 3rd stage, but I was bleeding a lot and so they hauled me onto dry land and gave my the injection. By that point I was sick of pain and pushing, has my beautiful boy and just wanted it out. Once ds was born I was a lot more open to being given an injection.

My midwives did do the no touching, no talking thing, but it didn't work.

Original poster

mckenzie · 07/02/2005 19:34

thanks again Mears and Pupuce and everyone. I'm definitely going to make sure the computer is up and running with Mumsnet on line when I go into labour so I can refer back (via DH probably) to all this advice.

I think I'll forget about the placenta for now as you say and see what happens at the time but Pupuce is right, the midwife is hardly going to be able to drag me kicking and screaming out of the pool if i really dont want to come out is she ?

OP posts:

princesspeahead · 07/02/2005 19:39

I had a home water birth with a v experienced independent midwife (ie she did masses of home births). I had a natural third stage which took quite a long time, so I did the first hour or so in the pool (maybe a bit less) and then another hour out of the pool (because I got a bit cold). Then it delivered very nicely with NO blood loss! I do remember the placenta taking longer than the baby though

motherinferior · 07/02/2005 19:40

My midwife told me firmly 'we deliver on land' and I clambered out - but by then quite frankly I wasn't that bothered (and was still out of it on gas and air); in the end I had the injection, but it didn't bother me.

princesspeahead · 07/02/2005 19:43

OK just checked my notes...
"22.45 male infant born in water
23.50 helped out of pool, no signs of separation or blood loss, having strong afterpains
00.35 3rd stage complete - maternal effort"

So my memory isn't too bad! 2 hours. Glad I didn't have syntometrine as I did with my 1st two births - made me vomit both times.

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