Placenta delivery question....

[WellyBelly]

Am hoping for water birth and have been told that it is standard procedure to have a natural placenta delivery afterwards. My question is IF the water birth doesn't go to plan/happen should I ask for the assisted delivey or just stick with doing it au-naturel? I don't really have any major preferences as such and am not sure what the pros and cons are for assisted versus natural....if anyone has advice I'd be very grateful.

It's entirely up to you but I understand from my MWs that if you are going to go for assisted, you will need to have the injection as soon as the baby's shoulders have delivered...so they will need to know in advance what your wishes are.

I was advised after dd to have the injection to assist delivery as I lost quite a lot of blood and it helps prevent further bleeding. I guess this is one of the pros. I would have had it anyway (and did with next) as just wanted to get it out quick as poss so I could get on with have a bath/tea & toast/holding baby.

My advice is go for natural. Allow the cord to stop pulsating before it is clamped and cut, put the baby skin to skin, sitting up or reclining, not laid flat on your back, breastfeed baby if s/he is interested and let the placenta come out on it's own, no injection, no cord traction.

Why? Because there is around 250mils of blood in the cord that your baby will be better off having in his/her viens and not left behind in the cord/placenta. This can reduce the level of jaundice in the first few days. Allowing the cord to stop pulsating before it is clamped and cut also gives your baby time to start breathing slowly, whilst the cord it still attached baby is still getting oxygen from the placenta, babies who are allowed to start breathing in thier own time like this are less likely to go blue, suffer respiritory distress and need to be resussed. Finally, the injection to expell the placenta is a synthetic hormone, not a real blast of oxytocin, it does not trigger the same chain of endorphin releases that a natural third stage does, and this can have an effect on your over all endorphin levels and hormone balance. Michel Odent explains it in "Birth Reborn", I'd quote it for you but my copy is in the loft!!

Hope this is helpful,

Monkies

I'd go natural if they will let you. There is a risk that they can pull the umbillical cord off if they do manual cord traction. It happened to me and the way they deal with it isn't nice - expecially if you've not had an epidural!

Thanks so much for the advice, just as a matter of interest has anyone heard of or had an assisted delivery after a water birth or is this just not feasible? Sorry to sound like moron...
Also if you go with natural delivery does this affect the post-birth bleeding? Thanks again.

"if you go with natural delivery does this affect the post-birth bleeding?"

I bled a lot less after my natural 3rd stage (HB with DD2) than I did after synto and cord traction (hospital for DD1).

Monkies

I went natural with DD3 and it was fab. Green Monkies has given all the technical reasons why.

Those that said they just wanted the injection to get it over and done with and get a bath. I think I delivered my placenta after 25-30mins. It certainly did not feel like 30 minutes. It felt like a couple of minutes. You are unlikely to take a bath in that 30 minutes. You will want to b cuddling baby. Feeding baby. You can do all of that before the placenta is delivered, and before the cord is cut.

You can be given injection if a bleeding problem develops. I had it on standby as I had previously had a retained placenta (which is a risk of having the injection) - but didn't need it.

WRT the blood loss. There is a certain volumeo fblood your boody needs to expell after birth. If you have the injection, your cervix closes up very quickly and it gets trapped in your uterus - too be lost over the next 4-6 weeks. If you have a natural placenta delivery a lot more blood is lost over before the cervix closes - so you leave it inthe delivery suite and the lochia tends to be a little less heavy. I know which I would prefer .

Bit off topic but I had the injection with DS1. Midwife was so busy fannying around with the syringe that DS crowned and popped out without her paying any attention....