injection for placenta

[GirlWithTheMouseyHair]

starting to think about the birth plan and I don't know anything about the injection you can have to speed up the delivery of the placenta - does anyone have any pros and cons (interested in personal opinions/experiences as well as medical stuff)

ta

I decided to have it. I have torn and wanted to be stitched as soon as poss. I had no side effects and my placenta was delivered within 5 minutes and was intact.

The funny is that it hurt when she gave it! Like I should have worried about that after giving birth!

I said I didn't think I wanted the injection and would go for natural delivery of placenta....after daughter was born I had no urge to push placenta out and no contractions, so 45 mins later they gave me an injection and whoosh job done. Was relieved by then to get up off the floor and sit on the bed and feed the baby!

purely personal experience but I declined it and then it took 1 and a half hours to get the placenta out
the contractions were agonising and I was knackered
I just wanted to sit and cuddle ds2 and relax - it was kind of a nightmare
would have injection next time i think!

My placenta took ages too - I had a homebirth and tried to do without the injection at first, then I had the injection - not sure it made much difference in my case tbh! (it did come out in the end though...I think the midwife was just about to have me transferred to hospital...)

I had the injection. No adverse effects. Just meant everything was over and done with more quickly. Would definitely have it again next time.

Unlike the other posters so far I delievered the placenta very easily and quickly. Didn't really hurt I was too wrapped up in DD. I guess it varies and some people are just lucky. Pity we can't tell in advance who will be fine.

Oh I should say it was a natural 3rd stage.

I chose not to have the injection (I personally wanted as non-medical a birth as possible), and getting the placenta out was easy-peasy. I didn't have any contractions, or any urge to push or anything - after the birth (can't remember how long after) the midwife just asked me to try pushing and I did, and out it came, intact. I'm definitely going to go that route again with this pregnancy.

I thought about having a physiological third stage both times. First time ended in emergency c/s anyway so wasn't relevant; second time frankly, when it came down to it, I just couldn't be bothered. I'd just pushed a baby out and I wanted to recline and cuddle her rather than go through the hassle of waiting for the placenta. I could justify it with waffle about blood loss, etc., but ultimately it came down to not fancying doing it physiologically at the time.

Hey GWTMH - want the hippyish answer? When you have just given birth, your body releases loads of luuurve hormones, so in theory, all these hormones cross the placenta and up through the cord to the baby, so that he also gets flushed with these hormones. If you have the injection then the placenta gets expelled usually after 5 or 10 mins, so then there are no love hormones for the baby

Probably a pile a rubbish and tbh I think I'd prefer to have the injection so I could start cleaning up (or get DH to) as I have a mild case of OCD.

Unsure why people want the injection so they can get on with cuddling their baby - why can't you cuddle your baby while you wait for the placenta. I've not had the injection at any of my three births. I know it can make some mums vomit. There is also a very small risk with it that the placenta doesn't detach before the contractions close the cervix and then you need surgery to remove it - it is a very, very small risk though.

Babies also get a lot of advantages of having placental blood continue to pump through to them after their born - helps boost their own body's supply - iron etc. If you have the injection you have to cut the cord very, very soon so baby may miss out on all that extra blood. Nothing to do with love hormones through the cord, though.

You'll both release love hormones through cuddling baby skin-to-skin, and even more so if he latches on. The love hormones cause the contractions your uterus needs to expel the placenta - so if you don't want the injection and you've had a natural birth so far, then get cuddling and feeding and enjoying your baby and the placenta will come in from 15 to 90min.

You need the injection if you've had a medically managed birth (because if nature's been interfered with in the first place, it's not possible to really trust it to do what it's meant to do later on either), or if you're bleeding too heavily after the birth.

I had the injection with DD1 - fine and fast delivery. DD2 was a more hippy affair where I "learnt" my lessons from previous birth experience (over managed). Started home birth but was transferred thanks to complications (still happy I got to 10 cms and pushing at home - was lovely to stay there so long). However, I didn?t have the injection. My placenta didn?t come out easily and someone in the room tried to "help" it out with a bit of tugging as it was slow to deliver after the birth. Result was an incomplete placenta that the same person "possibly" didn?t check fully/chose to ignore that it was incomplete and I was left with part of the placenta still inside. This little fiasco left me seriously ill with a nasty infection of the womb, emergency treatment and antibiotics about 4 days later. I wished I had just had the damn injection now and an incomplete or torn placenta is not good.

Hi Lemontart - you see having the injection after a complicated birth is a good idea for the very reasons you mention. Sorry you had such trouble thanks to ignorant staff :-(

Yes, if you have a long or difficult labour, then I understand that it is usually advised.

I had it with my first after a very long 2nd stage and it was a relief that my labour actually ended! I had no ill effects at all.

With my second I just wanted to get out of the pool and cuddle my baby on dry land, so had the jab. This time I felt very sick and had to have another injection to counter the nausea. On the plus side, it did allow dh to bond with her while I recovered.

I has the ingection after DS1, adn DS2

DS1, was a complicated birth, didn't even notice injection palcenta.

DS2 easy birth, had injection, placenta didnt' deliver easily - lots of pulling and tugging form midwife to get it out before my uterous clamped down on it. I still had bits of placenta comming out for a few days, but didnt' get an infection thank goodness. It was actually more difficult delivering the placenta than the baby.

Didn't have injection with DD. I can't even remember why not. but the palcenta delivered easily as I fed her - I think feeding is supposed to contract the uterous, adn expel the placenta.

I think I was just unluky with DS2, and unless you are going for a totally drug fee labour, and you are gong to wait for the cord to stop pulsing before it's cut, etc, you may as well have the injection. They don't ask you, they just do it with out you noticing.

No injection either time. Can't remember how long 1st time took but 2nd was only around 20 mins and felt lovely, after a bony baby it slithers out.
To try and get it moving I cuddled ds1 and offered him a feed: gets all the contracting hormones contrating iyswim. (ds2 was a homebirth btw)

With subsequent babies after pains can be a lot more severe and worsened by the injection - or so I've been told by people how've had it.

Do what you feel comfortable with but some midwives want to speed up the process to free up beds etc.

I had a long and difficult labour and needed to be sewn up. By that stage I'd just had enough, and so I had the injection. I think that this time around, I'll try for a natural third stage, so that DD2 can get the blood from the placenta while it's still pulsing. It's not something that I'm too bothered about though.

Hi - I opted for a purely natural (water) birth with DD. All went really well, but then she (the MW) made me get out of the water to deliver the placenta. DD was placed under one of those heat lamps on the other side of the room. She was crying and crying and all I wanted was to hold my baby, but the MW wanted me to deliver the placenta first. I was absolutely shattered and couldn't even remember how to push. It took me the best part of an hour to get it out, during which time DD was on the other side of the room howling. It was an upsetting end to what had been a very good birth.

Next time I would definitely have the injection and just get rid of the placenta so that I can focus on my baby.

i had the injection and my placenta didn't deliver

so then I had it manually removed which was deeply deeply unpleasant especially after an already long labour

will be going for physiological third stage this time
don't care how long it takes as long as I don't end up in an operating theatre!

so, if you ahve the injection does that mean they have to cut the cord before it stops pulsating? Can I not have it in my plan to wait, whateverm half an hour or something then if it's not budging to have the injection?

I had the injection with DS2 after quite a tramatic birth and my placenta didn't detach either.

The midwife and doctor tried to manual help it along, to no avail and because I was losing so much blood and my blood pressure was so low, I was rushed to surgery to have it removed under GA.

To this day, I never knew that was a complication to do with the injection, even after I met with a guynacologist to discuss issues with the birth. I asked at that meeting why the placenta didn't detach and if it would affect future conceptions and/or pregnancies, I was simply told it was 'one of those things' and that all future births would have to be in hospitals.

Thinking about it now, that meeting was pretty useless and all they were interested in was talking about Downs Syndrome (DS2 was born with Trisomy 21) and the likelyhood of future children and the 'risks', which was completely irrelevant and not at all why I asked for the appointment.

Reading this thread, I shall definately being doing a bit more research on this, especially as we are trying for DS3 currently.

GirlwiththeMouseyHair - I had asked to wait before the chord was cut but it was snipped before I knew what was happening (busy being amazed that I had just had a a baby - even took me quite a while to think to check what gender!)

Pros of injection are that delivery of placenta can be quicker and you may have less bleeding.
Cons are that the umbillical cord may snap (they usually pull the placenta out by the umbillical cord - at least they did in my case anyway). If it snaps then you'll have to have a manual removal of the placenta - this is very umpleasant if its done without painkillers (i.e. if you didn't have an epidural during the labour/birth) - labour pain is nothing compared with having a man stick his hand and arm into your uterus and start rummaging around for the placenta! I speak from experience having opted for the natural delivery of the placenta (leaving cord to pulsate, putting baby to the breast etc etc) in my birth plan which was overruled by the busy hospital staff who needed the bed and cut the cord straight away and stuck the injection in while I argued! I would definitely fight again for the natural delivery next time rather than endure the pain and subsequent problems of a manual removal of the placenta if they mess up on their 'managed' delivery. However, I think you have to be prepared to allow a managed delivery if the placenta doesn't deliver within a certain amount of time (e.g. 45 mins) as there is a risk of haemorrhage which is life threatening.

I'm another who was given the injection, retained the placenta and, having delivered naturally and vaginally, found myself being given a complete spinal block and wheeled into theatre to have it removed surgically.

I think retained placentas are a pretty common side effect of the injection. I also think, because I'm a cynical old cow, that the injection is given as standard hospital procedure because placenta-usually-pulled-out-in-20-minutes-and-then-woman-out-of-delivery-suite is a better outcome for the hospital clock watchers than wait-up-to-2-hours-for-nature-to-take-its-course. But like I say, I'm a cynical old cow.

The experience of the injection and its aftermath is a major factor in me planning for a homebirth with independent midwives this time around...

If you do decide to have a physiological third stage, I would strongly advise you to have your birth companions absolutely on the message with it. As you go into transition, your birth partner says to the midwife: physiological third stage! As you start pushing, birth partner says to the midwife: remember! physiological third stage! As the baby crowns, birth partner says to the midwife: remember! physiological third stage! As she approaches with the scissors, your birth partner says "stop! we're waiting for the placenta to deilver before cutting the cord!"

Noone will read your birth plan if you are hospital, and even if they do, chances are that the midwife who talked through it with you will have gone off shift by the time you deliver - you really need to have an advocate there whose job it is to make sure that everything goes according to your plan not their procedure - maybe even worth hiring a doula for peace of mind.

And my IMs this time are indeed suggesting that we go for the phsyiological third stage. If after an hour the placenta hasn't delivered, they have to suggest the injection. They say that I should be able to keep discussing it with them for a good half an hour or an hour, by which time chances are it will have delivered naturally If it doesn't come out, then go for the injection. And if the mother starts bleeding majorly, then they can stop it in minutes with the injection. Seems to me that a physiological third stage with the injection in a box waiting to be used is the best of all worlds.