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 had the jab, it took a very long time to work and they were almost going to take me to theatre when it came out. It was horrid.

thanks so much for this girls - we're planning on a homebirth so I'm hoping the midwives will be pretty relaxed about allowing a set amount of time for natural delivery...but I didn't realise so many people ended up having a retained placenta after having the injection so must keep that in mind if we end up in hospital

onward - you really are a cynic

There are 2 types of injection - syntocinon and syntometrine. Syntometrine is composed of syntocinon and ergometrine and it is the ergometrine which will clamp down the cervix and make you feel sick. Syntocinon is much slower working and less potent and rarely causes these problems.

From a midwifes point of view, when baby is born it goes straight to mum for skin-to-skin, and then when the cord has been pulsing for at least a few minutes (research suggests that for baby to get the maximum benefit the cord should pulse for at least 3 mins), I will suggest we cut the cord, give the syntocinon and then deliver the placenta by controlled cord traction. I dont remember when last I had a retained placenta, its been at least 2 years (which equates to nearly 400 births), so using this method its not at all common. If someone wants physiological 3rd stage - no problem, but there is a slightly higher risk of heavy bleeding.

I would only use syntometrine if the woman has a higher risk of PPH, and even then, if you dont wait too long for the placenta, there is very rarely any problem with getting it out.

bloody hell I wish they HAD suggested injection after an hour in my case
I was desperate for it but under the mistaken impression it was 'too late' as hadn't had it at the time
and they were determined not to make any suggestions to compromise my birth plan
what a cock up LOL

I had the injection (midwife suggested it would be a good idea as there was a lot of blood when my waters broke).

It was fine. Only problem I noted was the fact that she was so busy getting the injection ready that she was no where near me when DS crowned. I tore badly and I blame the injection

I had the injection with my first birth and i cannot know for sure if it caused it, but my placenta did retain and after 1 & 1/2 hrs of various people trying to get it out i was taken to theatre for a spinal block and a manual removal (which i can honestly say was the most unpleasant experience of my life) It took a further 1 & 1/2 hrs to remove it (in pieces) and because they weren't sure they got it all out i was put on strong antibiotics incase of infection..

I had my ds in June this year and after finding out through a friend of my mums who's a mw that the injection 'can' actually make the placenta retain i asked every mw i came across in my pregnancy what i should do this time. They all agreed a physiological third stage was the best option, they all agreed it can make it retain (why aren'twe offered this information when discussing our birth plan??) And i was even told if it didn't come out after an hour i could still have the injection. I had no idea with my first that you could have it after an hour! why do they give it to you straight away?? I'm pleased to say i delivered my placenta this time naturally with no probs atall and it took about 10 minutes. I wish i'd been more clued up about the pro's and con's of the injection the first time round, i just thought everyone had it and it sped things up.. i'd definetly have gone for a physiological third stage first time round if i'd been more informed.

i had the injection, 10 minutes later I coughed 3 times and my placenta was out. wish i could have coughed dd out!

First time - I had the injection as I was worn out after a long labour and couldn't be bothered to argue/wait by then

2nd time - they recommended it due to my anaemia.

It was fine both times but I think it is probably best avoided due to the risk of retained placenta etc

I had the injection and placenta slithered out in 6 mins. No side effects and DS had to have cord cut immediately due to meconium in waters - and his cord fell off beautifully at 4 days.

I've been led to understand that SOME of the problems that women in the UK experience with physiological third stage (like the incomplete delivery of the placenta mentioned here in one post) might be down to midwife inexperience..... understandible given that around 95% of births (or is it higher?) involve a managed third stage.

I had managed third stages after all mine as had complicated births, but was recently at a friend's birth when she had a natural third stage. The placenta took 2 pushes to get out - was very quick. It was all done and dusted in ten minutes. VERY little bleeding after the birth too.

Had the injection both times. With ds1 the placenta came out while he was rootling around my boob (so within 10 minutes). With ds still nothing after an hour and a half. Queue 10 minutes of MW levering herself at the end of the bed. Thankfully it came out in tact, but I will not be repeating the injection with nr 3. It just felt really wrong what she did to get the placenta out - scared me. My lasting impression of that labour is that they were in a hurry to get me out of that room and get the next person in and therefore didn't give proper care and attention. Was never warned of possible side effects. It was presented as the quick and easy way of finishing everything off so we could enjoy our baby.

Haven't read the whole thread, but with my second I chose not to have it. It was a lovely natural birth with me upright and active and very much in control. Then the flipping palcenta wouldn't deliver. It can take a while if you don't have the injection, but the midwifes here clearly weren't v experienced in doing without and got pretty twitchy. I ended up getting a catheter in to drain the bladder to get the placenta out. of the whole labour this ended up being the biggest deal as I was picking up of the MWs anxiety.

After giving birth, I'm just desparate to cuddle baby, eat, have shower and get home the last thing I want to do is for this to become a bit deal.

So third time round I had the injection and (like my first time) the placenta popped out without me even thinking about it.

This is a brilliantly informative thread for me. With my first delivery, I had the injection, uterus clamped down very strongly, problems delivering placenta, narrowly avoided theatre trip (thanks to excellent and decisive registrar!) but probably not all placenta out as got infection and had prolonged bleeding after birth (8 weeks) and strong antibiotics. With my second delivery there was no such problem: injection given without me really noticing, placenta delivered easily and quickly. Am now approaching third delivery and I've been asking midwife about benefits of injection versus physiological third stage, especially with view to avoiding problems of first time. But I wasn't getting any real information. Now, however, I can ask about whether syntocinon or syntometrine would be used, and about waiting for an hour first etc ... brilliant! Thank you so much Mumsnetters

DS had to have te cord cut straight away as he had to go to SCBU (prem), and I didn't want the injection. Took ages and I was bleeding heavily, so eventually I had it. Had to have some cord traction, but it did come out. But I was really, really, really sick with it.

I had the injection (despite my birth plan saying I didn't want it) with DD1, it was a classic over managed ventouse delivery, baby yanked out, cord clamped and cut instantly and simultaneous injection and cord traction. My placenta was allegedly intact, but I did have to have some "clots" manually removed (the Dr just shoved her hands inside me and rummaged about ) and I did get an infection (inside, not in my stitches) which needed antibiotics to clear. I also bled out aprox 850 mils (which is a serious bloodloss) so had to stay on an synto drip for what felt like ages after DD1 was born. I bled for a good 6-8 weeks.

I had a homebirth with a physiological third stage with DD2. The cord pulsed for about 15 minutes and once it stopped we clamped and cut it and I had half a dozen (if I'm honest, very painful) contractions and it slooshed out without me actually having to actively push, but I was sitting upright (cross legged!) rather than lying down like you tend to be in hospital. My bleeding was much lighter, estimated bloodloss a birth was about 200 mils, and long term I only bled for about 3-4 weeks. No infection that time either.

Michel Odent is not in favour of the injection. In Birth Reborn he does go into detail about how the injection can interfere with the release of natural oxytocin, and how the synthetic oxytocin only prompts the uterus to contract, whilst the natural oxytocin does more (I can't remember it exactly and I can't find my copy of the book to quote it!).

I have a (totally unfounded, unproven) theory that the research that states that the injection reduces bleeding was done in the 70's when virtually no-one breastfed and babies were whisked away to nurseries within minutes of being born. With no skin to skin and breast/nipple stimulation the uterus wouldn't be prompted to contract and this would lead to bleeding. So we started giving synthetic oxytocin to replace that which isn't being released due to the lack of stimulous.

If we do it "natures way" and leave the cord alone (I also wonder if allowing the blood to transfer to the baby "empties" the placenta making it detach easier) until it stops pulsating and put the baby to the breast as soon as possible after birth that the placenta detaches and the blood vessels in the uterus clamp and this reduces bleeding to a minimum. After all, why would we evolve a birthing/placenta expelling system that is likely to make us bleed to death? It's far more likely that if we do it the way it is designed (by evolution/nature) to be done that 9 times out of 10 it will work just fine.

So, for me, go for physiological third stage, including leaving the cord to stop pulsating before clamping and cutting it, with the injection on standby just in case things don't move on thier own!

i had the injection to remove the placenta a week ago today and 2 days after i lost the feeling in my right thigh, at the same time i had a stinging sensation which was really painful, the doctors didn't seem to think anything was wrong, has anyone else experienced this and if so do u know if it is a side effect? i still have no feeling in my thigh but have the need to scratch when it feels itchy if that makes any sense. This also happened to my scar and bottom of my stomach when i had an emergency c-sec 2 years previoulsy. would appriciate any comments left, many thanks kerry-louise.

DS1 had the injection and spent the next few hours chundering as a result

DS2 opted not to have it (strange that) and it took 40 minutes for the placenta to appear, by which time I must admit I was a bit bored of waiting. But there were no contractions, I just stood up and coughed, and out it plopped into our old washing up bowl (at home, I hadn't brought this to hospital for the purpose).

Very interesting thread, this.

I posted earlier today about the fact that my midwife is urging me to have DC2 at the local MLU not at home (DD was born at home) because with DD I ended up transferring with alleged retained placenta.

I tried for two hours to deliver placenta naturally. During this time I breastfed, squatted, pushed, had my tummy prodded, the cord pulled gently, you name it. Nothing. So they offered me the injection, and I accepted. Spent the next 2 hours or more in total agony with one long non-stop contraction which was a million times worse than giving birth. They transferred me in an ambulance, hooked me to a drip and waited another couple of hours for an anaesthetist to become available during which time nil by mouth as I was supposedly being prepped for spinal block/theatre.

Before wheeling me off to theatre, a doctor offered me some gas and air and had an exploratory feel and actually the placenta had detached and was "just sitting there".

So now I'm having to fight for "approval" for a homebirth because I've been told I'm at high risk of it happening again.

I maintain that my placenta was slow to deliver but not "retained" and I think it was in large part due to having a very full bladder (struggled to pee in labour) and a long labour.

In theory I've said I'll have the injection straight away next time but actually this thread is making me think I'll try for a natural 3rd stage again.

Am very unsure!