Placenta delivery if the cord snaps.....

[lauraloola]

My friend gave birth 5 weeks ago and everything went brilliantly, no tears, fast labour, healthy baby.

But, once the injection for the placenta had been given she heard the midwife say 'oh shit' and then the next thing she knew was some doctor had his hand inside her and was pushing her stomach trying to grab the placenta.

A friend of ours had the same thing a few years ago and can not anymore children due to this.

Is this really the only way the placenta can be retrieved? Do cords snap often or is it due to it being pulled too hard??

There is the Hinchingbrooks trial which looked at the results of expectant versus managed third stage, also an article here which may be useful.

Manual removal is horrific, how are both of your friends now?

The MW pulled off both my cords from my DTs. Luckily I managed to push out the huge placenta by myself, after they had hoisted me into a squat on the bed. I was so cross

I meant to write Hinchingbrooke (incase you wanted to look it up).

She wasnt offered to push it out herself which I find odd. After a while of him trying with her having g and a they took her to theatre for an epidural. My friend who delivered recently is ok about the situation I think.

Our other friend cannot have anymore children because of this.

It got me thinking because I want a 2nd child this year and after being on MN for some time now I want to be clued up about everything that happen IYSWIM.

Thanks Barking - Thats interesting. I am going to go for a natural 3rd stage in my next pregnancy as I hope the risk of this happening is eliminated.

I just dont understand the need to pull that hard. Surely if you have the injection it is just faster then a natural process and comes away on its own??

I think the synotonicin (sp?|) allows for a short window for the placenta to be expelled, and I think there lies one of the problems - the uterus can then clamp shut and the placenta can be trapped behind it.

Oh dear my spelling is truly awful, it should be syntonocin injection. I think.....

my consultant also snapped the cord...his response was "oh, dear, that always happens to me..."
didn't really notice him pulling out the placenta by hand after he had already manually turned the head of dd2 during delivery...

I had controlled cord traction with two of my deliveries (I think that's what it's called) - the first time I'm not entirely sure why actually - dd2 had been in a bit of distress so I wasn't really focusing on that end of proceedings! I think it was because it was taking it's time about coming away but after 8 years I can't remember! The second time I do know why - it was because I was bleeding very heavily and they wanted the placenta out asap to help the uterus contract. The midwife told me very firmly not to push - I was more than happy to comply and it came out very easily. In both cases it was done by midwives with many years of practice behind them and I had no problems. The consultant who said that always happened to him should have guessed by then that he might be pulling too hard!

If you have active management more often than not you are given syntometrine...the ergometrine part can result in the cervix closing. So you have a fairly small window of opportunity to get placenta out which means (unfortunately) it can't be managed like a physiological...

Anyway, cord snapping...nightmare. Especially after lovely birth. Your heart sinks for so many reasons!

Yes my heart sinks reading this - I had a manual removal a few months ago with DD2. After a lovely birth I was on top of the world - had a managed 3rd stage and felt the cord snap and the MW's look at each other as one of them said "oh sh*t"...before I knew it I had been kicked out of the birth centre & was down in theatre with epidural and sedative. Granted, the Dr was lovely, but a slightly surreal experience during the 25minutes it took with his entire arm inside me standing on a box pushing down on my tummy...I think it left me more traumatised than I like to think. And I think about it often.

Brownmia and MimiD, this happened to me too 7 years ago and I found it very hard to get over. I think only women who have gone through this procedure understand what I mean by that.

It took an hour of manual removal to retrieve the placenta. Nobody has ever told me why and I couldn't bare to go back to the hospital to discuss the incident. Reading this thread it sounds like they snapped the cord. The experience of manual removal is barbaric, veterinarian, violent even. I had terrible flashbacks for a long time.

Have you heard of the birth trauma association ? It may be helpful. I phoned them a few months after the birth and found it so hard to articulate what had happened, especially after the midwives, health vistor and dr were so dismissive, they were very good at listening.

I had read there is a 50% chance of retained placenta happening again and was terrified of getting pregnant again, when I did I luckily had a very understanding midwife for my next birth and had a c-section.

I had the ingection with DS2 (won't try to spell synotonicin) And my uterous clamped shut, making delivering the placenta more diffucult than it had been to deliver the baby.

I'm horrorfied by what I'm reading on this thread.

I went for a natural 3rd stage with my 3rd labour,because of this and all was well.

Somtimes I think things should just left be left to happen as nature intended, but I'm sure there is some good reason I don't know about that medics like to manage the 3rd stage medically.

LynetteScarvo, I think it maybe a time issue

Sorry, that should be LynetteScavo, my eyes are melting! I spend far too much time on my computer.

I think there are a number of reasons why a managed 3rd stage has become the norm. I think the original reason may have been that by getting the uterus to clamp down faster you'd help prevent excess blood loss from the placental site. Syntocinon (?) should do that of its own accord, and I'm not too sure why they felt the need to add the ergometrine to encourage the cervix to close - that seems to be the bit that REALLY causes the clock to start ticking on getting the placenta out.

I suspect that time pressure does have something to do with it. What makes me even sadder, however, is that I've heard so many stories of women wanting a physiological 3rd stage but having MWs that didn't know how to handle one appropriately - they still applied traction to the cord, or refused to allow the mother to hold or feed the baby until the placenta was delivered thereby preventing the release of oxytocin (natural syntocinon) which usually comes in barrels when the baby suckles but not so much till then .

A managed 3rd stage can be a useful tool, but it seems to have become standard practice and I'm not sure that's a good thing.

I thought that the Hinchingbrooke report highlighted there was minimal difference between managed and expectant 3rd stage and pph postpartum (haemorrhage)?

That was the reason I managed to argue for a c-section as I just could't bare having a manual removal again.

I haven't got the info to hand but I thought the trail studied over 500 births.

I mean trial

Get off that computer! ()

In your shoes I think I'd have done exactly the same thing. Any time I've heard it discussed its sounded barbaric

Just had a look - the abstract of the trial concludes:
"FINDINGS: The rate of PPH was significantly lower with active than with expectant management (51 [6.8%] of 748 vs 126 [16.5%] of 764; relative risk 2.42 [95% CI 1.78-3.30], p

Thanks Tangle I wonder where I got my findings from, unless there is data within the trial comparing rates of retained placenta rather than PPH?

I was terribly naive about my first birth and didn't do any research on the 3rd stage. I do remember on my birth plan asking for just the midwife to be in the room during labour and them not taking any notice of my request and begging that I allow the trainee to perform internals, some places must take dreadful advantage of the fact that a woman in labour is incredibly vulnerable to this.

I have no idea whether she was the one that (maybe) pulled the cord. I remember them telling me to stop pushing at the end as they weren't ready, though by that point I had been in labour for over 30 hours and had had 3 different midwives, I was so exhausted and was just looking forward to meeting my baby.

Ros3 thanks for that link and your support. I know what you mean about HV's, GP etc being dismissive - all I got was a passing "oh thats a shame" when all I really wanted to do was talk to someone about it. Absolutly agree with your descriptions, violent yes; my ribs were bruised for weeks, vetinarian yes; immediatley afterwards when the dr was showing me my mangled placenta I even said something like "jesus this is just like something out of 'All Creatures Great & Small' with blood up to your armpit".

Glad to hear you went on to have another pg and I can appreciate your decision to have a c-section. I suspect it happens more frequently than the 2% figure the MW quoted me and/or that it would have happened regardless of managed or natural as untrue. I am now off to read the Hitchingbrooks report.

I am shocked that so many women have been through the same as my friend. I am lucky that the injection worked for me and my placenta came out ok.

This has scared the hell out of me though and if we do have more children I am going to opt for a natural 3rd stage.

I saw my friend yesterday and I think she is putting a brave face on it IYSWIM. I think in a few weeks when everything settles down after the birth it will hit her - Did this happen with anyone? Or was it instant that you were upset and angry about what happened?

Do you have any advice I could give her?

I had a problem with dd1. All went great but then the placenta wouldn't come out and the cord snapped and all contractions stopped. I had the injection but until reading all your posts did'nt realise quite the effects of it. They tried to get me to push it out but I just lost lots of blood. They then tried manual removal giving me gas and air but it hurt like f*. After about an hour they took me to theatre for a surgical removal under general anaesthetic. I was groggy for about 2 days and couldn't get up easily as I had to have 4 pints of blood transfused.

They said there was a 50% chance of it happening with baby 2 so a home birth I wanted was out of the question, but thankfully that all went really smoothly with no problems. My main focus was that dd was ok.

Lauraloola, I think I was in very deep shock from day one, I kept asking everyone why and how did this happen, I tried to make sense of it, I would talk with other new mums on the off chance that it had happened to someone else, the only other mother I knew of was the woman who gave birth after me and we ended up on the same ward, she said that after her experience she didn't want to have any more children, I hope she found a way through it.

My advice would be to send her on here, I found most of the health professionals very unsympathetic. Just to be able to talk with other women who have gone through this and come out the other side could be incredibly cathartic and hopefully she will get some great support and information.

I was minutes away from going to theatre for a manual removal of the placenta after I had ds. I got him feeding though. I didn't know that this helped until reading this thread so thankyou and thank ds! It put me off having any more though.