Previous retained placenta, but hate the idea of another hospital birth

[PhDMum]

With my first child, I had a retained placenta that required manual removal in theatre with an epidural. I strongly suspect that the fact that I was induced contributed to the situation, but my consultant insists that induction has no effect on retained placenta rates. I was induced at what the hospital insist was week 41 (2weeks over). In fact, I am certain about the conception date, and was only 1week overdue at the time. (I would never consent to induction again except in the direst of emergencies).

I am currently 18wks pregnant with my second child, and have been told that I have to go in to the consultant unit for this birth. The consultant has given the reason that though retained placenta is normally only found in 1/200 births, because I have had it happen once, my chances are now more like 1/3 of it happening again. For reasons of safety he insists I go to the main hospital. I really don't trust his statistics, as they don't tally with other info available online. The consultant unit is over 40 miles from my home, and my partner can't drive. Men are not allowed to stay overnight, even if their partners are in labour. I desperately want my partner to be at the birth of this child, and I know that if I am forced to go to the main hospital then that is unlikely to happen. I want to have this baby in my local, midwife-led unit (40 miles from main hospital and Consultant unit), but I have no idea what the true level of danger to myself or my child would be if I insisted on this, or if I can demand it - they seem pretty certain that they can dictate how and where I give birth-

Can anyone help?

ok so i have caught up!

well with me my placenta had come away from wall but was sat in my uterus so not 'officially' stuck... where the cord had broke and my rubbish attempt of pushing high on pethidine it was just sat there going no where!

it was eventually pulled out by doctor in the delivery suite was agony

i think what scares my dh so much is if i have another PPH it scared him and must have been frightening for him

like some others have said i think i will opt against the injection as perhaps if i had not had that my cervix would not have started closing etc and made the whole thing more traumatic.

i will also be asking like pavlov to have the cord left well alone and feed my ds etc

as much as i would love the home birth (can you tell from the last post!) i will be going in but leaving it as late as possible.... perhaps if i lived next door or very close to hospital it wld be different but we are about 25 mins drive dont want a blue light trip in that amount of pain

I had retained placenta with dd2 who was born at 38 weeks.

Had to have MROP in theatre it was AWFUL. Managed a quick labour with gas and air and one shot of pethidine for the pushing part only to have a spinal block to remove placenta, missed dds first feed, clothes, cuddle etc.

I lost loads of blood due to them taking far too long to get me into theatre and ended up with a blood transfusion and a 5 day hospital stay.

Despite my mum having RP with both me and my sister and my sister having it with one of her three dcs I was told it has no family connection.

I asked about future births (we are ttc atm) and was told only thing they could do is not give the injection for the placenta.

I would not have a home birth anyway - just not my thing and have health issues- but definitely not if there's a chance of RP. I would've bled to death if I'd been at home.

girlsyearsapart

like you my dd2 was born at 38 weeks! and also like you had speedy birth then pethidine just before she was born. i remember nothing just like you and it upset me more than i had realised. only recently that i had midwife go through my notes at home with me that i could draw a line under it all type thing....

maybe worth you doing that on the next baby? good luck with ttc no2

pavlov, madmissy and girlsyearapart - I feel I should mention that I had a planned physiological 3rd stage with DC3, as I had done with DC2. Unfortunatley it didn't help, so unless it's just a case of cervix closing up quickly it's not a sure fire way of avoiding an MROP and PPH. The one benefit was that I got the chance to feed DD2 for a good hour before they realised things were going wrong and I went into theatre knowing she was ok. I really feel that helped with our bonding.

Good Luck to all of you.

swissmiss thanks for that, i understand that it reduces the chance, but does not eliminate it, so will go in with my eyes open. if it is going to happen with a natural third stage, it will happen anyway, but i will have some element of control, which i felt i did not have last time. Sorry it happened twice to you.

same here at least this time around i am hoping to be aware of whats happening and determined to remember my babys first moments

I understand what you mean about having some element of control and not wanting to miss out of the first moments.

I wasn't making myself too clear late last night. I only had MROP with DC3 after physiological then managed, incl pulling on cord and snapping it, 3rd stage. DC2 physiological 3rd stage went fine. And honsestly in spite of what I've read on the other natural vs. managed 3rd stage thread I don't even remember the passing of time between either DC1 (injection) or DC2 (natural) births and placentas arriving as I was so engrossed in the babe I was holding in my arms. I have no clue how quickly it all happened either time. I'd have to get a copy of my notes for that info. Not that I'd trust everything written in them anyways .

Sorry for thread hijack PhDMum

Thanks madmissy we're trying for number 3 - dd1 was born on her due date and didn't have RP.

I'm hoping to avoid it again if we're lucky enough to have a 3rd so if anyone has any info I'd be glad to hear it.swissmiss I know what you mean about the 3rd stage- really once you have the baby safe & sound they can do what they like and the pain somehow seems irrelevant but I'd rather be feeding than in theatre.

They did put dd2 on my chest for a cuddle but my sister was holding her onto me. I was so out of it from losing blood/pethidine that she thought I was going to drop her brand new niece on the floor..

You are right about preferring to be feeding than in theatre. Sorry to hear about you being so out of it from pph and pethidine so you missed those moments. As I had a water birth with G&A I hadn't thought about the being out of it aspect.

I'm finding it slightly that prior to DC3 I'd never even heard of retained placenta of any type and now there are at least 3 threads on the subject. Weirdly I feel I can be more frank about what happened on a thread where others have been throught RP than on the general ones.

I had only heard of it because my Mum and sister had it both times. It has to be a family connection surely??

Unlike OP who was past due date I've been told that chances of RP are greater if baby is born earlier than 40 weeks as placenta designed to last 40 weeks.

My sister had it with her 1st who was 9 weeks prem but not with 2nd or 3rd who were late. Mum had it with both of us and I was 4weeks prem but I don't know about my sister.

sounds like you might have a case there about the family connection. interesting point about increased risks if born early. fwiw all mine arrived during wk 40, RP or not.

i've no idea what my mum had, other than DB2 was a c/s! no sisters to check with. i must remember to make sure i mention it to my DD's in the future.