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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Natural/ physiological 3rd stage - what's it like?

31 replies

Squarah · 30/12/2009 13:33

I'm aiming for a VBAC in about 6 weeks after an EmCS at fully dilated as my DS was malpositioned (deflexed OP). I'm feeling confident about managing it if this LO is in the right position this time but have had to really think about my birthing options this time.

Last time we were hoping for a natural third stage (i.e. no injection) and wondered about the same again but I wondered what it was actually like - pros and cons and would you recommend it??

I was hoping it would give us more time with our DD in those precious early moments but does it actually prolong the pain and keep the MW loitering?

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sweetkitty · 30/12/2009 13:39

I have had one injection and two natural third stages. I would say the placenta plopped out after about 10-20 mins each time. I was too busy cuddling the baby to really take much notice. After the pain of a big hard head coming out, it's really nothing more like a big squidgy clot IYSWIM.

The reason I chose a natural third stage second time around was that with the imjection they have an hour to get the placenta out, after that the uterus clamps down and you have to go to theatre, the MW was on the phone to the theatre when the other one managed to tug it out, but it has it's pros too in that it prevents a PPH.

I would have a read around the pros and cons and decide for yourself.

RollBaubleUnderTree · 30/12/2009 13:50

I have also had one managed and two natural. Was not a decision I really made, I just went with the flow but needed the managed 3rd stage the first time as I had a epidural. I was so pre-occupied each time I did not really take much notice but there was no real difference and not any pain.

There are pros and cons for both but as my midwife said why introduce drugs into a birth is there has not been any all the way up to that point?

mama2moo · 30/12/2009 18:33

Im going for a natural 3rd stage this time but only because friends of mine have had retained placentas recently from the cord snapping.

I spoke to my mw about it the other day and she was really positive. Im going to give it about half an hour, if nothing has happened then I will have the injection.

With dd I hadnt found MN so didnt really know about the other options out there. Good luck with it

thisisyesterday · 30/12/2009 18:38

it isn't really "like" anything, iyswim?

i can tell you there was zero difference for me between having the injection and not having it.l
had the injection for the first 2, but didn't for the third as midwives didn't get there in time.

just delivered it naturally after about 25-30 minutes i think,

drosophila · 30/12/2009 18:43

Injection made me vomit. Two subsequent natural ones and it is just as sweet said. One advantage I noticed was that my subsequent was far more managable the weeks after the birth. With my first it was very heavy and went on for ages. With the two natural it was just like a normal period.

Fibilou · 30/12/2009 18:52

Lots of interesting stuff here about natural 3rd stage www.radmid.demon.co.uk/pph.htm

I'm opting for natural 3rd stage (unless medically contraindicated) and for the cord not to be cut until the placenta is delivered. There seems to be a school of thought that early cutting of the cord does not help swift delivery of the placenta.

Horsiemummy · 30/12/2009 21:25

just a word of warning. i wanted a natural third stage and it was in my birth plan, more to do with the baby getting all the cord / placental blood than any risk / benefit for me.

BUT

once DS was born he was placed on my chest and the MW just went into autopilot. she handed my DH the scissors to cut the cord and got him to do it right away. - i was too overwhelmed by holding this tiny baby to realise what was happening - after this the MW then said (in an irritated voice " oh right - you are doing a natural third stage are you?") to which i said - well if the cord is cut i dont see the point so i allowed them to give me the injection - which make me immidiately vomit!.

i was cross by this as having had a lovley natural delivery - i then had to have this hormonal interference that was not needed. just because "most" people take the injection

needless to say - my DH is under strict instructions this time to refuse to cut the cord until all pulsations have stopped.

just something to be aware of if you opt for a natural third stage.

Original poster

Squarah · 31/12/2009 17:49

Hmm looks like it's a matter of luck as to whether it happens anyway and whether it's worth it. To the people who had a natural third stage did it change how long you were kept in the room with your babies or feel any more special/ different?

OP posts:

Fibilou · 31/12/2009 18:08

also there's less risk of RP with a natural 3rd stage (but greater risk of PPH) I'm booked in a birth centre so if I manage the whole delivery there but get an RP I would end up being transferred to a hospital which is obviously not what I want.
That's the main reason i'm opting for it but also that I want the cord blood transfer to complete.

ChasingSquirrels · 31/12/2009 18:20

1st birth - had injection, placenta came away pretty fast - it's not something I have any memory of.

2nd birth - didn't have injection, placenta took about 1h40m (so about 7 times longer than the 1st & 2nd stages combined). MW was not at all concerned and let my body deal with it. Before MW arrived (an hour after the birth I cuddled & bf baby, after I did a bit of the same and then moved to the bathroom and delivered placenta in loo. I was more stressed about the time it took than she was - mainly because I didn't really want to have to go to hospital for me after such a straightforward birth.

chocolaterabbit · 31/12/2009 18:26

I had a natural third stage and it was lovely. Sat on the side of the birthing pool cuddling DS and being cuddled by DH just waiting for the cord. It just felt peaceful and relaxed after the rshing around and injection I had with DD. Also bled less after the birth and it felt as though feeding established better and I was generally less tired.

Like other people though, I went for it on the basis that if nothing happened after an hour or so, I'd have the injection.

earlyriser · 31/12/2009 18:32

With dd i opted for a natural third stage but the placenta was taking ages to come out. the midwives thought it might be because i had a full bladder, i was unable to produce any wee though so they had to fit a catheter (ouch!).

With ds, it looked like i was bleeding lots after so i was given the injection before getting out of the pool, placenta plopped out no problem.

So although i was quite militant about having a natural third stage, if i gave birth again, i'd opt for the injection

norfolkBRONZEturkey · 31/12/2009 18:34

I found it fantastic
Less stressful and less painful. I got to bond with dc4, eat a sandwich and feed him then worry about delivering the placenta.
I didnt get any afterpains and the bleeding only lasted a few days. I've been raving about where possible ever since as I wish I had known sooner

ILikeToMoveItMoveIt · 31/12/2009 19:05

I had a natural 3rd stage after ds2. The placenta took about 45 mins to deliver. After I had delivered ds I didn't have any further contractions and the placenta sort of sat at the entrance to my vagina for a while, but there was no pain. So I sat on a bucket and it plopped out by itself. No pain no fuss, simple as.

craftynclothy · 31/12/2009 19:14

1st time round had the injection.

2nd time round I had a natural third stage (I actually lotus birthed - where you don't cut the cord at all) despite having had an epidural so other interventions don't always have to prevent a natural third stage.

It took 50-odd minutes to deliver the placenta 2nd time round though tbh the midwives (my independent one and the nhs one) thought it had probably detached and told me to try giving a little push and it came out so had I not been lying on a bed it might have been quicker. I also didn't really notice it was that long because I was too busy holding a new baby . I wasn't aware the midwives were loitering, I think actually they did a little paperwork iirc.

Like Drosophila I had less bleeding afterwards, just 5 days as opposed to about 5 weeks with my first.

mathanxiety · 31/12/2009 19:15

Had 5 natural third stages. They encouraged me to bf right after delivery to produce contractions and squeeze the placentas off and out. (This is a good idea for a multitude of other reasons too.) I think this might have speeded things up (?) -- I kinda lost track of time during all my deliveries and right afterwards, so I have no idea when the placentas all eventually emerged, but I don't remember feeling anything coming out, probably was too stretched out and banged up in general to notice anything smaller than the baby making its way into the world. The medical staff wouldn't let me out of the bed until the placenta was delivered (I had all mine in the US), and there was no hurry to get me out of the delivery room to make room for anyone else.

bexaa · 31/12/2009 20:12

This reply has been deleted

Message withdrawn

galadriel77 · 01/01/2010 09:44

I wanted the cord to stop pulsating before it was cut and then to have the injection with my first DD. The midwives didn't give me the injection though and I found it incredibly painful - worse than the drug free water birth I had just gone through. The contractions were hideous and the midwifes were massaging my stomach to help the placenta come out. In the end I screamed at them to give me the damn injection. They did so and about 1 minute later I felt an urge to push and out popped the placenta. I was so relieved.

For my second DD I made sure they gave me the injection straight away as my first experience with not having it had been so unpleasant. It took maybe 5-10 minutes and was all done.

I just wanted the placenta bit over and done with after labour so I could concentrate on the baby - not still be contending with it an hour later.

Both times I was in the delivery room for a good hour afterwards anyway - maybe it was quiet! - having tea and toast etc so didn't feel rushed or anything.

FrannyandZooey · 01/01/2010 10:03

I had a horrible natural 3rd stage and would not opt for it again I don't think
the placenta got stuck behind my very full bladder and eventually i had to be catheterised
(this led to me getting an infection and having to be separated from my baby, who was by then hospitalised due to poor feeding)
i was in a lot of pain for about an hour trying to deliver it
i was exhausted and couldn't stand up or move about to get in a good position, so was left sitting leaning back having lots of very painful contractions
ds2 meanwhile was being held by someone else instead of quietly feeding or just snuggling with me - i do partly blame this for the feeding problems we experienced
it was nasty - i still shudder about it tbh

i wish i had known i could still have had the injection - i thought once the baby was born and you had not had it, that was too late - the midwives just followed my birth plan

sorry to give a negative story but i had no idea this could happen and wish i had kept my options open at the time

callmeovercautious · 01/01/2010 10:12

My experience is almost identical to the last poster. Went for a natural birth all the way through but after 45 mins of trying to deliver the placenta I was back on G&A because the contractions were so painful. Midwife gently suggested I have the jab so I could start enjoying DD rather than being in pain. She was right, and about 2 mins after jab I pushed and the placenta shot out so fast it almost hit the MW

I would try for natural again as I believe DD benefitted from the gentle start she had and DH was happier to cut the cord once it had stopped pulsing (he is a bit squeemish). I would not rule out the jab if in pain or it takes ages.

mvemjsunp · 01/01/2010 10:15

I barely noticed my third stages.

IIRC, I had a single contraction about 5 minutes after the baby was born and the placenta slipped out. I didn't have any pain greater than 'afterpains'.

Original poster

Squarah · 12/01/2010 18:51

Thank you everyone for your experiences - I think I'll aim for physiological but see how we go - not sure I feel massively strongly about it which is probably for the best!

OP posts:

seeker · 12/01/2010 18:57

But don't be as bonkers as I was - I was determined to have a natural 3rd stage with dd but they had to cut the cord because it was round her neck twice - and I didn't think to tell them that there was no need to wait for the placenta to deliver naturally because there was no cord to stop pulsing! It was 2 years before I realized that!

steph1512 · 13/01/2010 21:37

hi i had injection first time n placenta took bout 10min.

second i had home birth n no injection at 59min the mw was getting ready to call ambulance to send me to get placenta removed..luckily it came in the nic of time.

dont know if the lack of injection was the reason but i will def be having the injection this time round

ChocolateMoose · 13/01/2010 22:15

I was in birth centre so midwife tried to get it out naturally but my baby wouldn't feed, so I had no contractions. I had a catheter put in as she thought my bladder was too full and in the way. After a bit I really wanted the injection as baby had already had the extra blood from the placenta and it was getting tedious. After injection, placenta came out and I could lie back and relax at last...
Midwife did ask twice if we wanted to keep the placenta. Er, no. Baby yes, placenta no thanks.

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