Managed or natural 3rd stage?

[nunnie]

This is my second and I am 32+3.I have an appointment with Consultant at 36 weeks to confirm if I want a managed or natural 3rd stage (they recommended managed) as placenta had to be manually removed with DD as it refused to come away from womb lining.

Now I am still undecided and if I go in with this attitude I know I will just agree to what they suggest.

I have also read that they can inject the cord, is this what they mean by managed? I presumed it was thigh jab, but after reading I am now confused (too much google).

My other decision is whether to have general as apose to spinal anaesthetic if manual removal is needed again which I am 99.9% certain on so have put that to the back of my mind as I think that decision is easier for me.

Any advice would be wonderful and any experience if you have had similar in the past would also be great.

Thank you.

It was what I thought was managed jab in thigh.

I was aware it increased the risk so questioned it at 16 week appointment.
I was told by my consultant that in my case as it was stuck to the lining of the womb, and not trapped by the cervix then natural wouldn't have made a difference.

This is why I am partly confused to be honest, as I don't want to have a natural stage as it prolongs the time it will take for them to take me to theatre if it should be required again. But I don't want to have a managed stage if it is likely to increase the risk of needing to go to theatre anyway. So I was fairly sure at my last appointment that I wanted natural but when she told me it was unlikely as of the way it was stuck that that injection had any impact I am now not sure.

Hiya I had manual removal with dd and have just had ds with fully natural 3 rd stage and it was fabulous and easy :) I found some articles suggesting that synto can actually cause retained placenta plus some really excellent wording for your birth plan. I'm on my phone so can't look it up for you now but will do later. I have no idea why your consultant is pushing for managed again when it clearly didn't work last time. Will post later this evening as we have guests arriving immnently :)

I don't know why she is pushing for it either, but did tell me if I didn't have it it would prolong the need for theatre which would increase the risk of PPH. I did breastfeed straightaway with DD, but the cord was cut before I knew what was happening. Think I am more inclined to go with natural, but just feel like I will be backed into a corner unless I am 100% certain that is what I want. She was very anti natural last time. However I am aware I might not get the same Consultant so fingers crossed as she was very this is this and this is that, no pause for questions etc.

Thank you it has helped alot.

Possible stupid question so sorry in advance.

Is the mamaged 3rd stage with the thigh jab? Or is it the one where they inject into the cord?

Sorry have tried to google it, but can't get an answer or I'm not looking in the right place, or reading it correctly.

It is the thigh jab sorry.

www.babycentre.co.uk/pregnancy/labourandbirth/labour/managedthirdstageexpert

It does say in here that a natural third stage isn't advised if you have had a retained placenta in a previous birth. Oh the joys of google Well at least I still have 4 weeks to decide.

I would recommend a natural to anyone who can have one

i would think either mean it's managed - ie they are intervening in the natural course of events. I'm not exactly sure about what or why the consultant is saying what they are saying - starlight talks sense though.
I had a managed 3rd stage with DD1 - had no choice in it I don't think (the whole thing was very managed after being induced)
And in March I had a natural 3rd stage with DD2 which was AMAZING. She had a better start to life than DD1 as a result of this I think. I stress though that we were lucky - have a few friends with retained placenta, it's just not something you can always predict.
FWIW one of those friends has been told she must have a CS this time around. So you do have some choice, which is good!
Good luck