Home birth after retained placenta

[Dr0pThePirate]

Does anyone have any experience of this?

I had a managed 3rd stage delivery and my placenta got stuck. I had to have an epidural to remove it and ended up with a 3rd degree tear and a few nights in hospital.

I've enquired about a home birth for this, my 2nd pregnancy, however a consultant I spoke to really wasn't happy with the idea. We live about 23 minuets away (by car) from the hospital but the consultant worried about problems during rush hour traffic.

I'm seeing my MW in two weeks and I was going to asked about the possibility of not cutting the umbilical cord and waiting for the placenta to pass on it's own (either at hospital or home) but I'm worried about coming across as a crazy hippy, putting a "natural birthing experience" before safety but I just want to avoid the same thing happening again.

Anyones experience of of leaving the placenta to pass on it's own would be most appreciated too

Yes, I have been in this exact same situation!

I had a managed 3rd stage delivery with DS but the placenta got stuck and had to be pulled out of me. I was torn as part of the process but nothing too terrible. Really irritating to have to have an epidural AFTER the birth.

Anyway, 2.5 years later I wanted a homebirth for DD. My reason for this was that I'd had a very rapid labour with DS and was worried I wouldn't have time to get to the hospital. The midwife was very unhappy about this and referred me to a consultant who said it would be fine as I hadn't lost a lot of blood last time. The midwife wasn't pleased about this and said if the placenta hadn't arrived 45 minutes after birth then I'd have to call an ambulance. I was worried about this as didn't want to feel under pressure straight after the baby was born.

I'd read that my retained placenta could have been as a result of having a very rapid delivery and being given the injection to deliver the placenta - apparently with a rapid delivery this can make the contractions stop and prevent the placenta being deliver. I got a free booklet from AIMS about a natural 3rd stage. I also got some advice from some independent midwives and they said that it can take 2 hours for placentas to arrive and that if I felt under pressure I should ask to be left alone on the toilet as privacy can speed things up. She also suggested blowing into a bottle might help!

Anyway, DD was born at home (within 45 mins of first contraction, so I was right about not having time to make it to hospital). We all hung around waiting for the placenta and the midwives did put a bit of pressure on. When they started talking about calling an ambulance I asked if I could go to the loo which they agreed but one of the midwives came with me which I was glad about as didn't know practically how to do it any other way as had to hold the baby and watch out for the placenta. Anyway, the placenta popped out immediately as soon as we were aware from the room of people. DH then cut the cord which was something he'd never really wanted to do before. It was all really lovely!

The stroppy midwife hadn't been there for the birth but came to check on the baby a few days later and said, "What a good thing you didn't try to go to hospital!" as if the whole thing had been her idea.

Good luck!

Thanks Lindt

My tear was pretty bad, I think it was from every Tom, Dick and Harry having a go at pulling on the cord

DS was born less than 10 minutes after my first need to push. Is this a quick delivery? I didn't ask for the injection to speed up the delivery of the placenta either, I was just given it within seconds/a minute of birth

I'd really like to be at home this time. I'll see what the MW says next time I see her. Fingers crossed she's on board with it too!

I had a managed third stage with no problems in hospital first time.
Second time was a home birth last month. I had a natural third stage with delayed cord clamping but the placenta never came on its own (I think this is due to the MWs not getting me up and moving about). They waited an hour and then gave me the injection and it still didn't come. My instinct was to get up and move about so I asked to go to the toilet and immediately delivered it down the loo lol. The mw's never tugged on the cord though, I was very against this incase of a retained placenta.

I would say if you're having a home birth, whether you decide to go natural or managed, get up and get moving rather than lying down.

DS was a planned homebirth but I transferred in when I was about 9cm (severe vomiting!). Did the whole thing with just a tens machine as gas and air was making me even sicker then ended up with retained placenta and second degree tear. "Luckily" I had a manual extraction with only gas and air as pain relief although we got to the point of the doctor saying this is the last attempt before theatre and spinal. I was so desperate for a 6 hour discharge that I could put up with a lot!!

2 years later had DD at home. I mentioned the retained placenta to the midwives when I had my booking appointment and again when we went through the homebirth stuff but no-one seemed overly bothered. I was told that if it's happened once the chances of it happening again are slightly higher but that was all. DD was born at home after a fairly uneventful labour, I had the jab and within about 5-10 minutes the placenta came out. I can honestly say that I was more thrilled about that than I was about DD arriving!!

I think that it helped with DD that the midwives were very hands off and had been at a homebirth the night before where the woman had opted for a natural third stage and they'd been there for over 2 hours waiting so I felt quite relaxed knowing that they wouldn't mess with me or clock watch.

Currently 17 weeks with DC3 and another homebirth planned.

Hi Dr0pThePirate. I had mine manually removed with gas & air (not a pleasant experience) without any tearing. They then decided the placenta may not have been complete and so I had an epidural while they went back in to check. The woman who did this check was really annoyed about having to do it because she thought the placenta was complete. She was irritated when I asked someone to talk to me to distract me while I was having the spinal block and then she was very rough with me and tore me. I'd been told I wouldn't need stitches before she'd got involved but needed stitches afterwards. After all that, the placenta had been complete.

My delivery was quick in that I'd arrived at hospital at about 8:15am (contractions had started at about 7am). They didn't do an internal but they put a monitor on me to see if I was actually in labour as I was only 36 weeks and they weren't convinced it was the real thing. At about 8:40 I said I couldn't lie down for monitoring any more and it was only then they did an internal and discovered I was fully dilated. DS was born 10 minutes later.

I'd said that I didn't want the injection but as DS was being born (head out) they sort of said "We can just give you a quick jab to help you deliver the placenta" and were sort of hovering with the needle. Everyone was agreeing, saying it was the best thing and I remember muttering, "Oh go on then" as the next contraction took hold and they jabbed me.

It was good that it was so quick but I think I was in shock with the whole experience and wonder if my body went into shock too.

This interests me too - I also had a retained with number one, currently pregnant with number 2. My 2nd stage was over two hours so I don't know if having a quick delivery affects it all that much? I didn't have any pain relief because I was 'too late' for the epidural and just had to get on with it, there is no gas and air in germany where I live. But actually it was ok - I found the first stage worse. The placenta got stuck, I had an injection, which did not work, then a drip, which also did not work. I think this was because my second stage was so long and they had been giving me oxytocin spray and the end to keep the contractions going - so that when I was given yet more to deliver the placenta it had less of an impact. I ended having it pulled which was a terrible idea and some remained. They did a manual removal which was worse than childbirth (and I wished I had made them take me to theatre looking back) with some local anaesthetic and then stitched me up (2nd degree tear - I think that was from the delivery through). Fast forward a week and I felt awful. I started to not recognise my daughter as my own and I never had any milk come in. I ended up with a raging temperate and went back into hospital - it turns out some was still there! I ended up with an D&C and then back into there again a couple of hours later from bleeding out. I lost over 2 litres of blood and was lucky to be here after, womb intact! But all of this could have been avoided with a proper delivery of the placenta IMO - and the pulling and fiddling about did not help. I wonder therefore if the hospital is the right place... They also have birthing centres here which is like a halfway house between the two and I am going to seriously look into that. Personally I think go with your gut feeling.

I had retained placenta with my first in hospital. It was a managed third stage and I needed a blood transfusion. With my second the midwife asked me to see the doctor to discuss my wish to have a home birth, because of the retained placenta. Doctor not at all concerned. I went on to have two home births and no problem delivering the placentas. I did have managed third stages with both as midwives recommended (and I hadn't really worked out whether natural would be less risky or not).