What worries me...Retained placenta, have had two out of three....

[love.tillie]

Hi everyone,

DD1 placenta was delivered with no issues at all within 20 mins..

DD2 placenta took over an hour with me initially trying to push it out, then standing up and myself giving the cord a tug at the same then the needle in my thigh still nothing then the midwife put in an indwelling catheter which drained my bladder and the placenta just fell out... So i and the midwife put it down to obviously my bladder being so full it blocked the way for the placenta to exit. (during hospital time delivery, 1 hour, i managed to drink almost 1 litre of water)

And this yr DS i was very conscious only to have very small sips of water during the time i was at hospital (6 hours ) as i had thought that maybe it was my full bladder that blocked the cervix.. Tried to push again no luck so consented to the needle again...after almost 2 hrs still nothing...Me pushing, 2 separate midwifes pulling then the surgeon came and had a look he gave it one last try before sending me off to surgery and managed to get it out....most HORRIBLE experience....

Anyway, i'd like to have another baby in the next 1-2 yrs and thats what is on my mind!! What if that happens again? Apparently the chances are quite high....boo!!

Anyone had any experience with it??

I thought this time i might ask them not to give me the jab as i read that it can make the cervix close too tightly and that's why the placenta cannot get out....

Peace and Love...xoxo

[Traveller]

There are two drugs they use to assist with the 3rd stage, namely syntometrine and syntocinon. The first one is the most common and this can sometimes cause the cervix to shut before the placenta is delivered. The 2nd one works more slowly and is not linked with a higher incidence of retained placenta. You could request, if you decide to have a managed 3rd stage, to have syntocinon instead of syntometrine. You also have the option of having no injection for 3rd stage at all (called a physiological 3rd stage) however this can sometimes result in a larger post birth bleed and you will possibly be considered high risk for a bleed anyway because bleeding often goes hand in hand with a retained placenta, so be prepared for a bit of a debate with your caregivers if you choose to go down that route.

[Julie Doula]

tillie I can only speak from experience of all natural third stages.

there are many things we can do to help the flow of the mother's hormones be at peak levels so that her third stage is safe and gentle.

I have often been at home births where we have waited hours for the placenta. So long as there is minimal bleeding, and the mother shows no signs of shock, we just keep mum and bub skin to skin, let bub feed and feed and feed, keep both of them warm and calm, and we wait. The mother will not release the placenta until she is ready. And when she is ready, it happens.

There is too much rush associated with getting that placenta out and I think this disrupts the peace and calm the mother needs, inhibits her hormones and sets the whole thing back. All this also affects her bonding with her baby - that most important window of time in both their lives.

I tell my clients, 'your birth is not over when you have your baby in your arms. It's not over till the placenta is born too.' So we maintain the optimal birth environment: peace, calm, quiet, dim lighting, warmth, soft voices, letting the mother put all her focus on her baby and her body. I suggest everyone hold off on phoning and texting and birth announcements etc until the placenta is here. Sometimes the big celebration ruckus can inhibit what her natural hormones are trying to do. And sometimes all the hospital busy-ness and 'to dos' - examining the baby, examining the mother, getting baby on the breast, paperwork, moving trolleys around, cleaning up etc - have the same effect.

Sometimes in hospitals, when the staff have been 'rattling sabres' about the placenta (mentioning the injection) I've encouraged the couple to go into the toilet, with the mama sitting on it (with a bowl in the toilet) holding her baby, and her man cuddling her, with the lights out. Privacy and darkness, shielded from the stressy vibes - bingo: placenta.

There's a difference between two hours of trying to get the placenta out, stress and worry and focus on getting it out, various things being tried to get it out .... and two hours of mother and father snuggled up skin to skin in bed with naked little baby lying skin to skin on mummy's chest, bobbing and nuzzling and breast-crawling spontaneously to the nipple, suckling, suckling, drinking in the oxytocin and soaking up the warm skin contact, and the couple being left in peace to fall in love and bond in the haze of lovely oxytocin.

Here is an article I wrote about After Birth herbal tea and Placenta Wisdom

Be sure that ministering the herbal tea to the mother does not disturb the most important thing of all: skin-to-skin cuddles and the miracle of bonding that is unfolding between mother, baby and father. It would be better to delay the warm tea for a while if there is any chance bringing it could disrupt such a once-in-a-lifetime experience that is so vital for the new family. When the time is right, it should be easy to quietly offer the tea through a straw, let her drink, then quietly fade into the background again, leaving the family to continue falling in love.

Warmth, soft lighting, quiet, privacy, gentle voices, loving care and unhindered skin-to-skin cuddles are the things that optimise the flow of hormones that cause the placenta to detatch, the uterus to involute and the placenta to be born, and the bleeding to be minimal. This important stage of the birth process is often rushed in hospitals, where time is money. Usually they want that placenta out within an hour - or even half an hour. But if blood loss is normal, the mother's vital signs are good, she is not pale or shocky, and her after pains are not too severe, there is no need for rush. The placenta will come. I have been at perfectly safe normal homebirths where it took 4 hours or more for the placenta to come away, and it did, in the fullness of time - when the mother was physically and emotionally ready.

Gloria Lemay writes here about the '30 minute third stage' - in her experience, when the third stage is unrushed and the mother and baby are kept together and warm and quiet, the mother feels ready to release the placenta around the 30 minute mark, the great majority of the time.

One of my doula friends tells me that she encourages the women she serves to not only visualise themselves giving birth but also to visualise themselves holding their baby, having after pains that herald movement of the placenta, and then see themselves birthing that placenta, catching it, the cord still attached to the soft, warm little body in their arms. That's a good idea.

I hope this helps, Tillie, and that your next third stage is peaceful and calm and worry-free. Rather than reducing fluids, I'd encourage you to drink plenty during labour, especially a nice rehydration drink like 'labour ade' and remind yourself to try to pass urine every half hour. "Keep walking, keep drinking, keep breathing, keep weeing" = good progress.

I had an experience after my 4th birth when it was like my bladder or sphincter just 'went on strike' and I absolutely could not release the wee - and my IM actually did an in-out catheter. What can help is, who would have thought it - Peppermint essential oil. Shake a generous amount into the toilet bowl. It really works. Apparently it causes the capilliaries to constrict and this helps the swelling and the woman is able to pee. Worth a try.

[love.tillie]

Hi Traveller,

Thanks for that reply, i don't know which one i was given but i will make note of both of those and do some research on both.

: o )

[love.tillie]

Hi Julie,

That is very interesting, yes there is a lot of pressure to get it out quick! My midwife said i might need to go off and have it surgically removed... Which i didn't want saying that they'd give me a block and get it out which i really didn't want to have done as i had just had a completely natural labour, lights off, my daughters and husband massaging and loving me in the birth centre. I didn't even have panadol to get my placenta out!

What is the longest you could wait before becoming concerned then? After reading your reply it seems as if mine was rushed..

Your way sounds beautiful, right up my alley. : o )

[Julie Doula]

Tillie the longest I have heard of is 7 hours.

That story here

But my midwife for my first birth, in Ireland, said she once heard of a woman who took until the following day to release her placenta. She told me this before I gave birth, as a first time mother - I think what she was trying to do is get me totally relaxed about the placenta, not worrying a bit, but reassured that no matter how long it took, she would be patient and not rush me. In the end, after a lovely primip homebirth, my placenta came about an hour and a half after the birth. I was so caught up with meeting my baby that this one and a half hours only felt like a few minutes to me.

When the post-birth atmosphere is kept quiet and respectful, with the needs of the baby and mother paramount, you know placentas do usually come within an hour or two - in my experience - and Gloria's "30 minute third stage" is quite common. But it is one of those paradoxes, where we need to "reverse the energy": the more pressure we put on a mother to give birth, the longer and harder it will be. The more pressure we put on a mother to release her placenta, the harder it will be for her to do so. The more pressure you put on a man to 'get it up' the less likely he'll be able to! Oxytocin just does not respond well to pressure or time pressure! So we have to do "Midwife Tai Chi" and 'reverse the energy'" by reversing the expectation and pressure on the mother to produce a placenta, the more likely it is she can relax, not worry about it, focus on falling in love with her baby .... and what do you know - look here's a placenta!

The After Birth Bliss tea might be just the thing for you too.

[nyigi]

Not much advice to give.

But I know how you feel. I had a retained placenta with my son's birth, I was also hemorrhaging and needed surgery for a very large episiotomy so it was off to surgery for me.
But they spent an hour trying to get the placenta out. They used syntocinon and pushed and pulled with everything they had. I remember it as much more painful than the rest of the birth. It's not an experience I'd like to repeat.
Of course mine was a different story and I needed the surgery for other reasons as well, but it's really interesting to hear that you can wait longer for the placenta to come out. Something I'll discuss with my midwives next time.