I had three manual removals for retained placentas - my second involving a very significant PPH. For my third I asked for a natural 3rd stage and was told the same as yourself - only to have the cord snap off with the tugging, hands up my hoo-har and end up in surgery anyway.

My 4th was an induction, but I managed to occlude the drip during 2nd stage so it was useless anyways, I ended up with a natural 3rd stage which suprised the hell out of me - no cord clamping, breastfeeding and boom, out comes a placenta about 20 minutes later. I had been told that it would never happen for me, that my uterus was probably scarred from all the manual removals and such, but it wasn't.

I firmly believe that the managed 3rd stage CAUSED my retained placentas, my body needed to do it my way, not be rushed into it.

I dont' know why they think they need to rip the placenta out of there within seconds of birth. It can take over half an hour sometimes. Do they think that the placenta is going to weld itself to the uterine wall if they don't grab it out in the same contraction as the baby comes out? If it's going to stick, it's going to do so 30 seconds or 30 minutes after the birth. They have time to wait. Only if you start haemorraging does it become an emergency situation.

How long do they think it takes to put a canula in? It takes a doctor 30 seconds - why do you need to labour with it in? After half an hour, if the placenta isn't budging, then they can take the half a minute to put it in before giving you the drugs can't they? I mean, think about it, how long after you were determined to have a retained placenta last time did you get to theatre for a manual removal? Half an hour? Don't think there's time to pop in a drip in that time eh? Even on the time I was bleeding out, it was still over half an hour between first gush and anaesthetic.

In my last birth, I requested no managed 3rd stage at all, even in the event of a retained placenta. If I had a placenta still stuck in my after a prolonged time, I was to be taken straight to theatre. I find that the trauma I have suffered through my managed 3rd stages was far more significant than the trip to theatre to knock me out. I did ask in my 3rd birth not to have any pulling, pushing or tugging at all, but the doctor just had to give it one go apparently, and said cord snapped, and then just just wanted to grab it, so I ended up with two hands up my bits at the same time. Talk about painful and undignified. I was begging to be taken straight to theatre instead, but nobody listened to the birthing woman grrrrr.

HTH a little