natural third stage with bad history

I've got a ob appointment next week but just thought i'd ask you ladies in here to see if i can get some insight.

I've been reading a lot about labour this time around as i am *hoping* for a natural birth (was induced with sytocin, and had peth and gas with dd). With DD a piece of placenta didn't come out and i haemorrhaged, was taken into theatre for it to be manually removed, then had 3 blood transfusions over the next couple of days.

Because of my history is it still possible to have a natural third stage??

Have any of you experienced something similar?

Is it recommended i have the syntocin injection to get the placenta out asap?

i'm pretty clueless, so any info would be great
thanks

id be inclinded to pop bubs on the breast ASAP after the birth to encourage natural expulsion of the placenta, hopefully even though it happened the first time is wont necessarily happen this time!

I have a bad 3rd stage history too. I Haemmoraged very seriously after my first birth requiring LOTS of blood, don't remember how much now, as well as a years worth of iron injections and three months of terrible fatigue. I haemmoraged fairly badly after my DD's birth, requiring three blood transfusions (I think) and some terrible fatigue as well as depression (I attribute to blood loss and fatigue as well as having a non sleeping baby!) and a bit of blood loss with DS requiring one transfusion. I am still on ferrous grad C (iron tablets) and have a borderline iron count.
I tried to have a natural 3rd stage with DS but it was not to be. I ended up losing too much blood and the placenta was taking too long to come out, so I agreed to have the synto. It came out not too long afterwards. I ended up having to have one transfusion anyway cause I lost too much blood. I also fainted when I got into the shower several hours after having bubs. I had a completely natural 1st and 2nd stage though, so was more than happy with that (not to mention mega proud of myself!).
Good luck making your decision, and with your birth!!

I would say that with your history, your OB would not be overly keen on you having a natural 3rd stage. For that matter they generally aren't keen on any women having a natural third stage, let alone those who have a history of hemmorrhaging or retained placenta. This is not to say you can't have what you want - it is up to you to decide what interventions you want during labour, no matter how much your doctor may protest, you do have to right to refusal. Just be prepared for your doc to be against the idea.

Ask your OB :)

I think because it's happened once it's not necessarily going to happen again. My second birth had a retained placenta but after my third it came out fine. I did have the injection though but that was my choice to have it ;)

The fourth came out fine too but I had a secondary PPH which was unrelated to the placenta. That was perfectly intact and they went and inspected it to be sure.

Yeah i'll definately have a chat with the doc next week
Talk about pro's and cons. Might do a bit more reading on BB about the third stage to see if i can become more informed

thanks ladies

To have a natural third stage what you may need to stay away from is managed labour (inductions) your more likely to have a PPH after an induction. The retained placenta no one knows why it happens to some and not others but pulling on the cord before the placenta is ready to detatch (aggressive management of third stage) may be one cause. Your Ob may see this history as even more reason to manage even more aggressively next time ie a syntocinon drip after the birth rather than just an injection. What have you been reading to get more educated and informed about natural third stage ?

I second that last post by femme. Inductions or augmentations with syntocinon increase your risk of bleeding, it makes the uterus pump harder and faster than what naturally occurs, so you can imagine what happens if you start to bleed - pump, pump, pump... Inductions are my pet topic, avoiding them would avoid so many c/s and PPHs.

Just the thread I was looking for!!!

I find out on monday if I will need to be induced at 37-38 weeks due to low levels of amniotic fluid. With DS I had low levels and was having monitoring and US every other day from 39 weeks, i was in the public system and they let me go 9 days over before i was induced. I only needed the 1st app of gel and things got going. Labour was fine just had a bit of gas, but the placenta didn't come away and needed a GA and manual removal (no blood trans). Long story but bleeding didn't stop went back to hossy a few times they weren't concerned, was still bleeding 3 months later when I went to my own GP who sent me for a US and found retained placenta, in the next day for D&C. After D&C I started to recover from the birth and get some energy back, but the 1st 3mths of DS's life I was a real mess.

So with my history of retained placenta I am very nervous about the possible induction and potential for problems delivering the placenta. Plus at 37 weeks i imagine i would need the full induction gel and drip to get things going.

What is more risky low amniotic fluid vs retained placenta and possible haemmoraging???
And what is the chance of needing another manual removal?

Thanks Ladies