Retained Placenta/C-sect

Is there anyone out there who has had another baby after having a retained placenta?
We are planning TTC soon but I am having worries. I had to go to theatre after having Angus as the placenta wouldn't come away after the injection and I was bleeding so much that they didn't want to leave it any longer.
There was also a knot in the umbilical cord which was also wrapped around his neck.
These reasons are steering me to consider a C-section.
Please let me know of any experiances which I can take on board for when I make my decision.

Cheers Sam.

Sam,

I'm not going to be much help given I haven't been there, done that yet, but in our ANC the midwife made it very clear that some dr's are in a rush to get the placenta out, and tug too hard. Mainly the Doogie Howsers of the medical world - ie young!
I'm not sure I want the needle, but Shane has said he wants me too. Even then, I dont care if the placenta takes 1 hr to come out - just keep me safe please.
She said a good midwife will be able to feel if its coming away - it doesn't need to be yanked, and they should be strong enough to stand up to the dr and say - back away buddy, dont touch this woman yet!!

HTH
Fi

I like the idea of letting the baby suckle to stimulate the placenta to come loose. I guess I just got caught up in having the baby out with me that I didn't think to suggest it.
I think the bleeding thing was what made OB rush it a bit.
Shannon, what happened with you is very similar to my situation. Thankfully the cord was very long which prevented it from getting too tight around Angus' neck. Don't think I would have been too happy about the scissors situation.
Having the OB "massage" my belly was the worst feeling. I thought it was worse than labour pains.
Hope thing are better for you this time.

Hi Sam. Did they tell you if there was any reason for the retained placenta, such as scar tissue from a previous c/s or scar tissue from previous cord traction? How could they tell it was still attached to the wall and not just detached and waiting to come out? (Length of cord, feeling the tummy). What length of time was involved, ie how long were you bleeding for?

You probably can't remember all this stuff, but I'm just suggesting these are things to talk to your care providers about.

I did know someone, (I think I mentioned to Shannon) who had a piece of retained placenta with her second birth, resulting in haemorrhaging, and needing a txf to hospital after her homebirth just in case (of needing a transfusion). They thought it was cord traction (unnecessary) after her previous birth which might have caused the scar tissue.

I wouldn't rule out going for a vaginal birth, but it needs plenty of discussion with good care providers about why it might have happened, how serious it was, whether it's likely again and how they would manage it. It's great that you're thinking ahead. O:)

Thanks for replying Yvette!

My first birth was textbook vaginal birth so says the OB so no C/S scar.

What is a cord traction?

I really don't remember how long I was bleeding for as it's all a bit of a blur. I think it was around 1/2 hour.
The OB was massaging my belly and tugging on the cord at the same time, while I was sucking on the gas so I was off with the faries most of the time.

Hi guys,

Sam cord traction is basically tugging/pulling on the cord to try to help the placenta separate. It should only be done if absolutely necessary, and very carefully, and they're massaging your belly while they're doing it, basically trying to get the placenta to separate. It can cause scar tissue on the uterine wall, especially if done badly/inappropriately/unnecessarily, but I imagine there are times when it's unavoidable, they've got to be so careful with bleeding. Having scar tissue on the uterine wall, as Shannon says, makes the next placenta more likely to 'stick' in that spot, and have trouble separating.

That's scary what you both said about the massaging the belly hurting so much. This is a really important issue to know about. So Shannon, it sounds like your situation is very similar to Sam's. It sounds to me Sam like you wouldn't need a c/s just for that reason, it's management of the 3rd stage that's the issue.

Cords is a whole other thing. My babies have all had the midwife loop the cord over their neck as they came out. It would be scary if they had to cut it because it was so tight, but I don't imagine you can predict this kind of thing unless you've just had an u/s? My cords were all pretty short, only just reached long enough to hold the baby in my arms. I read recently with interest, that one of the reasons the midwife stares so much at your bottom end after the birth, is not just looking for bleeding, but seeing if the bit of cord sticking out has got longer, indicating placenta has separated. Lol, it seems so obvious now, but I never thought of it before. Third stage gets a bit forgotten about by us mums sometimes.

I was given the needle in the thigh with both my homebirths, it's after the baby is out, so I figured it couldn't hurt. They said it was to help the process of the uterus contracting back down to minimize bleeding. I think they did it more as a precaution than anything, although I do bleed a bit, and with Lola was quite white. At the hospital birth of Angus, I didn't have the needle & it was fine. I agree Shannon, I think it's good to go for feeding baby to help the natural contracting of the uterus, & only have the needle if you really need to. Ruth fed heartily straight away, but the other two took a little while to really get into it, lol. Lola just slept & slept. I wouldn't worry too much about the needle though, I had it the first 2 times as I said, & no probs. Actually, the midwife was fussing a bit about how long the uterus was taking to contract the first time, and it went a bit to one side, and she was massaging it. This was hours later though. I think it said on that article about 3rd stage on the main site (that you pointed out in another thread) that drugs in labour could affect 3rd stage too, basically that if you've had all the natural endorphins & hormones needed to cope with the pain of labour, it's a natural progression for your hormones to give you what you need for 3rd stage, or something like that.

Fingers crossed for you Shannon. This is a great subject for a thread Sam, I'm sure this is an issue for lots of mums, and not something that the doctors talk about much until after the event.

I didn't want to freak anyone out but when I said massaging, I really shoud have said digging in his fingers. This was no gentle rub.

Thanks for the info Yvette. I've been thinking of calling my OB to ask about what he thinks about this.

I decided not to be one of those people that exaggerate. I don't sugar coat it either but some go too far.

Well I finally got around to chatting with my OB about this. So the percentage for a retained placenta is around 1:200 births.
Having a retained placenta previously does increase the odds that it will happen again but does not mean that it will nescessarily happen.

So I do feel better about it now :D but I will still have it in my mind of course.

Thanks Shannon for sharing that and good on you for being assertive and getting taken straight to theatre.