Benefits of a physiological third stage????

[BekZ]

Jasp - I am going to insist on the wait and see approach. What do you think you'll do?

BTW - The shots are not painful. I actually didn't even know that I had them

[Fleur]

Well, I spoke about this with DH yesterday.
He is happy to delay the cord clamping, so we will definitely be having that in our birth plan.
However he is all for the synto for me... he stresses & worries about me I guess ...so I think the compromise is we will wait & see. (He thinks I will have a shot after 10-20 minutes - I think we will just wait & see what the mids / drs think).
I'm certainly not opposed to having it if I need it! I just don't see the point in having it 'just in case'.

So yeah - 'wait and see' for us too

Sounds like you at least have a supportive midwife there My next appt at hosp is at 41 weeks, hopefully I won't make it! but if I do I will certainly be bringing it up then & see what they say.

[dust]

ive had one managed 3rd stage (synto, cord traction) and one physiological stage. With bub #3 around the corner im head strong to have a physiological 3rd stage again!!!!!!!!!!

[BekZ]

I got my physiological 3rd stage and all went well!!!! Whoot

[Shades]

Yay - well done

[Fleur]

Well done Bek

Just goes to show, there's no need for 'just in case' interventions

Well ATM looks like I will make that hosp appt on Tuedsday so I will see what they say about it then....

[femme]

I just wanted to say that delayed cord clamping does not lead to blood draining back through the cord causing anaemia. This is not true, there are many studied to indicate that delayed cord clamping actually can reduce incidence of anaemia and lead to higher blood volume due to the extra blood that the baby recieves through the cord as it continues pulsing until the placental transfusion is complete when the cord then becomes white. This is one of the benefits of delayed cord clamping. The crying of the baby help to regulate the placental transfusion.

[jpelc]

I wanted to delay cord clamping but my doctor said not too as the baby would receive too much blood leading to jaundice. I agreed to cut the cord soon because of this (not immediately though)

[BellyBelly]

jpelc - this is not true. In fact all the studies that have been coming out have been concluding that delayed cord clamping should be standard practice... makes you wonder why it's not... birth is an industry, nothing to do with the best for women and babies like you might think.

Anyone wanting to get their hands on loads of info/studies/articles on this click my facebook group in my signature about cord clamping. There are a huge load of them. There is also the article on BB.

[jackrose]

My research and readings agree with femme

delayed cord clamping actually can reduce incidence of anaemia and lead to higher blood volume due to the extra blood that the baby recieves through the cord as it continues pulsing until the placental transfusion is complete when the cord then becomes white. This is one of the benefits of delayed cord clamping.

In addition delaying the clamping of the cord can help avoid PPH in many cases as the placenta has less blood in it (it is in the baby where it belongs) and therefore the uterus can more successfully contract to expel the placenta.

With all that and this

The crying of the baby help to regulate the placental transfusion.

we have to remember that human beings are incredibly marvelously designed - the only problem is we don't trust our own bodies sometimes, do all sorts of things to interfere then get really worried about the outcomes of the interferences. Somehow we blame the natural state of our bodies in the end rather than looking at what the interventions do...

[Luna1991]

The comment that delayed clamping can lead to blood flowing back through the placenta in incorrect - physiological third stages are usually conducted in a squating/upright position (ideally the best position for labour and birth) and therefore gravity would prevent the blood from flowing upwards from babe to placenta. If this position is used it usually takes very little effort or time for the placenta to be expelled.

Physiological third stage is the recommended option when labour and birth have gone smoothly as it doesn't interfere with your natural hormones. Whilst there is a little more blood loss duirng the 3rd stage it is not normally dramatic enough to make a difference and if it does become dramatic then you can revert to active management.

Whilst active management may prevent some blood loss during the 3rd stage it can actually result in a heavier and longer lochia (the period type loss for days after birth) so either way the blood is lost.

Babies also benefit from the delayed clamping as they are meant to receive that influx of blood from the placenta and denying it through early clamping can lead to anaemia.

[Mummato2]

I had considered doing a natural third stage but my OB recommended against it. He said there is a higher chance of haemorrhaging if you opt for a physiological approach and he has witnessed it on several occassions. That was enough for me to think twice about it.

My mum is a midwife and she is pretty easy going.

Her take is she has been practicing for around 40 years and seen the trend swing between both managed and physiological third stage.

Her personal opinion (which I absolutely trust and will practice myself) is that she has seen an increase in PPH with a physiological third stage vs managed.

It is a very personal preference, but she explained that the injection allows your uterus to contract efficiently after the birth and essentially cauterize off any small bleeds AND ensures the contractions birth the entire placenta - not just parts.

So based on her observations in the field, I trust medicine in this issue.

I think there's a fine balance between a wholly natural approach and making good decisions that can still make it a natural experience IYKWIM?

[femme]

If your going to birth in a hospital it is very unlikely that you wll have a physiological labour so many hinderances to a physiologic third stage.

So your saying uteruses dont contract properly or work properly without the injection well mine does .If it doesn't then give me the injection but I would rather try than just take it just in case

[Mummato2]

If your going to birth in a hospital it is very unlikely that you wll have a physiological labour so many hinderances to a physiologic third stage.

So your saying uteruses dont contract properly or work properly without the injection well mine does .If it doesn't then give me the injection but I would rather try than just take it just in case

No I'm not saying that they don't contract properly or work properly without the injection - what I am saying is the injection ensures in most cases that it prevents PPH whereas it is a real risk in a physiological third stage.

Like I said, this is such a personal choice, but I can't see the benefit of waiting TBH - once my baby is out I'd rather take no risks

[Sequoia]

If your going to birth in a hospital it is very unlikely that you wll have a physiological labour so many hinderances to a physiologic third stage.

I birthed in a private hospital setting and my OB asked me to cough, that was it. No injection.

[femme]

For those who are interested this article

Hastie C, Fahy K, 2008, Optimising psychophysiology in thid stage of labour: Theory applied to practice, Women and birth, Vol 22 pg 89-96.

The authors discuss factors which interfere with normal physiology and placental birth and that should be considered risk factors for Post partum haemorrhage. They are:

bright lights,
cold room temperature,
noisy strangers int he room.
Midwife unknown to the woman and the woman unable to maintain mindful focus. Under the influence of pethidine, morphine etc
The baby taken to be resuscitated or transferred to the nursery,
unneccesary talking,
uninvited touching of the woman or baby.
Being in a hurry to finish and clean up or carry out fear inducing activities such as setting up for an emergenc,
phone calls from family of friends.
The mother exhausted and feeling that the birth is over.
The baby being abnormal, unwanted or the 'wrong' sex. (pg 93)

Something to think about when writing your birth plan.

[femme]

mumma to 2

Yes it is a personal choice I can see the benfits of waiting and I prefer to allow my body a chance to work properly before helping it along with artificial hormones. If syntocinon prevented PPH as most women have it in hospitals then we would have no more PPH. Most women that have a PPH have already had syntocinon. It is just another means in which birth has been medicalised.

[femme]

retained placenta may be one reason for PPH however it is not the most common reason which is uterine atony (weak muscle tone). Putting the baby to the breast can also release natural oxytocin.