Yay - well done :)
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Yay - well done :)
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 :doh: so I will see what they say about it then....
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.
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)
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.
My research and readings agree with femme
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.:
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.
With all that and this
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... :dunno::
The crying of the baby help to regulate the placental transfusion.
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.
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?
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.:wall:
So your saying uteruses dont contract properly or work properly without the injection well mine does :D.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
I birthed in a private hospital setting and my OB asked me to cough, that was it. No injection.:
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.
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.
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.
I didn't want a managed third stage, but the doctor talked me into it. Even so, during the conversation he told me the injection only prevents 30% of pph - which means 70% of the time a woman will still have a pph even with the shot. This is what happened to me, and I had to go on an IV drip for 4 hours to stop the bleeding.
It seems to me that the only way to prevent a pph is to have a homebirth! Something I am seriously considering for my next birth.
This is often the sort of information and opinion I like when making decisions as I think a good professional at grass roots level who has the best interest of the mother and the baby and has a 'heap' of hands on, up close experience is generally going to have a good idea of the reality.:
However, it is a good idea to also have read widely and consider lots of different things when making a decision.
What jumps to mind for me is - why? Why is a natural process more likely to end in a potentially life threatening situation for the mother? Mother nature generally does not work that way and usually has incredible natural solutions for potential problems that come up.
So, my next question is, what things do we do in the modern hospital system which may interfere with Mother Natures natural safeguards?
The two things that jump to mind are
- not giving mothers enough time to have skin to skin contact directly after the bith and to establish that first latching on therby releasing a natural surge of oxytocin. The natural version of the drug used to contract the uterus. Modern birth demands that a baby is weighed measured and tested at birth and can be whisked away too early. This is thankfully becoming less the case as we have fought to keep our babies with us in those early minutes and the hospitals have heard and responded, but I still think there is a rush to move mums on and this interferes with the natural processes.
- Clamping the cord too early so the blood destined for the baby (that he/she is designed to have in the few minutes the cord continues to pulse) is left in the placenta. Therefore the placenta is heavier with blood than it is designed to be and is more difficult to expel.
I am not saying that the above experiences are everyones, I realise that there will be people who had plenty of time with their newborn and a delayed clamp and still had PPH. That is the nature of human beings - we always have exceptions to the rules! In these cases and in emergency cases, it is excellent that we have solutions such as drugs to inject to potentially save lives. Still, I think this all holds for a majority of people, and I personally prefer to try to give Mother Nature the benefit of the doubt.
Finally, in making my decision, I ask, what do the hospitals have to gain from following a managed vs physiological approach?
My answer to this (and other people may have other answers) is that although they undoubtedly have the mother and babies health and well-being as a high priority, I feel that they also have to answer to the bottom line. They need to move people on quickly and leaving a mother to appreciate the wonder of Mother Nature's plan does not make sense in that regard. Also, if there has already been a usurping of Mother Nature with early cord clamping, (or even a managed labour with the use of induction drugs) it may well be safer to have a managed third stage.
In saying all this, I am not wanting to judge anyone's choices by any means, I just want to share my thought process on the issue. I think everyone has a right to make their own mind up. For me, I am choosing a home birth this time so I don't have to be on the defensive when in birth asking for the right to birth my way rather than the hospital 'standard' and I'm going for delayed cord clamping and a natural third stage!
Another reason for increased PPH ay also be that midwives themselves having been trained for so long to do managed third stages are not that aware of the what they need to provide to facilitate a physiologic birth and third stage. A previous poster also stated that they had a physiologic third stage after having an induction (with the synto drip) which isn't really advisable to mix the methods. When a labour has been managed the third stage I my opionion should be too because you have tampered with the natural course of the birth.
Okay......so natural 3rd stage for dummies............:lol:
If hospital midwives aren't necessarily trained in facilitating a natural 3rd stage, what do I need to know to help ensure a smooth one? I am going to chat to my Ob about it next week, and AFAIK he is amenable to not giving synto, but I would still like to be informed for when it actually happens.
TIA :)
Hmmm, interesting question Janie. I'd be interested to hear from MWs out there who regularly attend those kinds of births.
FWIW, I think (as has already been mentioned) you need to specify that you want to delay the clamping of the cord until it has finished pulsing and it's a good idea to breastfeed to assist with the contraction of the uterus.
Personally, I found the delivery of the placenta the second time was much quicker even without the shot (the first time I had the shot) but I'm not sure if that's common or not. I think the other thing the MW would have to judge is how much blood loss is normal and how much is excessive. They obviously have to know this anyway, but I think mine was really anxious about this and very worried about how much blood I was losing, whereas if I had've had the shot I wonder if she would've been so worried, KWIM?
Janie
I will say that most obs know very little about physiologic third stage and may try to frignten you off it with warnings of bleeding to death etc
try this:
The Third Stage Maze : Child Birth Information
My Ob has been practicing for over 30 years, and used to routinely observe/manage natural 3rd stages with his patients. I would guess that he routinely uses synto these days, but I am confident that he is knowledgeable about physiological 3rd stages.
Thanks for that link, it has some useful info :)
I recently recieved the latest edition of 'Down to birth' the magazine of the home midwifery assoication of Queensland and it is all about hnouring the placenta. Articles include: lotus birth, placenta musings, placenta rituals in other cultures, homeopathy and the placenta, placentophagy exploring the taboo
HOMEBIRTH.ORG.AU - Homebirth Information, News and Support
You can order copies for 7-8 dollars this includes postage.
hey there,
I don't recall having a jab with my last pregnancy. It seemed as if the placenta was delivered quite quickly but then, my son came into the world really fast so may be I dfidn't have time to notice!!
Janie did you talk to you Ob about this and what was his response ?