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Thread: Benefits of a physiological third stage????

  1. #1

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    Question Benefits of a physiological third stage????

    Can anyone tell me what the benefits are of a physiological third stage...(and the cons too please!)

    I haven't really given it much thought as yet but have now decided that I'd like to know a bit more about it...

    So here's what (I think) I do understand...

    Managed third stage involves syntocinen injection for quick delivery of the placenta sometimes assisted by pulling on the cord, and immediate (?) cord clamping & cutting???
    Physiological is basically letting nature take it's course???



    So..have I got that right? and if so,

    Why would a managed third stage be the 'default' process in hospital? I don't ever recall being given an option before... what is the benefits of this as opposed to just letting it happen?

    Are there any risks associated with either plan?

    What is most beneficial to bub? and why?

    I am planning on a VBAC... does this affect anything?

    TIA

  2. #2

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    I'm not exactly sure what the hurry is when it comes to birthing the placenta (not being smart, I really don't know).
    All I know is that I suffered a mildish PPH when I was given the injection with DD1. I was also annoyed I wasn't warned they were about the jab me - seriously it HURT!

    I had no interference with the last 2 (actually I think the stupid middie started pulling on the cord with #2 but I asked her to stop), and the darn thing came out on its own, of course.

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    Without getting too medical on you, always happens! (NICU Nurse). If there is too long of a delay between cord clamping the baby's blood can start to drain back through the cord and thus the baby becomes anaemic and compromised due to low blood volume, doesn't happen everyday but it can happen. The aim of the syntocin is to evenly and quickly allow the placenta to pull away from the uterine wall and out. Yes, it can be quite painful but it ensures all products are removed and quicker than waiting for your body as to reduce infection. PPH can occur which ever way you go as this is a complication of birth, not necessarily, with the birth of the placenta. What occurs greatly depends on your own body, location of the placenta, birth of the baby, and ofcourse scar tissue from previous C/S.

    I hope that helps, I'm not really swinging either way as I have been to alot of births of both, managed and physiological complications. The medical staff SHOULD be supportive in both options and yes, you have every right to decide on what choice you would like to make, however, if your health could become a concern they will do the best for you and your baby.

    GOOD LUCK

  4. #4

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    Zoo - why wouldn't your body, after birthing the baby, have a problem with expelling the placenta?

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    The uterus doesn't contract evenly, IYKWIM? When the last contraction births the baby, majority is from the sides of the uterus. The placenta doesn't fill the uterus like the baby does and therefore the uneven contraction can break away only parts of the placenta thus causing it to go into pieces and leave retained products behind.

    Like I said, it happens and then it doesn't happens. Studies are showing that retained products are now having a link with the duration of labours aswell.

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    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.

    I did a bit of research and often it's fine to deliver the placenta without any drugs but I figured it really isn't going to hurt me to have the shot and get the placenta out sooner rather than later. After all that hard work I think I'll be quite happy to finish off the labour and get on with just bonding with my baby.

    That's just my personal opinion though.

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    To clarify - delivering the placenta doesn't hurt, it was the jab in the butt that did!

    Also, it's not a hassle birthing the placenta - it usually comes out whilst you are sitting up holding your bubba, so it's not like you are waiting around for it to make an appearance!

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    Quote Originally Posted by Lulu View Post
    Also, it's not a hassle birthing the placenta - it usually comes out whilst you are sitting up holding your bubba, so it's not like you are waiting around for it to make an appearance!
    I know it's generally quick but not always. A friend of a friend took 2 hours to deliver hers. She's opted for the shot with her next labour.

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    Thanks for the replies everyone.

    I am wondering if maybe we can delay the cord clamping for a bit and then have the needle etc if it seems necessary? I don't know how long I'd leave it though, or what hosp limits would be before they deemed it necessary.

    2 hours does seem a bit long...

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    Quote Originally Posted by jasp View Post
    Thanks for the replies everyone.

    I am wondering if maybe we can delay the cord clamping for a bit and then have the needle etc if it seems necessary? I don't know how long I'd leave it though, or what hosp limits would be before they deemed it necessary.

    2 hours does seem a bit long...
    Yeah, good questions. I don't plan on delaying cord clamping (no one shoot me!) so providing the shot is given to me after the cord is cut, then the drugs can't be transferred to the baby.

    Would be interesting to check with your midwife/OB as to how long you can wait though.

    I was suprised by the 2 hour marathon as I don't think it's all that common, but it really made me think twice about it. Each to their own I guess

  12. #12

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    I was holding DS on my chest when the MW asked me to give a little cough and the placenta came out all by itself.

    All I could think about later was how I didn't I cover my mouth when I coughed!

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    Please excuse my ignorance - I didn't do a lot of research while pregnant with DS.. just assumed the midwife knew what she was doing. Bit naive I guess.

    My question is this - Is it the "norm" to have the injection to birth the placenta?

    I ask because my midwife had just transferred to Aus from NZ and told me that she is used to doing things a little differently from the rest of the midwives in the hospie. Everything was fine and she always consulted me about what I wanted in accordance with my birth plan.

    I didn't have anything in the birth plan about the placentas delivery though. Once I was cradling DS she put a little bit of pressure on my uterus with one hand and a slight little tug on the cord. It didn't budge so she said "We'll give it a bit longer" and tried again in about 10 minutes, this time it moved so she told me to give a little push and out it plopped.

    So - is this normal or would any other midwife insist I have the shot?

    Sorry bit long winded.

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    Midwives are probably more likely to avoid the shot I'd say - just to give you that chance at the full 'drug' free birth. They tend to avoid any intervention where possible. Sounds like you had a wonderful middy to be honest!

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    Cheeky monkey - no need to feel ignorant - I haven't looked into any of this until now, and this is bub number 4!

    I am assuming I had a managed third stage with the others, I think I did...TBH I really wouldn't know...so how's that for ignorant!

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    You'd be surprised, I have seen many a hospital midwife do the whole super fast third stage thing. One of my clients had a quick pushing stage and the midwife whipped out the syntometrine shot, and my client said with horror, OMG whats that for (we'd not had a birth plan meeting, it was all very last minute but she had an awesome birth!) and before the midwife answered she'd already put it in her leg and then said, to stop a haemorrhage. Hmmmmmm.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
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  17. #17

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    Can I thread hog for a minute (though it is still about third stage)

    I had a meeting with my doula last Monday (22/6) and I must admit I did not know much about the managed third stage or physiological/natural third stage before then... infact in all honesty I didn't really know how the placenta came out - I just assumed it followed the baby

    But after discussion with my doula and doing my own readings re benefits, processes etc I would like to try a physiological third stage... I want to have a delayed cord cut as well.

    Can I ask - I am going to a public hospital as a private patient - will it be the hospital's 'policy' or my Obs stance that I should be looking into???

  18. #18

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    #3 i had naturally - midwives totally respected my desire for 3rd stage natural too.

    however my pesky placenta took 45 mins & they were starting to say 10 more mins etc .... i was fine with that by then & just wanted it out cos oh man i had contractions that were just as painful as ones during labour!!!!

    short - bubs in arms

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