What worries me...Retained placenta, have had two out of three....

[Julie Doula]

tillie I can only speak from experience of all natural third stages.

there are many things we can do to help the flow of the mother's hormones be at peak levels so that her third stage is safe and gentle.

I have often been at home births where we have waited hours for the placenta. So long as there is minimal bleeding, and the mother shows no signs of shock, we just keep mum and bub skin to skin, let bub feed and feed and feed, keep both of them warm and calm, and we wait. The mother will not release the placenta until she is ready. And when she is ready, it happens.

There is too much rush associated with getting that placenta out and I think this disrupts the peace and calm the mother needs, inhibits her hormones and sets the whole thing back. All this also affects her bonding with her baby - that most important window of time in both their lives.

I tell my clients, 'your birth is not over when you have your baby in your arms. It's not over till the placenta is born too.' So we maintain the optimal birth environment: peace, calm, quiet, dim lighting, warmth, soft voices, letting the mother put all her focus on her baby and her body. I suggest everyone hold off on phoning and texting and birth announcements etc until the placenta is here. Sometimes the big celebration ruckus can inhibit what her natural hormones are trying to do. And sometimes all the hospital busy-ness and 'to dos' - examining the baby, examining the mother, getting baby on the breast, paperwork, moving trolleys around, cleaning up etc - have the same effect.

Sometimes in hospitals, when the staff have been 'rattling sabres' about the placenta (mentioning the injection) I've encouraged the couple to go into the toilet, with the mama sitting on it (with a bowl in the toilet) holding her baby, and her man cuddling her, with the lights out. Privacy and darkness, shielded from the stressy vibes - bingo: placenta.

There's a difference between two hours of trying to get the placenta out, stress and worry and focus on getting it out, various things being tried to get it out .... and two hours of mother and father snuggled up skin to skin in bed with naked little baby lying skin to skin on mummy's chest, bobbing and nuzzling and breast-crawling spontaneously to the nipple, suckling, suckling, drinking in the oxytocin and soaking up the warm skin contact, and the couple being left in peace to fall in love and bond in the haze of lovely oxytocin.

Here is an article I wrote about After Birth herbal tea and Placenta Wisdom

Be sure that ministering the herbal tea to the mother does not disturb the most important thing of all: skin-to-skin cuddles and the miracle of bonding that is unfolding between mother, baby and father. It would be better to delay the warm tea for a while if there is any chance bringing it could disrupt such a once-in-a-lifetime experience that is so vital for the new family. When the time is right, it should be easy to quietly offer the tea through a straw, let her drink, then quietly fade into the background again, leaving the family to continue falling in love.

Warmth, soft lighting, quiet, privacy, gentle voices, loving care and unhindered skin-to-skin cuddles are the things that optimise the flow of hormones that cause the placenta to detatch, the uterus to involute and the placenta to be born, and the bleeding to be minimal. This important stage of the birth process is often rushed in hospitals, where time is money. Usually they want that placenta out within an hour - or even half an hour. But if blood loss is normal, the mother's vital signs are good, she is not pale or shocky, and her after pains are not too severe, there is no need for rush. The placenta will come. I have been at perfectly safe normal homebirths where it took 4 hours or more for the placenta to come away, and it did, in the fullness of time - when the mother was physically and emotionally ready.

Gloria Lemay writes here about the '30 minute third stage' - in her experience, when the third stage is unrushed and the mother and baby are kept together and warm and quiet, the mother feels ready to release the placenta around the 30 minute mark, the great majority of the time.

One of my doula friends tells me that she encourages the women she serves to not only visualise themselves giving birth but also to visualise themselves holding their baby, having after pains that herald movement of the placenta, and then see themselves birthing that placenta, catching it, the cord still attached to the soft, warm little body in their arms. That's a good idea.

I hope this helps, Tillie, and that your next third stage is peaceful and calm and worry-free. Rather than reducing fluids, I'd encourage you to drink plenty during labour, especially a nice rehydration drink like 'labour ade' and remind yourself to try to pass urine every half hour. "Keep walking, keep drinking, keep breathing, keep weeing" = good progress.

I had an experience after my 4th birth when it was like my bladder or sphincter just 'went on strike' and I absolutely could not release the wee - and my IM actually did an in-out catheter. What can help is, who would have thought it - Peppermint essential oil. Shake a generous amount into the toilet bowl. It really works. Apparently it causes the capilliaries to constrict and this helps the swelling and the woman is able to pee. Worth a try.