this time, baby is born into water, cord stops pulsing after a few minutes, mom is in bliss and holding baby. daddy cuts the cord. then the cord detachs from the placenta, and placenta is still in. the midwife quickly got mom to the bed (not easy!), gave her pit and cytotec, and went in to get the placenta.
thank you God, it came out in about a minute. the cord had grown into the amniotic membranes and through them into the placenta, instead of just into placenta like normal. this was a complete surprise and apparently very rare. the midwife even took photos to show her colleagues. mom's bleeding was fine and there were no other problems.
if the cord had come off earlier - in labor, or before, well, you know so i won't even say it.
this mama is so grateful they didn't know about the cord issue, because it would have meant a high-risk pregnancy, a ton of anxiety and probably a very medical birth at a hospital, instead of the calm, serene, estatatic and safe waterbirth at the center.
i'm all full up with funky placentas thank you very much.
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It's called a velementous insertion and I've had two clients have them in my career.
In both cases the cord tore away from the placenta when the provider provided traction to see if there was placental separation and manual extraction was needed to get the placenta out.
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It's called a velementous insertion and I've had two clients have them in my career.
In both cases the cord tore away from the placenta when the provider provided traction to see if there was placental separation and manual extraction was needed to get the placenta out.
yep, that's just what happened, but the MW truly didn't pull much, just a little tug because she thought the placenta had separated and it came right off.
It's called a velementous insertion and I've had two clients have them in my career.
In both cases the cord tore away from the placenta when the provider provided traction to see if there was placental separation and manual extraction was needed to get the placenta out.
Why does this require manual extraction, necessarily? I'm thinking...shouldn't the uterus still do its job of expelling the placenta, even though the cord has detached? Is there something else different about the placenta that causes it to remain behind?
Why does this require manual extraction, necessarily? I'm thinking...shouldn't the uterus still do its job of expelling the placenta, even though the cord has detached? Is there something else different about the placenta that causes it to remain behind?
i wondered this too. what i have thought of is this: if the placenta IS attached then the placenta would bleed through the cord attachment place, mom could bleed out. but if the placenta is already detached, seems like it would just come. i think maybe they go for it because they can't tell which way it is. i don't know this for sure, just speculating.
Why does this require manual extraction, necessarily? I'm thinking...shouldn't the uterus still do its job of expelling the placenta, even though the cord has detached? Is there something else different about the placenta that causes it to remain behind?
I don't know, I'm just guessing here, but I would think that they would do the manual extraction to get it out as soon as possible in order to prevent too much blood loss.
Perhaps someone w/more experience can comment and inlighten us as to the reason.
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B'earth Angel the absentee doula "He who passively accepts evil is as much involved in it as he who helps to perpetuate it. He who accepts evil without protesting against it is really cooperating with it."
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I've had a client with a velementous cord. Actually, it is the same one that I just wrote about on another thread that pushed for 5 hours! The cord was attached to the side of the placenta and it was barely hanging on. I, too, didn't want to think about what could have happened!
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Cindy
Married to the love of my life for 20 years
Mom to Rebecca, Rachel, Richard, Ruth, Robert, Riley, Reece, Ridge, and Reagan
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Holy moly! You do have the luck! All very interesting though!
Thank goodness mom and baby are alright. And it is great that they were able to have the calm birth they wanted.
Kristin,
In the two cases I've seen the first started bleeding like a faucet while they tried to wait on the placenta to come, I mean you could **hear** her bleeding.
the second had a large fibroid and the placenta was implanted up behind it and the OB actually went in and did the C of a D&C on her. Totally unmedicated birth, had to be knocked out for the placenta
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I have heard of two velamentous insertions, both from midwives, both were undiagnosed.
In both cases mom and baby were well.
In one case the midwife had a feeling something was going to be a bit off in the third stage... which put her in an bit of a situation because she was technically the student... and her preceptor used a bit too much cord traction then she had seen previous preceptor use.
Anyways, once the baby was out, she guarded the mother and was super assertive about her comfort as the student... meanwhile she's a bit paranoid, and very on the look out for something to go amuck... when she saw the signs of separation, she had the mom squat and cough... the placenta came partially down into the vagina, then she pulled to facilitate, and... cord came off in her hand!!!! Luckily the placenta was off.... The bigger issue was that the cord wasn't clamped, but she squeezed it shut, while the other midwife clamped it. The placenta was exposed so she just had to grab it with her thumb and forefinger and pull it out.
Even though these placentas are a deviation from normal, so far I have yet to hear of one not holding onto until after the baby is out... amazing.
it seems like maybe these placental variations are not that rare? the MW at this birth made a point of saying it was rare, but we all don't have THAT much experience and several of us have seen or heard of it.
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That is really scary! I'm so glad everything turned out okay!
Cindy 
