Met with a new client last night, and she had retained placenta with her first.
But she said the dr seemed really impatient and manually removed in minutes after birth, he just said it was taking to long to come out. Then he told her husband to put the gas mask on her ' this was gonna hurt'.
She remembers very little as she had a shot of morphine at 7 or 8 cm.
Then she had alot of heavey bleeding and he stuck a wad of gauze in there, and the nurses did not find it until about 8 hrs later....she asked if it was normal to leave it in that long.....ummm NO.
Then she had lots of bleeding after she got home, and BF trouble, and her she went back to the Dr and she had retained placenta.
Anyway...all this happened after she laboured at home peacefully until 7cm, and then she went to the hospital, and they pretty much took over ( and she didn't know that they were not the experts and she could have had choice if she only asked or refused!) and she is not letting that happen again! She wants a doula and she wants no meds, and she wants a more involved, alert, aware experience.
around 20 minutes is average in a MANAGED labour, but in natural birthing, it can take even an hour without problems. I think i read in Ina May Gaskin's book of a woman who birthed her placenta the next day, with no ill effects (though personally I'd be nervous to suggest that is normal if there is a risk of retained placenta).
but my understanding is that it is dangerous to manage the third stage, especially manually removing the placenta by pulling on the cord, etc, since this greatly increases the risk of broken placenta and retained placenta. yet for some reason, many OBs do it!
Keith's placenta was delivered within minutes after he was born, complete with the L&D nurse on top of my applying fundal pressure. Oh how fun that was <tic>.
I'm glad she wants a doula this time.
The third stage was definitely something I needed to learn more about after the first birth I attended! It seems that once the baby arrives AND EVERYONE IS PREOCCUPIED the OB's just get in there without reason or consent!
I now do a lot more education wise regarding the placenta.
around 20 minutes is average in a MANAGED labour, but in natural birthing, it can take even an hour without problems. I think i read in Ina May Gaskin's book of a woman who birthed her placenta the next day, with no ill effects (though personally I'd be nervous to suggest that is normal if there is a risk of retained placenta).
but my understanding is that it is dangerous to manage the third stage, especially manually removing the placenta by pulling on the cord, etc, since this greatly increases the risk of broken placenta and retained placenta. yet for some reason, many OBs do it!
Right - the 20 minutes is managed timeline. Henry's was born about 45 minutes after he was, and my midwife's apprentice's was 3 hours. But both of those were at home. If you have drugs during labor, for example, the placenta needs to be birthed quickly b/c the drugs are contraindicated for an expectant management.
Right - the 20 minutes is managed timeline. Henry's was born about 45 minutes after he was, and my midwife's apprentice's was 3 hours. But both of those were at home. If you have drugs during labor, for example, the placenta needs to be birthed quickly b/c the drugs are contraindicated for an expectant management.
And thats just it..she arrived atthe hospital at 7cm. She was probably given morphine during transition.... no one really told her she was in transition, and was doing great, and it would be over soon. So the morphine slowed everything down, but being so close to delivery, it was still pretty fresh in her system. She was stoned, baby was stoned.
So her labour was great...until that point. ARG!! Our nurses really hate seeing normal birth I think, and seem to think everyone needs something!
If you have drugs during labor, for example, the placenta needs to be birthed quickly b/c the drugs are contraindicated for an expectant management.
but for some reason many OBs will treat every mother in the 'drugs during labour' category and get the placenta out asap, even when the baby was born naturally.
I recently attended a birth where the mother was very adamant about natural birth without interventions, and the second the baby was out, the MW gave her a shot of pitocin and PULLED the placenta out by the (already cut) cord - it was over in less than 2 minutes, despite my client clearly stating that she wanted NO pitocin, and to wait till the cord had stopped pulsing before cutting!
i just think they are in a rush and want to get out of there.....
Heaven fobid they work more than hour to make that $2000. or how ever much they make at a birth!
active management about 15-20 min but in a natural, uncomplicated labour 45 min is still good and fine.
Glad that she is thinking ahead this time and is getting a doula. I always get mom's who are insistent about this kind of thing to get their birth plans signed by the hospital, midwife, doctors etc. Anyone and everyone who may be involved with the birth.
This seems to help in avoiding unnecessary interventions.
Hope better attitudes prevail this time.
but for some reason many OBs will treat every mother in the 'drugs during labour' category and get the placenta out asap, even when the baby was born naturally.
I recently attended a birth where the mother was very adamant about natural birth without interventions, and the second the baby was out, the MW gave her a shot of pitocin and PULLED the placenta out by the (already cut) cord - it was over in less than 2 minutes, despite my client clearly stating that she wanted NO pitocin, and to wait till the cord had stopped pulsing before cutting!
yup - I agree. I think part of it, at least in my area where over 90% of women in hospitals get an epidural, so I would guess even more get *some* kind of drug, is that OBs never see a placenta delivered naturally. I'd bet $ that there are OBs who think that a placenta NEEDS pit to be delivered kwim?
So if mom has had an epidural, it is normal or even ok for OB to tug on the cord to get it out?
At my first birth, I was over taking pictures of the baby getting cleaned up, etc...and when I came back over about 2 minutes later, ob was just a pullin on that cord, and plop--out came placenta. I was a little shocked! She did have an epi.
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"If you want to know what a man's like, take a good look at how he treats his inferiors, not his equals". ~J.K. Rowling, Harry Potter and the Goblet of Fire
I'd bet $ that there are OBs who think that a placenta NEEDS pit to be delivered kwim?
exactly! in the birth I mentioned, immediately after, I said to the MW that the mother had requested to deliver the placenta naturally, and wait till it was born and stopped pulsing, she looked at me like I was mad (actually, the same look she gave me when she announced they would need an episiotomy and I asked if I could get some hot compresses to put on the perennium, to try avoiding it. they did the episiotomy in the end, and even pressured for a vacuum too, though we managed to avoid that). She actually muttered something like "no, we need to do this to get the placenta out", before she took the baby off to be 'warmed', despite the mama's request to hold her baby.
Actually, I vowed never to attend another birth in that hospital after that; it really was so awful. We arrived with the mother at 10cm dilation, and feeling a strong urge to push, the baby was born exactly one hour after we arrived, so the mama had been physically on the bed in the delivery room less than 30 minutes, and they still managed to do all that to her!
and to make it worse, after they took the 2 minute old baby to the warmer, all the staff left the room, didnt say a word to the parents, left mama with her cut open vagina bleeding, baby alone and crying in the warmer, and didnt come back for 20 minutes! no explanations, nothing
sorry for ranting, that really is for another thread
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