3rd stage/delivery of placenta

[blessedwith7]

I'm planning my 2nd homebirth (due in Nov.) and this will be my 7th baby. I'm curious about the delivery of the placenta. I never really paid close to attention to how the hospital handled that, too distracted I guess, but I did have some troubles. The first time it was removed manually and with the fifth I had "extras" left inside that needed to be taken care of. For my last birth I was able to pay close attention. The midwife waited for the first noticeable contraction after baby, told me to push, and she pulled on the cord. I felt a pain deep inside almost like it was ripped out plus it seemed to last for awhile afterward. I didn't care for that at all and wonder if there is a better way. Advice is appreciated or if you could direct me to some good reads?

Thanks so much,
Theresa

[HeatherB]

Cord traction is NOT recommended by most natural birth advocates. You should be able to wait until the placenta has fully detached and then push it out. After pushing out a baby, it feels rather bizarre but it shouldn't be difficult or painful. Definitely discuss 3rd stage "management" and what you do or don't want with your MW this time. Waiting until it is ready to come out is definitely a good way to go.

[AZgirl2207]

The third stage certainly felt strange to me. While snuggling with baby, I felt a 'whoosh' of warmth (blood) and the placenta slid into my vagina. I sat up (about 45 degrees) and it felt out onto a chux. Baby was still attached when placenta detached, probably about 15 minutes after birth. It didn't hurt but it certainly felt weird. I expected it to hurt (after pushing) and was starting to get stressed (about more pain) when the placenta just 'fell' out.

[erin_brycesmom]

My homebirth was my third birth and the first where I did not have active management of third stage. Even with my natural hospital birth, I did not have an IV (not even a heplock) and they gave me a shot of pit in my leg, blah. They pulled the placenta out both times with my hospital births. With my homebirth, it was just totally relaxed. I didn't birth the placenta until about an hour and half after the baby was born. My MW didn't make a big deal about it. I asked her not to do cord traction. Once it came out, there was finally a little blood (none before then) and that was it. I had massive bleeding with my two hospital births but very little with my homebirth. No uterine massage or anything else.

[Momtotwo2004]

Third stage is really odd to me. The contractions still hurt and it feels like I'm passing a baby with no bones. *bleh*

This last time, my midwife and her assistant kept telling me to push to get the placenta out. And I just didn't feel ready. I can't explain it but it didn't feel ready. Like a gut/physical feeling.

They kept asking and I kept saying it didn't feel right. It did come out but I felt like I did more work than I needed to. That if I had just waited, it would have done more of it on it's own. Then it got "stuck" behind my pelvic bone...? Which was weird because I had JUST had a nearly 12 lb baby that just slipped right out without any pushing.

They told me to stand up and I did. It just fell out then.

[cocoanib]

MW told me to tell her when I felt like it was time. I stood up about 15 minutes after birth and it slipped out into a bowl. A little strange feeling, but not difficult to get out.

[lunarlady]

I had that cord pulling with my reactant HB, and a similar ripping pain. I think it contributed to the PPH I experienced and my subsequent emergency transfer. I say leave well enough alone! Make sure you discuss third stage with your MW. I didn't but certainly wish I had!

[Joyster]

I've never felt any pain when the placenta came out. With my second, I felt a good urge to push and out it came. With my third, I didn't feel any urge, I was pooped and I felt strange pushing when I didn't have to, but there was no pain and no one ever pulled on it.

[etsdtm99]

my placenta came out abotu 20 mins after birth - no contractions that i could feel, almost no bleeding, no pain.. it just kind of happened.. i think my midwife asked me about it and i just pushed a little and it came out.. with my hospital births i know something was done to get the placenta out.. my OBs arm was up inside me both times, and i had a LOT more bleeding ..i only had light period type bleeding for 2 days after birth.. i am 1 week out now and barely spotting where i had bleeding for 6+ weeks with my other births..

[momasana]

[QUOTE=etsdtm99;15878652]my placenta came out abotu 20 mins after birth - no contractions that i could feel, almost no bleeding, no pain.. it just kind of happened.. i think my midwife asked me about it and i just pushed a little and it came out.. QUOTE]

This was my experience. I was nursing my baby and it just sort of came out. I remember looking down thinking "hunh, there's the placenta" and then going back to staring at my nursing newborn.

[mamaw/two]

I've had 4 babies. First was a hosp induction birth with an md, babe was born after 30 hrs on pit, placenta was a manual extraction with pph. The next three births were natural hospital births with midwife, placenta came out with in 5-10 minutes WITH "gentle" cord traction, all three resulted in pph. The last two I have begged to have the placenta come out without traction and to leave the cord attached and unclamped until the placenta is birthed. It has not worked out as the midwife is so set in her ways and hospital policies.
Alot of the studies I have read say that active management (shot of pit as soon as the shoulders are delivered, cord traction to deliver placenta, and uterine massage) is the best way to prevent pph. Not my experience!!

[Baby_Cakes]

The delivery of my placenta w/DD was less than ideal, as well. I remember snuggling DD and all of a sudden my MW whole arm was up inside me and she was digging for it. I remember being like, "P! Whoa, that's enough!" and she said it had been a long time and she needed to help it out a little. I think it had been about 30 min? Maybe 45? And then once it was out she needed to make sure it was all out, which was a little more than uncomfortable. I too recall the cord being tugged on. Made me really apprehensive and I wasn't pleased.

The placenta was pretty calcified and she made some remark about how maybe it was b/c I had a mostly vegan diet during pregnancy. I still need to look into this more before birthing my next baby. But that's another thread.

Definitely look into what can be done to help with the 3rd stage. I know I will. KUP on what you find.

[BlackSheepPDX]

With my first (freestanding birth center "homebirth" with midwives), my placenta fell out within a few minutes of birth, as I stood up to move from the kneeling position where I delivered to get in bed. No one helped it out, I didn't feel anything telling me it was coming, and it was later inspected and determined to be intact.

With my second (homebirth with midwives), I had a very fast labor, about an hour of intensity, and I again delivered the placenta within a few minutes, but this time it was accompanied by pretty significant contractions/afterpains. After I felt the placenta come out, my midwife said something about there still being a few fibers attaching it, and asked me to cough...I'm not sure exactly what she did at that point to free the last bit, but it wasn't traumatic to me sensation wise.

Both times it just felt warm and squishy and passed pretty passively.

[Earthylady]

I don't remember how long it took for hb #1, but I know that hb #2 it took almost an hour for the placenta to come out and the umbilical cord was so short that babe couldn't even reach my nipple to nurse so we cut the cord about 15 minutes after she was born so I could bring her to my breast to help detach the placenta. Never no tugging or pulling though other than gently to see if it was ready to come out. Both times I remember thinking I'd just peed on myself though cause I got that warm gush of blood when the placenta was ready to come out.