Delivering placenta question

[lovelylisa]

Hi everyone!

I am currently trying to address some questions/fears I have about labor so I won't be so nervous this time around. Maybe you all can explain something to me? 

I read all these birth stories about people delivering the placenta and it seems rather easy. Push and out it comes. However, when I gave birth to my son, I barely remember delivering the placenta. What I do remember is the doctor (I gave birth in a hospital) telling me that they had to make sure all of the placenta was out of me. So he had to clean me out, I guess...and that involved what felt like his entire hand inside me scraping me down. It really felt horrible. That was worse than anything I felt during labor, and (dont know if this is TMI, but anywho) really put me off sex for a while. I wanted NOTHING going in there ever again, lol.  I'm scared of this part happening again, although if I am prepared for it, I won't be as shocked. I just remember saying afterwards, "WTF was that? I don't remember reading about that anywhere!"

My mom told me they did the same thing to her when she was in labor and that it was normal. But I haven't read any stories where people talk about this. Is this normal? Do I need to be scraped out after? What would be the need to do so? Is that why I might have bled so much after?  

Any input would be much appreciated... thanks!

[Lish]

Although I have not personally experienced this I do have a girlfriend who dealt with the "whole forearm in the womb" treatment after the delivery of both of her children and it was very hard for her, too. In her case she was not very connected to her birth process and gave herself over completely to her OB in a very *typical* hospital. Even after the fact, although she shared her experience with a few close girlfriends, she never followed up with her doctor with any questions about the circumstances of this treatment and even stayed with him for care through the pregnancy and birth of her second child, after which she had the same experience.

My suspicion (I am not a birth professional) has always been that instead of her OB taking the time to wait for her to deliver her placenta spontaneously he tugged at the cord to expidite the expulsion and possibly tore off all or some of the organ. This can be dangerous for the mother and my guess is he "went in" to remove any remaining placenta, etc. Whether this sounds like it could have happened in your case, I would not be surprised if the literal "manhandling" of your womb contributed to your excessive bleeding.

If you are receiving care from the same provider I think the best approach is a direct question about the circumstances surrounding this treatment at your previous birth and a conversation about how to avoid it with this baby. If you are seeing a new provider I would bring it up with them to find out their philosophy/reaction and their thoughts about what can be done to avoid this happening again.

[Banana731]

it's not the norm. that's very invasive.

i would say cord traction is fairly common in a hospital setting, and that has the potential to leave fragments. If you have fragments then you would get the situation you described.

[lovelylisa]

Luckily I have a new provider- this time I'm birthing with a midwife in a free standing birth center. Hopefully this is not something I will have to experience again.   I will ask her at my appointment next week but I suspect just from reading your responses that this was NOT the norm. I guess I am just afraid that I will bleed a lot again and require a hospital transfer.

I hate when you go to hospitals and nobody tells you whats going on. I was so loopy after giving birth and so excited to see my baby that I couldn't ask what was going on and why that happened.

[Evergreen]

It doesn't sound like the norm to me.  I had my 2nd child in the hospital and I know they didn't do that.

My mother had one child with a retained placenta and they did have to scrape some out. She hated it.

I would hope they would not do something so invasive unles there was actually retained placenta.

[Banana731]

also if you're placenta was in a long time (in a hospital that means more than 5 minutes, it seems) then sometimes a cp will go in and manually remove clots that will have formed.

that's also very invasive, and not the norm for a FSB or a HB MW.

[jcregan]

As you said, asking your MW about it is definitely the best course and I think will relieve many of your fears.  Both of my babies were in a hospital with a MW and this was not done in either case.  With this my 2nd there was more bleeding then they like after the placenta was delivered so they did a shot of pitocin and that seemed to work fine to slow the bleeding  (with my first it was a pit. induced birth so I was already on pitocin).

It took maybe 10ish minutes to deliver the placenta with each and the MW did carefully examine it afterward to ensure it was all there, but that was it. 

Your experience sounds very invasive and I am sorry you had to go through that, it sounds like you are on the right path to avoiding that kind of treatment this time around!

[lovelylisa]

Thanks for the info guys, I will certainly ask my midwife.

[happysmileylady]

I have had 3 kids in 3 different hospitals with 3 different care providers, that's never happened.  I do remember after all three births though the docs examining the placenta and commenting that it was whole.  I imagine the "cleaning out" is due to fears of parts being left behind, but really, of course they should explain that, that's just awful.

[Tumble Bumbles]

Hospitals are notorious for managing the third stage of labor (delivery of the placenta) in a really invasive and (imo) damaging way. There is a lot of rushing, cord traction, pressure on mama, pitocin, and various other interventions that almost guarantee a hemorrhage or retained bits of placenta. In most cases (there are exceptions of course) the placenta comes out on it's own, without any "help", and the best way to ensure that happening is to ensure the proper release of oxytocin right after birth -- oxytocin is released in optimum levels when:

mama feels safe

baby is directly on mama skin to skin, on the breast preferably

mama is kept very warm

mama is not pressured, spoken to, or touched --is left to bond with baby in the first few minutes after birth -- look into baby's eyes, touch baby, putting baby to breast etc.

As you can see, almost none of the above is the standard hospital protocol. I would speak to your midwife about management of the third stage and request that the above criteria be respected to ensure the biggest release of natural oxytocin which helps expel a whole, healthy placenta and avoids common third stage 'issues' (again, in most cases... I realize there are exceptions).