Retained Placenta & Physiological Third Stage?

[Quickening]

I know a physiological third stage can go for as long as a hour or more before the placenta is birthed.

The thing is, everyone keeps telling me that a retained placenta is one that remains inside after 30 minutes to an hour. To me that is NOT a retained placenta.

Is there such a thing as a retained, whole placenta?

I know sometimes placentas are birthed and they are not whole, breaking apart as they are birthed and that some pieces can remain behind in the mother. To me, that is a retained placenta and the symptoms of that are feeling extremely hot but your temperature is normal to touch and sometimes there is heavy dark bleeding, haemhorrhage or signs of infection later on.

One of the reasons I want to UC without a midwife is because I disagreed strongly with my midwife's handling of my third stage and no amount of talking or information could convince her to lift her time limit of 30 minutes to get the placenta out so there was a lot of effort and fear when I was trying to push the placenta out before my 30 minute limit and that was damaging to my body.

How will I know by looking at the placenta, if that is really all of it?

How long do I wait for the placenta to detach (how will I know it has done that?)? I know that most of the time the placenta has already detached and is just sitting inside, waiting to plop out.

Btw at 18 minutes when I did get my placenta out finally, I felt it detach painfully - I was pushing really hard without the help of any contractions to try and get it to come out. I don't think it was ready to!

[cottonwood]

My first midwife had me pushing at 15 minutes after the birth! ARGH! My second we waited an hour and fifteen minutes. The midwife was starting to get antsy even though I was feeling and looking great so for her benefit I got up into a squat and it came out shortly thereafter. (Thinking back on it, geez I really didn't need all those people there waiting and staring and... ugh.)

When the placenta separates there may be a lengthening of the cord, and a gush of blood. I haven't noticed that myself. I think more telling is the change in mood of the mother. Your focus will spontaneously shift from the baby back to your body, and you sort of "wake up" a little bit. It's a subtle thing, I think you might not notice if a lot was going on. With my last UC, I think I know right when my placenta separated. I was completely focused on the baby in this kind of timeless space, then about 10-15 minutes after the birth I naturally drifted out of that birth consciousness, I became more aware of what was going on around me, and I started gettting uncomfortable. (I think that's when it happened.) I got up then and walked to the living room (other side of the house) and sat in the recliner. After a while (another 10-15 minutes ) I started feeling kind of antsy, like I was ready to do something, and I handed the baby to my husband and squatted over a bowl. At first it seemed "stuck" -- nothing seemed to be happening. Then I got that strange feeling, sort of a prickliness and pressure and feeling of fullness, and out it came.

I have never had pieces detach, but looking at the placenta it seemed pretty obvious to me that I would know if a piece was missing. It had a smooth surface, like covered by a thin layer of gelatin, and was the same everwhere (on each side, of course, as they are different.) What I was less clear on was if the membrane was whole. It's stretchy and clingy and thin and hard to examine. (I thought.) My uterus was firming up and I felt fine, though, so I didn't bother much about it.

[k'smami]

I know one UCer whose placenta came out after 12 hours. I read another birth story where it took 30 hours. Niether of the women reported any complications. I really think that placentas should be left alone unless the mother is feeling like something is wrong and feels she needs some type of intervention. My placenta with my UC came out after about 5 minutes. I had I feeling that it was time and told my Dh to get me a bowl, I sat on it and waited. It's funny because it came out as soon as he left the room and the baby and I were alone.

[DancerMom]

My placenta came out but stayed attached by the membranes for over 24 hours. I hope Pamamidwife sees this thread because I called her for advice and she told me a 30 hour story.

There's also a woman (friend of mine irl) who posts here whose placenta took 5 hours. And if I remember correctly, some membrane stayed inside and came out days later. Maybe if she sees this she can give more details.

My point is that if all other signs are good, there's no reason to worry, just monitor it.

[Kundalini-Mama]

Originally Posted by blueviolet

I have never had pieces detach, but looking at the placenta it seemed pretty obvious to me that I would know if a piece was missing. It had a smooth surface, like covered by a thin layer of gelatin, and was the same everwhere (on each side, of course, as they are different.) What I was less clear on was if the membrane was whole. It's stretchy and clingy and thin and hard to examine. (I thought.) My uterus was firming up and I felt fine, though, so I didn't bother much about it.

It was just so obvious that the whole placenta was there. My son's was a perfect circle about the size of a salad plate. I also had to take some blood from it to test my son's blood type (RH- crappola ) and it was obvious which side was whose as well, even though I really couldn't get my head around it beforehand.

I can't remember when the placenta detached per se, but I knew that it was sitting there in my vagina waiting for me to get up from the bed--but honestly, I was so comfy and so loving my newborn that I really didn't want to get up :LOL I was feeling great, so no concerns. So it came out at an hr PP, but probably detatched about a half hr PP.

Amy

[Defenestrator]

The one thing to watch out for if the placenta has not come is hidden bleeding. If your placenta has not come, you can feel for the top of your fundus (or get a partner or helper to do it) and then check every few minutes to see if it has gotten higher. Some people even like to mark the location of the top of the fundus with a pen on the belly. If the placenta has partially detatched, sometimes there will be a lot of bleeding, but it won't be visible on the outside because the placenta is blocking the cervical opening and the blood can't come out. But in this case, the uterus will fill up like a balloon.

If the placenta doesn't detach at all, there will often not be bleeding, but you may need to transport to the hospital for surgical removal.

If the placenta has detached but has not emerged, there will often be a gush of blood and a feeling of fullness as it moves down into the vagina.

I think that placentas are beautiful things. I have seen some really cool ones. I don't think that you will have any trouble knowing whether or not it is all together. You can hold it in cupped hands and the pieces will come together like a puzzle. The edges will look smooth and not ragged. There might be clots of blood on the surface, which can be smoothed away, but underneath it should have a certain order to it, little hills and valleys.

[Kundalini-Mama]

oh, wanted to add. Someone passed on to me a great website of homeopathic remedies and there is something on their for retained placentas.

http://www.lyghtforce.com/Homeopathy...ue4/nauman.htm

[Yummymummy74]

All of the above is good info, I mean it can be such an individual thing! my placentas usually come out about 20 minutes after birth on their own, but I think for some women 24-48 hours may be thier norm...kwim?

I also want to add that retained membranes can happen and are NOT a big issue unless your bleeding alot.. my last placenta came out whole but a week later I passed a piece of membrane that obviously had not come out initially.. your uterus knows what to do and it can and will expel what should not be there

[mwherbs]

the other things to think about would be steady bleeding with the placenta still in or if your uterus is enlarging after the baby your fundus should be at or below your belly button if it gets bigger and the placenta is not out the blood may not be coming out but filling the uterus.