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Manual Extraction of Placenta

post #1 of 20
Thread Starter 
My younger sister recently had her first child in a Navy Hospital. The experience was a complete 180 in contrast to my own homebirth in many ways that I'm sure you all can imagine. I had completely expected the experience to be very different and I made up my mind to leave my judgements about her care at the hospital door, and just be a supportive presence during the birth.

However, there was one aspect that my mother and I both could not get over. Less than 5 minutes after the delivery, the doctor reached in and manually removed the placenta! My sister was in obvious discomfort, and it happened so fast, that my mom and I just sort of stood there in shock. Later, I asked the nurse why the doctor had done this, the nurse replied "Because it wouldn't come out", and she gave me a dirty look. The next day, when my sister asked the doctor why, the doctor replied that the placenta was "Stuck". Mind you - this was less than 5 minutes after the birth.

So, I recently spoke with a friend of mine who has been apprenticing under a midwife, and her reaction was that this is the new 'Thing' in hospital birth - that some study has concluded that the immediate manual removal of the placenta reduces hemmoraging and that it's now standard practice. I myself have read that Manual removal of the placenta is a risk factor for postpartum endometritis.

Has anyone heard about this? Are links to support this theory? To contradict the theory? I think that it's barbaric, akin to assault. I was extremely uncomfortable and infuriated watching my sister writhe on her back while this doctor basically ripped her placenta out with no explanation. I personally think that the doctor was in a rush to proceed on with her evening and didn't want to stick around for the 30 minutes that it may have taken to deliver naturally.
post #2 of 20
Coincidentally, a friend of mine was telling me last night that she had attended a friend's first birth some time ago and the doctor did the exact same thing. She also said that the doctor spent most of the delivery telling the woman to shut up.

This woman has since had several children and she now hemmorages after each one as a result of scarring on her uterus due to the "ripping" out of her placenta.

This is another reason why I'm having a homebirth.
post #3 of 20
I've only seen one manual extraction that was necessary. I've seen several that were more like "doctor was in a hurry, so let's get this puppy out". A lot of them will see the seperation gush and suddenly it's all about getting the placenta out in under 30 seconds, I swear. The minute the baby is out they are talking about Pit. and getting out the placenta already. It's annoying. Manual extraction of the placenta should be reserved for when it's really necessary, which isn't very often. It can take a placenta anywhere from a few minutes to nearly an hour to come out and that's just fine.

Namaste, Tara
post #4 of 20
I can't tell you why they did it.

I can tell you that I *still* remember how much it hurt. I had labored unmedicated, was given a episiotomy that tore into my rectum, and did it all without even a sound. When that sOB reached into my body with both hands and DUG my placenta out of me, I screamed hysterically and stood up to walk off the bed. It was the single most excruciating thing I've ever experienced. This happened 9 years ago...

Hope your sister is okay...

Edited to add: This was minutes after my son was born. No hemorrhaging.
post #5 of 20
Thread Starter 
^

Your story made me shudder!

Yes, my sister is fine, and baby is okay. The placenta seemed healthy and intact, so I don't thing that there was any major uterine tearing, but still...it ticked me off! I can only imagine that it would have been more painful for her, had she refused the epidural. Never thought I'd be blessing the event of an epidural!
post #6 of 20
I delivered in an USAF hosp. and the doc started punching my placenta out as soon as my dd was born. I hadn't even seen her and he starts punching my stomach with a closed fist so hard I bruised in several places. He said it was common procedure. Butt munch
post #7 of 20
I had to have this done, and it actually didn't work and I was given an emergency D+C because I was bleeding badly. I do believe mine was warranted, I trust my midwife and she was about as hands off as she could be in a hospital setting, but I will never forget the agony of the attempted manual delivery. She gently tried to extract it, but had to call in the (s)OB and he was very rough. The pain outshone the pain of labor and delivery by about a million, and I believe I suffered from PTSD due to what happened.

I am so sorry for your sister.
post #8 of 20
Holy Crap!!!

My first reaction when someone causes me pain is to get them away - if it had been me that doc would have gotten a size 10 foot in their chest, and would have found themselves acroos the room. DAMN!

I am so sorry your sister had that happen to her. That sounds appalling and horrible.
post #9 of 20
My placenta was manually extracted as well. At the time, the doc said that it would not deliver, but she didn't wait very long (although my dh said I was bleeding quite a lot). I had also labored without any pain meds, but was given a shot of nubain (without my consent, by the way) before the doc scraped the placenta out. It was horrible, and according to the doc, the retained placenta is likely to happen again the next time. Personally, I think it wasn't my body's fault, but the pitocin that was used to induce labor (water broke, doc on call insisted on induction, stupid me didn't know any better...) might have had something to do with the retained placenta, which is one of the possible side affects of pit (which NO ONE informed me of). Hindsight is 20/20 and all that, but I think the situation sucked. I'm sorry anyone has had to go through that pain. Ugh.
post #10 of 20
Was she given a shot of pitocin? If she was- and you may never have noticed, it's a very small syringe and they do it while the shoulders are being born- then they would have done it to prevent a retained placenta caused by the iatrogenic intervention. (with most managed third stages over here, the midwives get worried 5-10 minutes after the shot if the placenta isn't out.) Basically, the managed third stage can cause the cervix to close enough that it doesn't give the placenta enough space to leave.

To be fair- whilst a full-on manual extraction is pretty horrendous, by all accounts, a D&C under general anaesthetic with a minutes-old baby would be even worse- which could be the other option.
post #11 of 20
Thread Starter 
She was on a pit drip intermittently, it's very possible that she was recieving it at the time of delivery or afterwards. I was not aware that the pit would increase the likelyhood of a retained placenta. Most of my knowlege and experience is in natural birth, so that's a new one on me.

It would have been helpful if the nurse had explained the correlation between retention and pitocin to us, rather than treating us like total idiots and telling us that it was 'stuck'. My mother had delivered 4 children and had pitocin for 3 of them, and delivered the placenta naturally, and I delivered mine naturally after 30 minutes in a homebirth. It's not like she was speaking to women with no experience in birth...

But I suppose the attitudes of hospital staff during birth is another thread and another rant, so I'll gracefully bow out...
post #12 of 20
Quote:
Originally Posted by AdinaL
Holy Crap!!!

My first reaction when someone causes me pain is to get them away - if it had been me that doc would have gotten a size 10 foot in their chest, and would have found themselves acroos the room. DAMN!

I am so sorry your sister had that happen to her. That sounds appalling and horrible.
i was JUST thinking that!
post #13 of 20
so maybe it is new again in some hospitals-- but 25 years ago a doc did the same thing after our son's birth. I was in a ward room postpartum and all the women were "delivered" by the same doc and all had routine manual removal.... we were all shocked , who would expect it. I think this doc just didn't want to wait at all
post #14 of 20
:Puke That just chills me to the core- I can't imagine anyone putting anything inside me after just giving birth! That is absolutely barbaric!
post #15 of 20
I would like to add that in addition to the physical and emotional pain this all to common practice causes. It can also cause infection in the uterus and complications with implantation of future placentas with future babies. All in all I'm sooooo sorry that this happened to your sister. I think that now adays when a women goes into the hossy to have her baby she needs to have a 100 page birth plan (just in case)
post #16 of 20
Quote:
Originally Posted by LoveChild421
:Puke That just chills me to the core- I can't imagine anyone putting anything inside me after just giving birth! That is absolutely barbaric!
barbaric is the perfect word for it.

I didn't tear from giving birth, I tore from the attempted manual extraction. (See what I mean when i said the OB was rough?) My legs were put up into some sort of hanging device and I couldn't move, couldn't get away. I screamed and screamed and the Ob said, "Give her some versed so she won't remember this.." (didn't work). The only thing I can compare it to is how it must feel to be abducted by aliens. I was separated from my baby, my dh, my doula, taken into that brightly lit room, tied up and brutalized.

Finally, after what felt like forever, the anesthesiologist agreed to put me under anesthesia (he wouldn't before because he felt I had lost too much blood and it was too dangerous to put me under, I wasn't 'stable') and it was removed with a d+c.

I had nightmares about that experience for weeks. Honestly, sometimes I still do. My dd is 2 now, and I spent both of her birthdays so far anxious and depressed because I can't stop the memories of what happened after her birth from taking over that happy day.

What I told you was far from the end of the story. I ended up still having retained placenta, hemorrhaging 3x and being blown off by the OB, finally being diagnosed at 9wks post partum by my midwife after all but completely losing my milk supply, getting an infection, being in nearly constant pain for weeks, and becoming extremely anemic. Then, when the midwife diagnosed the retained placenta she had no choice to consult with the OB and he decided to attempt another manual extraction in his office!

That one wasn't as bad, but again it didn't work, and I had to have an 'emergency' d+c. (that cracks me up. For 9 weeks the OBs at that practice treated me like a hypochondriac. After all that time they finally realized they were wrong and I suddenly needed an EMERGENCY d+c.)

Anyway, I am not telling this story to freak everyone out but to let you know that if you are going to give birth in a hospital, definitely include the delivery of the placenta in your birth plan. Like I said before, I do believe my placenta needed help coming out but not in the brutal way that it was done. My perineum was ravaged, it affected by milk supply, it affected my mental health, it possibly damaged my fertility. I believe all those things were a snowball effect and were at least partly related to what the OB did to me.
post #17 of 20
besides infection, there are risks of rupture, tears which have been mentioned but also tears in the uterine lining tear in the cervix if it started to clamp down while hand is in there, probably the biggest danger would be to end up creating a hemorrhage/life threatening situation when none previously existed- if you have a placenta this hasn't self detached even partially then you really don't know how deeply attached it is trying to force detachment even with your hands on the placenta-- is like pulling a scab off- some times it comes of cleanly and sometimes not and sometimes it is tightly adhered and just a corner or something pulls loose and starts bleeding--- now it has created a situation- because you have a uterus that has limited ability to clamp down on the bleeding area because the placenta is holding it out, now what is left to do- surgical removal- which is even more blood loss- and if it is too much bleeding and still not controlled then you could end up with an emergency hysterectomy......
post #18 of 20
My mom had an emergency hysterectomy w/ my youngest brother (I have 4 sibs) after the doc forcibly pulled her placenta out by the cord and she started hemmorhaging.
post #19 of 20
Quote:
Originally Posted by MamaTaraX
It can take a placenta anywhere from a few minutes to nearly an hour to come out and that's just fine.
It took my placenta 3 hours and 10 minutes to come. It came out intact and I was just fine. My bleeding has been minimal. I know that if I had been in the hospital (or even if I'd had a midwife) my placenta would have been forced out by some means. This is just another reason I'm so glad I had a UC.
post #20 of 20

This happened to me as well. I found your story while researching it. I remembered it happening but have always pushed it to the back of my mind. I truly thought I was crazy and just imagining things until I learned that it's a real thing. Then I realized I was repressing the memory. I already knew that that birth traumatized me but I just didn't realize to what extent. It wasn't the only thing that happened. A whole lot of wrong was done to me but it's a long story. I am sorry that happened to your sister. I know how horrible it is :(

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