Placenta emergency

[Ooey]

I had a pretty good home birth experience when my DD was born 17 months ago, and I'm now pregnant with #2. I only have one major issue with the experience, and that is the "placenta emergency" that my midwives FREAKED out over.

So DD was born in the bathroom and shortly after we moved to the bed. Then I was informed that we needed to start working on getting the placenta out, as an hour had gone by already with no contractions (this shocked me as I thought only 10 min had passed . At first I ignored them and continued snuggling and nursing my baby... but then they started in with "we need to be proactive about this" and told me that if the placenta doesn't come out very soon after birth the cervix will close up and I would have to go to the hospital. I had my doubts about this but I was not well informed and I think any home birther knows the kind of fear that comes with hospital threats. They wanted me to take something they had (I have no idea what it was as I don't know much about natural medicines/herbs) that was suppose to make me have contractions but I really didn't want to do that, so I agreed to move back to the bathroom and try to push out the placenta on the toilet. To do this the umbilical cord had to be cut, and the baby wrapped up and given to my mother to hold (she promptly took her in the other room, to this day I'm still upset about that The bathroom pushing was unsuccessful and I was getting really really cranky having been awake for 3 days straight and just given birth and all. I was exhausted and decided to lay back down with my baby. She started nursing and the placenta promptly came out within a few min.

Since the birth I haven't given much thought to that whole placenta situation, though I do keep meaning to look up more info about it, but now that I'm PG again I really need to talk about it and hear from others. I was just reading a beautiful UC story and read that it took this woman 3.5 hours to birth the placenta, and it kind of made me jealous and sad about what happened to me. Thinking back on it logically, my body was probably too exhausted for more contractions right away, and was giving me a little break.

If anyone has info or links that discuss this I would really appreciate it.

Also...at what point do you think getting the placenta out becomes urgent?

[dubfam]

I think that mine took about an hour. I had a very similar story to yours, but my MW's didn't mention the hospital. They didn't make me feel like it was an emergency, but like it was really important that I get the placenta out. I took some sort of tincture (don;t remember what, this was almost 5 years ago) and I had to hand baby off to my Mother while I birthed the placenta in my bath tub. it was the only part of my birth experience that didn't seem totally natural.

I have never put any thought into whether or not it was necessary...I guess I just assumed that it was. I am glad that you started this thread because I am so curious to see what other people have to say...also I would like to avoid any interventions for this birth.

[MsBlack]

Placentas take differing amounts of time to come out....lots of variation on normal!

and I don't know how anyone could say that you 'weren't having any contrax'--if that were true, you would have bled to death in fairly short order. Literally--and Long before the end of an hour. Of course you were having contrax, and of course placenta came detached with those contrax, uterus was shrinking down and shutting off vessels where placenta had been anchored...and eventually, placenta came out.

I prefer for the placenta to come out in the first 20 min...some do, but many take 45-90 min to emerge. I have not transported for stuck placenta except once, and that was at 5hrs pp. Still, mom was fine, no bleeding, firm fundus (I think--for a few reasons--that her cervix did shut down and trap placenta, but I know now that a healthy woman can work through this). Anyway, main reason for transport is that we'd all been awake for too long and needed sleep. She got an OBs help removing placenta, no biggie, and back home again an hour or so later.

To me, this is one of those things that you really need not carry into your next birth as a concern. What happened before was NOT really a problem; you may or may not have a repeat of 'slow placenta birth'...but it hardly matters since it was just YOUR NORMAL.

[NatureMama3]

Were you bleeding heavily? If not I don't see what the "emergency" was. It WILL come out, the body knows what it's doing.

I didn't have any other pushing type contractions after delivery, just pushed a little on my own and the placenta came right out.

[MsBlack]

Ooops! forgot to say--

Getting placenta out becomes 'urgent' if the mom IS bleeding (steadily and/or profusely), if her uterus is NOT shrinking down/getting firm.

[guestmama9924]

Also if mom in anemic, has low platelets.. that is also a potential for urgency. But in our state, midwives have a time limit and then they are required by law to transfer. 60 minutes.

I have seen home abruptions ( so placenta was coming before baby) and twice I have seen placentas take hours, yes hours. Both have potential for problems, but a skilled experienced midwife can handle both out of the hospital unless mother has a potentially high risk medical issue.

[Ooey]

Originally Posted by NatureMama3

Were you bleeding heavily? If not I don't see what the "emergency" was. It WILL come out, the body knows what it's doing.

I didn't have any other pushing type contractions after delivery, just pushed a little on my own and the placenta came right out.

No I was not bleeding heavily, at least nobody said anything to me about it. I was ripped pretty horribly in about 3 places though, maybe that is part of the reason they wanted the placenta out so desperately? At one point the MW's assistant pulled on the cord while she was examining my tares, I think it was kind of in her way.

[NatureMama3]

Then I wouldn't worry about it at all. I WOULD get a different m/w team. It sounds like it was all their problem and not YOUR problem.

[Datura]

Mine took a bit over 2 hours to finally come out. I'd had on and off labor for two weeks prior (lonnng story as to why), hadn't slept for 24 hours + before labor, had had an 8 hour labor and my body was pretty exhausted. The cord was really short so after it had gone flat we cut it and I was nursing Beastie Boy on the couch. The midwives left me alone for quite a while about it, but were chatting quietly in the corner about how long it had been. I was eventually encouraged to do some pushing (I was having virtually no contractions and had to "force" it out). My mw was WONDERFUL, she sat next to me for ages, very gently applying downward traction with each push. Eventually it came out, just as she was talking about giving the dreaded (at least by me!) shot to help it along. Its like it knew Turns out the darn thing was over 5 lbs and absolutely HUGE. Not horribly surprising, since my DS was over 10 lbs and needed a lot of support in there.

In my case, the placenta itself was on the upper end of the spectrum and the time needed to get it out was, too.

[soygurl]

Originally Posted by Ooey

They wanted me to take something they had (I have no idea what it was as I don't know much about natural medicines/herbs)

I'm pretty sure they wanted to give you "Angelica" tincture...

Originally Posted by Ooey

Thinking back on it logically, my body was probably too exhausted for more contractions right away, and was giving me a little break.

Originally Posted by Ooey

No I was not bleeding heavily, at least nobody said anything to me about it. I was ripped pretty horribly in about 3 places though, maybe that is part of the reason they wanted the placenta out so desperately?

I remember them saying something about not being able to tell if you were bleeding behind the placenta? Something about worrying that they just couldn't tell if your uterus was clamping down right or whatever until the placenta was out... :

Too many cooks in the kitchen IMO... :

[flapjack]

OK: it sounds to me like the part of this that you resented most was that the midwives asked you to cut the cord so you could move around more freely to birth the placenta? That's something positive that you can change, that you want to address next time: leave the cord alone. Were you planning a lotus birth, btw, or did you just want more time?
Personally, I think that hospital transfer is enough of a PITA that if the placenta isn't out at 20 minutes I'm going to start looking at homoeopathy, going to herbs at 45 minutes and chemical drugs (pitocin) at the hour mark. Then again, whilst I want the cord left attached to baby for as long as possible, I also hate the feeling of having an umbilical cord coming out of me: don't ask me why, it's just a big quease. Yes, it was just-in-case midwifery, but your midwives made the decision that asking you to be proactive about getting that placenta out was the lesser of the two evils: the alternative being the possibility that your cervix closed and hospital treatment was required. Talk to them about it, but I don't think it's a big deal.

[Shell_Ell]

The placenta took 16 minutes to come after my homebirthed son. I think it would have come out sooner had I been in a better position. It was really painful and seemed to take a long time (to me, not to my midwife) Once I stood up and did a semi-squat, it came right out. To do this, the cord was cut and my husband held the baby skin to skin. I was okay with that.

I agree with talking to your midwives about it. I had a few things I wondered about and asked my midwife about. I think if you approach it out of curiousity, you might be able to understand their reasoning.

[huggerwocky]

1-2 hours, I don't even remember correctly. I had the worst after pain, it should have come out faster . Next time I'll ask for a pitocin injection if it's not out within 30 minutes.

[homebirthing]

A retained placenta can pose a problem, so I understand them wanting to get it out. You can start to bleed up, which is serious. The idea with cutting the cord might have been to have you focus on you, not the baby, so that you can get the placenta out. Who knows. I would talk with them about it.

[dziwozony]

my placenta came out shortly after the birth (i was still on the birth stool), but i had trailing membranes. my midwife gave me a shot of something-or-other which was okay with me because i had had a completely natural homebirth & she knew i would only accept anything if it was urgent & since that seemed to be her outlook as well, i trusted her judgement. the shot (i can't remember what it was!) just helped the uterus expel any bits that might have been left. i climbed into bed with my babe & we didn't have any troubles.

however, about a week later, a chunk of placenta came out! i didn't have any pains or extra bleeding (it was steadily slowing down), but i was a bit concerned about that since it could have led to infection. but it worked itself out, so all is well. i wonder though if i was in a hospital they would have done crazy things like an ultrasound then an urgent attempt to get the last bit out? not sure.

[treemom2]

My DS came out with the placenta immediately behind him. My uterus had trouble clamping down, I lost quite a bit of blood until my mw got it to stop. My mw thought it was because they pretty much came out together. With Naiya, I sat up to see her and the midwives trying to get her breathing when it just came out, I think it was less than 30 minutes after the birth.

[BakerALM]

I remember my Midwife watching the clock, and starting to get a bit of a worried look on her face, I was bleeding and it was not slowing down. The placenta had been in for about 25mins and my uterus was not clamping down. The blood flow was not stopping, she got a bit nervous, I could see it in her face, she said we really need to get your placenta out ASAP. She issued a "shot" I have forgotten the name at the point (it began with an "M") and then and IV and pit and finally it poped out with one push once I felt it and the bleeding began to slow. They also massaged the HELL out of my abdomen, it hurt worse than labor. :

I could not walk under my own steam for almost 2 days and did not even shower I was too weak, I lost a bit too much blood. : I think the interventions were necessary due to the blood loss, she did wait almost 30mins before taking action. But other than blood loss &or a uterus that is not clamping I think watching and waiting is a good plan.

[DoomaYula]

I voted other.

If there's a lot of blood loss, it's urgent no matter how long its been.

After my homebirth I had a retained placenta, and my mw told me it wasn't the placenta that was the issue -- it was the blood loss. I ended up transferring and having a manual removal of the placenta, along with a bunch of clots. I got a ton of fluids and pit, and even then I could barely stand up for 24h.

[Mindyj]

I had waterbirth at home with my son 3 years ago. After he was born, I didn't have one contraction. I moved from the tub to the couch and the midwives and I just chatted away. After an hour, one of the midwives gently said to me that she wanted to give me Pitocin because they really wanted the placenta out and an hour had passed. I told her that I hadn't come this far to end up taking anything, much less Pitocin. I squatted over the bowl they had placed beneath me and pushed twice. Out came the placenta. Had I known that there was this one hour window, I would have pushed it out earlier.

My second baby is due in 2 weeks. We're having another waterbirth at home. I'll be pushing out that placenta before anyone gets worried about it!

Good luck, Sister!

[Mama Poot]

Mine took about an hour after having Henri. I was exhausted and didnt feel like pushing it out even though I could have sooner than I did. My bp was super low ( 60/30) and I was too weak to nurse him right away, so I just laid there moaning and doing nothing. My midwife didn't freak out about it, she just mentioned every now and then to try to push it out.