manual removal of the placenta?

[arimama]

I attended a birth last night where to OB did something strange.

About 5 minutes after the baby was born, I looked down and noticed what seemed to me to be a separation gush, and instead of letting mom know that the placenta would be ready soon, the OB reached in to her elbow and manually scraped and yanked it out! This was not a case of a retained placenta that needed to be manually removed, as far as I can tell, as it had only been 5 minutes since the birth. It seemed like her typical 3rd stage management. Is this common?

[heartandhandsdoula]

This happened to me at my daughters birth. I didn't know anything about birth and I remember thinking wow! he's really up there, like it was no big deal. Now that I know better I can't believe it! I just had a friend who was hemmoraging so badly that she almost had an emergency hysterectomy b/c the ob tugged on the cord. I know its not quite the same but its all under the umbrella of super aggressive management of 3rd stage.

[mwherbs]

when I had our 2nd baby many many years ago the doctor in attendance did routine manual removal- within minutes without the seperation gush just reached up and scraped it out--- I know it was routine because everyone else that had babies that night where he was in attendance also had it done we talked about it in the ward--- hurt like @#$
so I don't know how common it is but yes it does occur there are just so many practice variables to consider and try to rule out - why some things are done defies understanding
take care

[herbanmama]

My sister had her placenta manually removed about 5 minutes after the birth of her dd with no indication for it, and with no warning. My mother and I - who are pretty familiar with birth - were completely caught off guard and left with our jaws dropped to the floor as my sister writhed in pain. After learning that this was not standard procedure, my sis asked the OB "Why?", to which her response was, "Oh, it was stuck". Yeah, right. When I got home, I was LIVID, and in conversation with a midwife friend of mine, learned that the manual removal of placenta is becoming increasingly popular.

Now, I am suggesting that clients ask their OBs how they approach management of the 3rd stage, along with questions about C-sec and episiotomy rates, etc. Manual removal is *NOT* something that I would want to be surprised with.

My sister is pregnant again, and has asked her new OB about it. He was a bit incredulous that her other doctor did it. I really hope that this birth goes better for her, she's much more involved and active in her care this time, so that's one excellent step in the right direction.

[Reha]

I don't know if what OBs routinely do otherwise is any improvement, though. Tugging on the cord to get it delivered asap after the birth isn't a good idea, either, in my book.

I almost wonder if the docs who go in manually maybe do so because they have had a bad experience with a cord snapping (while they were pulling on it).

Better to leave 3rd stage truly alone, imo.

[cranberriesfor5]

For my 1st two kids they pulled the cord and I bled badly for weeks and had to be put on Iron b/c of anemia. With my 3rd baby I had an intervention free hospital birth and had to fight tooth and nail for everything to be followed the way I wanted it to be. The doctor cursed me the entire time and stood there yelling at me b/c I wanted an intervention-free birth. The nurse received our baby as the doctor was screaming at me and then she went to pull out the placenta. We told her no and she waited for 45 minutes until I pushed it out on my own.

I had very little bleeding this time. The only reason they do it is b/c they do not want to wait around. It's so sad

[Rockies5]

yeouch!! Is all I have to add to this discussion.

Just one more reason not to birth on your back with your lady bits easily accessed:

Education. Education. Education!

[ckhagen]

The OB who did my first c/s is becoming infamous in these parts for manual placenta removal. She's one of the most impatient people on this planet and if it doesn't come out within a couple minutes she starts pulling on the cord. One woman I met locally had this happen and the yanking on the cord ended in her uterus being ripped inside out, which took 3 hours of surgery to repair. Sad thing is... the OB convinced her it was normal procedure and the mama had NO clue that the resulting inversion and surgery were the fault of the OB. She thought her body caused the inversion! I was horrified. I hate to keep saying it, but if something doesn't give, it's just a matter of time before she kills someone. She's the most popular OB in town too...

[maxmama]

"Active management" of third stage is becoming very popular in some areas, because there are a few studies that show decreasedblood loss (not even the difference between bleeding and hemorrhage, just decreased loss) with active management. Basically, it's early clamping/pit/manual "encouragement" immediately following the birth.

We don't do it in my hospital and I haven't seen great increases in PPH. Seems like a lot of mucking around for not much.

[Black Orchid]

this is insane. they just keep coming up with ways to interfer with nature. as future CBE i am taking notes so i can help future clients avoid this.

when i had dd1 they were very patient and it came out pretty fast. with dd2 i was at a birth center and it seemed that they might have been a bit impatient b/c they kept pushing on me and telling me that dd2 needed to nurse more (she wasn't into it yet).

unbelievable that they just keep finding ways to procedurize everything about birth... i wonder if they will add that to the bill "fee to remove placenta" grrrrr

[trimestersdoula]

OMG I have never heard of this being done before. That is darn scary. I am definately going to be asking around to see if this has been done at our hospital. I hope not.