Third Stage of Labor Plans?

[mcbaby]

I've got my first hospital your this evening and my second tomorrow, so I've been reading up on questions I should ask and whatnot. I've run into many articles about the third stage of labor (delivering the placenta), how to manage it, and what to ask to make sure the hospital supports your choice. I'm kind of overwhelmed by the amount of information I just read on it all!
I've decided to go with delayed cord clamping for sure. I don't want to speed up labor, I want my body to do go through this process in it's natural time if both my baby's and my health permit it. And I plan to delay an epidural as much as possible, if I have one at all (but I have a feeling I'll be a wimp when the day arrives and have one!). What I'm curious about is delivering the placenta.
For you STMs, did you have an "active" third stage (medication and cord pulling used to speed up the delivery of it) or a "natural" third stage (using gravity and the mother's natural contractions, no speeding up the process)?
For FTMs, what are your plans?

Any insight, advice, experience or whatever else is appreciated!

[brittneysandra]

Honestly , I just really started reading up on everything myself, and felt the same way, overwhelmed. I still am a little bit.
So I plan on asking my doctor and reading and getting as much info as I can... and than deciding with DH, or letting some things happen as they happen I guess...
For example reading up on the skin to skin, my thoughts: I do not know which I would prefer, I've never had a baby,So how do i know if i want that or not?

[viola]

Jan 19, 2015 16:00:50 GMT -5 brittneysandra said:

Honestly , I just really started reading up on everything myself, and felt the same way, overwhelmed. I still am a little bit.
So I plan on asking my doctor and reading and getting as much info as I can... and than deciding with DH, or letting some things happen as they happen I guess...
For example reading up on the skin to skin, my thoughts: I do not know which I would prefer, I've never had a baby,So how do i know if i want that or not?

My policy on things like this is to look at the evidence. Specifically, skin to skin has tons of benefits and 0 downfalls so I plan on doing it. You always ALWAYS have the right to change your mind

[Starbuck128]

Whata what? Cord pulling??! What were you reading? Do not pull on the cord! That is very dangerous!

There doesn't need to be any active management for delivering the placenta unless there is some extreme situation where not all or it came out or something. Usually after a few minutes there's a quick, tiny contraction and the whole thing just slips out. It's nothing.

[jenari]

This sounds awful but I have absolutely no sweet clue how my placenta was delivered with DD. I know there was no tugging or pulling and they just let the body do it's job but I don't remember having to put any effort into it. I had DD freshly delivered and beautiful lying on my chest and that's the only thing I was focused on.

[mcbaby]

brittneysandra I think skin to skin is a great idea. This is my first as well, but I've had close friends who have given both sides and decided from that. The pro-"kangaroo care" as it's called here, say that it's such an amazing way to bond with baby and there's a rush of great emotions after labor. The friends who chose not to only said because they thought it was gross to hold the baby before it was cleaned, such as covered in meconium or vernix. All I can recommend is ask around, research and make your decision

[snapdragon]

It's hard to remember, but I do think my OB tugged on the cord a little bit when I delivered the placenta. I gave zero thought to this ahead of time.

[scattered]

I have precipitous labors so it's all said and done in under four hours (don't be jealous it's one long contraction). The first time it practically came out with DS. With my second, I had a retained placenta and my OB had to use this hook thing to get it out. That was exceptionally painful but over in a flash. I don't know why I shared this, I don't want to freak out FTMs but it can happen.

Skin to skin is my favorite moment. With DD, they put her on me and handed H a towel and he rubbed her while she was on me. It was awesome. With DS they put him on me and then took him to wipe him down. So preferred the way with DD!

[Starbuck128]

Jan 19, 2015 16:20:24 GMT -5 jenari said:

This sounds awful but I have absolutely no sweet clue how my placenta was delivered with DD. I know there was no tugging or pulling and they just let the body do it's job but I don't remember having to put any effort into it. I had DD freshly delivered and beautiful lying on my chest and that's the only thing I was focused on.

Same. I barely noticed because I was so busy looking at DS. My MW started to tell me the placenta was next, but before she could finish I had a tiny contraction and it plopped out. It wasn't like a normal contraction with a build up and peak. More like a grunt, plop, all done.

[hotcoconuts82]

I believe I was given pitocin after the baby was born to hurry the placenta along.

[Starbuck128]

Jan 19, 2015 16:25:08 GMT -5 hotcoconuts82 said:

I believe I was given pitocin after the baby was born to hurry the placenta along.

Hmm, I think the pitocin is to reduce the chance of hemorrhaging, but I could be wrong.

[mcbaby]

This article mentions an injection to speed up contractions, and then the delivery of the placenta. It's supposed to reduce the risk of hemorrhaging. I'm very low risk pregnancy so far and hate needles as it is, so I'd rather not get any extra shots!

www.bellybelly.com.au/birth/natural-approach-to-labour#.VL1kNtm9LCQ

Am I totally overthinking this? It's an Australian article.. *shrugs* I feel like there's a lot I don't even know I should ask.

[scattered]

Don't overwhelm yourself. If you're confident in your OB/care provider then ask as things come up and enjoy the ride!

[SassyPants150]

Jan 19, 2015 16:23:52 GMT -5 Starbuck128 said:

Same. I barely noticed because I was so busy looking at DS. My MW started to tell me the placenta was next, but before she could finish I had a tiny contraction and it plopped out. It wasn't like a normal contraction with a build up and peak. More like a grunt, plop, all done.

El oh el. Seriously!

The OB pushed on my lower abdomen and it was out in no time. Never even thought about it. 

[ksmith0803]

Honestly I have no idea what was done in the placenta delivering stage... I was focused on the baby and didn't even realize I'd delivered it until after it was all said and done. I know it wasn't very long after he was born that I delivered the placenta, I just have no idea if anything was done to speed it along or if I delivered it on my own. Does that sound crazy?

[chemmom1]

Jan 19, 2015 16:20:24 GMT -5 jenari said:

This sounds awful but I have absolutely no sweet clue how my placenta was delivered with DD. I know there was no tugging or pulling and they just let the body do it's job but I don't remember having to put any effort into it. I had DD freshly delivered and beautiful lying on my chest and that's the only thing I was focused on.

Same. I was focused on the new baby (they were a little worried about his breathing, so I didn't get to hold him right away) and just let the OB do his thing. I have no idea.

[brittneysandra]

Jan 19, 2015 16:20:29 GMT -5 mcbaby said:

brittneysandra I think skin to skin is a great idea. This is my first as well, but I've had close friends who have given both sides and decided from that. The pro-"kangaroo care" as it's called here, say that it's such an amazing way to bond with baby and there's a rush of great emotions after labor. The friends who chose not to only said because they thought it was gross to hold the baby before it was cleaned, such as covered in meconium or vernix. All I can recommend is ask around, research and make your decision

Thanks ! I have started to ask around a little bit and your right it is helpful! Its funny how many different reactions you get , Some people are so "grossed out" by the idea and others who have done it loved it!I guess it just goes to show everyone is different !, Personally Im leaning towards skin to skin, but who knows! 

[mcbaby]

Thanks everyone! I'm off to the hospital for a tour, check in afterwards

[CTri17]

well since I have had 2 homebirths, my experiences may be different, but I have had a "natural" 3rd stage with both, I actively pushed when necessary but no traction and no pitocin.

many hospitals around here you have to ask to NOT have pitocin during your 3rd stage. Many times it just takes longer than the Dr wants to wait (it took 30+ min for DD2's placenta to finally come out)

[CTri17]

Jan 19, 2015 16:26:44 GMT -5 Starbuck128 said:

Jan 19, 2015 16:25:08 GMT -5 hotcoconuts82 said:

I believe I was given pitocin after the baby was born to hurry the placenta along.

Hmm, I think the pitocin is to reduce the chance of hemorrhaging, but I could be wrong.

it is both, the pitocin causes your ute to clamp down more which helps it to shed the placenta from it's attachment in the uterus, by the uterus clamping down it starts to close off where the blood is coming from, which helps to not hemorrhage. 

But it is becoming more common to just give a shot of pit as soon as baby is born to speed the process up, which IMO isn't necessary.

[soyboy]

I also have no recollection of delivering my placenta. I was so relieved and overwhelmed having delivered DS and doing immediate skin to skin that I don't even remember that stage of delivery. I also don't remember them stitching me up, thankfully! Talk with your hospital and and your OB about your wishes and hopefully they will be able to accommodate your needs .

[viola]

Paging honeylemon for info about her Duncan presentation placenta

[CTri17]

Jan 19, 2015 18:23:38 GMT -5 bwisco123 said:

*sigh* and this thread is a prime example of how I feel like I know nothing and am so unprepared. I had no idea there were different ways to get the placenta out.

well really there isn't different ways, so much, it comes out the same say, but some things are a little more relaxed and some things are more "managed" I'm a huge researcher, so I read a lot when I was pregnant and still do, because I feel more in control

[honeylemon]

Jan 19, 2015 18:23:31 GMT -5 viola said:

Paging honeylemon for info about her Duncan presentation placenta

Oh God. Do you really want to know OP? I don't want to scare you.

[viola]

Jan 19, 2015 18:34:54 GMT -5 honeylemon said:

Jan 19, 2015 18:23:31 GMT -5 viola said:

Paging honeylemon for info about her Duncan presentation placenta

Oh God. Do you really want to know OP? I don't want to scare you.

Raise your hand if you want to hear honeylemon 's war story!

[rivers714]

I remember pushing on my fundus but I can't remember if they pulled the placenta .... I was a bit distracted by a baby

[CTri17]

Jan 19, 2015 18:35:59 GMT -5 viola said:

Jan 19, 2015 18:34:54 GMT -5 honeylemon said:

Oh God. Do you really want to know OP? I don't want to scare you.

Raise your hand if you want to hear honeylemon 's war story!

[CTri17]

also

<--- birth nerd

[honeylemon]

Ha ok. Let me get to a computer and I'll type it all out. Kids are in the bath right now.

FWIW, my first birth was like scattered said her births are. Fast, but like one giant contraction. I had no complications with my placenta that time.

[honeylemon]

Duncan presentation of the placenta is when the placenta flips before it is delivered. Normally the placenta will come out and push the umbilical cord, membranes, and all that stuff out in front of it. When it flips, the side that was attached to the uterus comes out first and the membranes trail after it.

So after Iris was delivered (which in and of itself was a giant feat including posterior, transverse, and asynclitic malpositioning), my placenta flipped. My MW had to manually get it out by very forcefully massaging my belly and pushing it out. IT WAS FUCKING PAINFUL. I almost kicked my MW because I just wanted her to quick fucking touching me. Even after the placenta was out, she had to continue massaging to get everything else out. It took probably close to an hour to finish. Duncan placentas often result in excessive bleeding. I did have a little extra, but nothing horrible. I was able to get through it without needing an IV or any drugs.

So yeah. That's my story. I have no idea what causes it, but it's really rare so please don't be scared!