3rd stage

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Just wondering if anyone has any experience/advice/has seen any research on the management of the 3rd stage of labour (delivery of the placenta) especially for a VBAC? My midwife was trained to manage it without the pitocin shot, but is comfortable giving it as well. she always has it drawn up just in case.I was basically given the choice (assuming there are no complications of course), and am really on the fence about it. I am having a hard time finding any info about it! TIA!


PS - I know I'm mostly a lurker, and probably have no right to be asking for advice, but I really have found this board to be very helpful and know that you ladies always have good insight. :) 

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Re: 3rd stage

  • I honestly never looked into this.  And nothing was mentioned specifically by my unvbac friendly delivering doctor. Basically what happened for me was, she tod me it as time to deliver the placenta, I bent forward because I couldn't hear her, the placenta fell out.  I was already on pitocin (she didn't realize I was a vbac when she ordered it.) 

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  • I didn't have any with my VBAC and I think either way is a reasonable choice. But that said, I'm generally in favor of 3rd stage Pit.  It's effective at reducing the risk of PPH and it poses little risk to the mom and none to the baby.  I don't know anything specific about 3rd stage Pit and VBAC, but since Pitocin can be used safely in VBAC for labor induction, I don't see why it couldn't be used safely in 3rd stage.  A friend of mine almost died of PPH last month and she ended up needing massive blood transfusions, an ICU stay and lost her milk--the risk of PPH is small, but it's not something to mess around with.  If there is a way to safely reduce the risk of it happening to you, I think it's worth it.

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  • Thanks ladies! It sounds like it's pretty uncommon to have an unmanaged third stage. I don't most care providers ever even give an option, so I was just caught off guard when presented with the choice. I've been trying to be as informed as possible this time around, so most things we have talked about I've already had an opinion/preference picked out, and this one left me shrugging. I don't really care either way, I told her that as long as the placenta comes out, I'm a happy camper :) 
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  • I had a high pitocin drip during my vbac, the OB mashed on my belly and the placenta came out. It was no big deal, other than the mashing hurt. 

  • skioskio
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    image Courtimilk:
    I do believe I had my VBAC without pitocin. However I was receiving oxytocin during labor to encourage dilation.

    Synthetic Oxytocin = Pitocin, most often. There is one other synthetic form called Syntocin that isn't widely used. If someone told you that you were getting Oxytocin during labor, it was most likely pit. Oxytocin is the term for the naturally occurring hormone.
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  • I don't know if the OB who delivered my DD#2 gave me a pit drip or not to deliver the placenta.  I do remember him pulling on the cord, so  maybe none was used.  I know he wouldn't have given me any pit during my labor, as he said as much. 

    With my DS, I was given a pit injection to help deliver the placenta.  If there was a risk, I'm sure the doctor wouldn't have done it. 

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  • image Ceefome:

    With my DS, I was given a pit injection to help deliver the placenta.  If there was a risk, I'm sure the doctor wouldn't have done it. 

     No, there's no research showing an increased risk of rupture during the delivery of the placenta in a managed third stage, even though it is apparently quite a large dose....probably because the uterus isn't stretched out and full of baby anymore :) 

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