May 2012 Moms
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Pulling out the Placenta
I posted early about Pulsing Cords and now Pulling out the Placenta...words I never thought I would name a post. 
In the same conversation with my friend who meets with a douala, she talked about the placenta. She said that some hospitals will pull out the placenta if it doesn't come on its own. This leads to more bleeding afterwards because the body didn't do it naturally. She said it was one of the things that they rush to get done that you shouldn't rush.
Has anyone experienced this or done research on it? Hopefully my next post will be about something more pleasant.
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Re: Pulling out the Placenta
They rush it for good reason. There can be major bleeding problems if you do not deliver the placenta, and completely. After I had DD they waited about 3 or 4 minutes then my doctor held the cord still connected and gently pushed on my stomach while I pushed at the same time. It is no different then delivering baby, although much much quicker and no pain involved.
My sister had a doctor who did not do it properly and she ended up passing out on the hospital floor from the intense bleeding it caused!
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I don't think they actually pulled mine out but they did help it along. They pushed on my abdomen then kind of pulled on the cord while I pushed. It wasn't strenous or anything, I honestly didn't really feel anything.
Not true, it's pretty typical hospital policy to rush to get it out. The reason being that after you deliver the baby, your uterus is still pretty stretched out from the baby having been in there. Because of this, while it is still contracting, there is often a lull of 20 minutes to an hour while your uterus condenses down enough that its contractions will push on the placenta. If you are given your baby immediately, have skin to skin contact, try to initiate breastfeeding, this is all totally normal and almost always fine and does NOT lead to hemorrhage, because your uterus will keep contracting even if those contractions are shrinking the uterus instead of pushing out the placenta at that point. As I said in your other post, the placenta is still functioning at that point at least somewhat, and so is still connected to your uterus. Then, after that time period, the placenta will have finished doing its job and will detach itself from the uterine wall and be delivered as your uterus keeps contracting.
Rarely your uterus will be so worn out or for whatever reason it will stop contracting or not contract hard enough, and then (I believe but am not sure this is especially true with immediate cord clamping when there is a backlog of blood in the placenta/remaining cord) hemorrhaging can happen, which is bad. However, immediate skin-to-skin and/or breastfeeding initiation can usually prevent this, and a shot of pitocin or one of a lot of other drugs (which are often standard procedure in hospitals anyway) also can if you'd prefer a more managed third stage. And if it does happen any doctor should be watching for it and it is typically pretty easy to stop and a fairly routine complication.
Pulling on the placenta by applying "gentle traction" to the cord or pushing on the stomach to force the uterus to contract is typically completely unnecessary and very dangerous! If the doctor is in too big of a rush he/she can leave part of the placenta attached to the uterine wall when he/she pulls on the cord. This almost never happens if the placenta is allowed to detach normally, but happens much more often with traction. If that happens it is VERY dangerous, and can lead to anything from serious hemorrhaging to even the need for a hysterectomy.
The reason for it? Again, it can take awhile for the placenta to deliver naturally. Doctors don't want to sit around and wait for it. They'd rather "manage" it. They can't leave, because until it's delivered you could still have issues (even if they're unlikely if you're left alone), but doctors usually don't do well sitting on their hands waiting. For a doctor, time is money, and they don't get any more money for waiting for the placenta!
I will absolutely not allow anyone to put traction on my cord unless there is a serious medical emergency (I can't think of one that would warrant this, but I'll look into it as the time gets closer). There is no reason other than the doctor's convenience, and it can potentially be very dangerous to me.
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Five years of working with moms and babies and I can only remember a couple instances in which the placenta wasn't out in at least 10 minutes after delivery. Most often the doc or midwives deliver the placenta in the couple contractions following the baby. The only time I can vividly remember an issue is with a mother whos placenta did not detach and had to be manually removed? This was after an hour of waiting for it to happen naturally. So the PP who discussed doctors rushing that's not always the case. I have personally witnessed a doc or midwife literally pulling on the cord.
This should be a question you review with your doctor at your next appointment if you are unsure/worried.
?BFP #1 3/27/11, 1st US Mono Mono Twins, 2nd US 2 HB's, MMC@8w6d 4/25/11, D&C 4/27/11 ?
BFP#2 9/17/11 1st US HB 171 10/13/11 EDC 5/23/12
?BFP #1 3/27/11, 1st US Mono Mono Twins, 2nd US 2 HB's, MMC@8w6d 4/25/11, D&C 4/27/11 ?
BFP#2 9/17/11 1st US HB 171 10/13/11 EDC 5/23/12