physiological third stages? do they happen in your trust?

smwife · #31 (**permalink**) 10-Aug-2008, 11:58

Originally Posted by Butterfly

I have never seen a physiological third stage- a few of my cohort have and we all gather round like it's some sacred story! It's so sad- and CCT just feels so unnatural- you're there pulling and staring and prodding- as if you haven't done enough to them in labour!

The really sad thing is women are definately not given informed choice most of the time, in my experience. All to often they just get "are you ok to have the injection to help your placenta come away?" making it sound as if they need it and then 'syntomaterine administered with consent' written in the notes , and i have not as of yet had the courage to go over my mentor, in front of her, and explain about the difference between physiological and active. It's infuriating that its so difficult to do this.

I know that i would go for physiological 3rd stage if i was to have a baby, unless indicate ofcourse!

Yes, Butterfly, exactly. This applies to tons of things doesn't it.

'are you happy to have the injection for the placenta?' I was asked this too, with my babies. It implies that it won't come out without it!!

Those who have written this in their birth plan are promptly talked out of it!

it makes me very sad, it's a worry that when qualified we may practice this way to fit in and save getting into trouble, as if they had a PPH if would be the first thing that was said!

Flowerpot · #32 (**permalink**) 10-Aug-2008, 12:54

Originally Posted by Butterfly

I have never seen a physiological third stage- a few of my cohort have and we all gather round like it's some sacred story! It's so sad- and CCT just feels so unnatural- you're there pulling and staring and prodding- as if you haven't done enough to them in labour!

The really sad thing is women are definately not given informed choice most of the time, in my experience. All to often they just get "are you ok to have the injection to help your placenta come away?" making it sound as if they need it and then 'syntomaterine administered with consent' written in the notes , and i have not as of yet had the courage to go over my mentor, in front of her, and explain about the difference between physiological and active. It's infuriating that its so difficult to do this.

I know that i would go for physiological 3rd stage if i was to have a baby, unless indicate ofcourse!

At my parentcraft classes the midwife talked through what would happen in labour. She said 'as the baby is born we will just give you a wee injection so that you can deliver the placenta'. That was it, no mention of it being choice or having other options available.

I didn't have the confidence at the time to say 'There is another way!' mainly for fear of being talked out of it.

As it was, when I was in labour I was told, 'it's likely you may need the injection anyway to help you deliver the placenta so I will prepare it and have it next to me just in case'. Thankfully I then had a shift change and my new midwife was amazing and got on with writing notes after he was born and the placenta popped out 40 minutes later with no fuss or worry.

Tasha · #33 (**permalink**) 10-Aug-2008, 13:11

I have had four babies at four hospitals and not once have I been told I can delivered the placenta myself.

Butterfly · #34 (**permalink**) 10-Aug-2008, 13:32

Those of you that are students, how would you approach a situation where you mentor has 'gained' consent for an active first stage, but you feel the woman has been misinformed and you feel she should be given the full facts?

I know what i should do, but nobody likes to tread on people's toes or look like they've got the wrong attitude. what are people's thoughts on this? x

incognito · #35 (**permalink**) 10-Aug-2008, 14:26

As a student i would feel exactly as if i were treading on my mentors toes by suggesting it!!
I have seen a physiological third stage and found it much more relaxing and peaceful. I think women are often given misleading info such as 'it will stop you bleeding so much'...in my view, that does not constitue 'informed choice'! I think that if the unit is busy CCT is the way the midwives prefer and very very few women are spoken to without bias regarding their options. Have just read a very interesting article regarding delayed cord clamping although, that too, would be an option not every midwife would like to wait for!! Sad but true.

smwife · #36 (**permalink**) 12-Aug-2008, 12:18

Originally Posted by Butterfly

Those of you that are students, how would you approach a situation where you mentor has 'gained' consent for an active first stage, but you feel the woman has been misinformed and you feel she should be given the full facts?

I know what i should do, but nobody likes to tread on people's toes or look like they've got the wrong attitude. what are people's thoughts on this? x

As a student? I will keep my mouth shut. As a midwife I won't, but as a student I will say nothing out of respect for my mentor. I think active third stages are another way of keeping women moving through the conveyor belt of hospital midwifery.

jmo, I want to learn as much as possible, and respect her knowledge, however, it is easier said than done, who's to say these midwives didn't say the very same things?

Milo · #37 (**permalink**) 15-Aug-2008, 21:54

My second child was born at home after an unplanned home delivery - he was in a hurry! The ambulance arrived about ten mins later, and a short while after that the placenta was born without any intervention. Loved the experience of giving birth at home, letting nature take its course. With my third child I was asked after she was delivered if I wanted the injection, and knowing that things would happen on their own, combined with my intense dislike of needles, I said no. I think the midwives were slightly surprised, but they were great, just accepted my answer and let nature takeover!

Sarahbs · #38 (**permalink**) 17-Aug-2008, 20:12

Ive only been at a birthing centre so far and only two out of seven deliverys I saw/conducted was CCT or active management and one of them the cord snapped.

I think my trust are lucky as I know in my community placement physiological third stage was pushed and fully informed. I will let you know my hospital experiences in Oct.

smw81 · #39 (**permalink**) 17-Aug-2008, 20:34

Almost never, was at a home birth and the woman had done her research and knew what she wanted but in hospital it never happens - "Are you ok for the wee jag to get your placenta out?" is always said! However on my first witness I wasn't working with my mentor and the midwife I was with knew it was my first but still made me put gloves on...long story short, it was my first catch, midwife ran to resuss with baby, didn't have a clue what i was doing so when another midwife came into room the "wee jag" hadn't been given so there was a physiological 3rd stage! I was made to feel really bad about it though but it's the only hospital birth where the mum hasn't been sick that I've saw!

Sarahbs · #40 (**permalink**) 17-Aug-2008, 21:36

Originally Posted by smw81

I was made to feel really bad about it though but it's the only hospital birth where the mum hasn't been sick that I've saw!

I have not been in the wards yet but what do you mean by the other mums are normally sick? My knowledge here is very very limited but can syntomectrine(sp? bit late now need bed) have strong nausea and vomiting affects?

How was you made t0 feel bad hun? It was your first witness and catch in one go you were not in a position to do anything but watch. x