Welcome to the MamasteFit podcast birth story Friday. Today we have Molly, who’s sharing her unmedicated birth In a freestanding birth center after a first trimester pregnancy loss in her birth story. She’s also going to share about having her retained placenta in which the midwives had to do manual extraction in order to prevent postpartum hemorrhage.
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Today we have Molly, who’s going to be sharing her unmedicated Free-standing Birth Center birth at the Monterey Birth and Wellness Center, where I also delivered Colin.
A freestanding birth center is a place of birth that is not attached to a hospital. Some hospitals will refer to their labor and delivery units as birth centers, BUT they are not the same thing as a freestanding birth center.
Free-standing Birth Center is:
- Not associated with a hospital
- Usually run by midwives.
- Have less interventions that they’re going to utilize during your birth
- Support more of a normal physiologic birth process versus the hospital where they’re potentially offering more medical interventions in your birthing process.
Who can deliver at a freestanding birth center? This is the same usual criteria that any out of hospital births will have to include home birth.
- Low risk patient – no complications during your pregnancy
- Usually just one baby that is in a head down position. But some birth centers or home birth midwives might have different criteria where if baby is in a different position or you have two babies, you might still be able to deliver there in a freestanding birth center versus a home birth.
The Free-Standing Birth Center may have more options for emergencies.
- They may have more medication or more equipment on hand because it is a building that all of that equipment is just staying at versus a home birth might not be able to bring like an entire infant warmer with her to your home. That’s just not physically possible unless she is the hawk. Whereas at a birth center they have that capability to have like an infant warmer with oxygen, to help resuscitate baby if necessary
- Might have more tools available to respond to an emergency with you as well
Having a conversation with your provider, if you’re choosing out of hospital birth, it can be really helpful to go over
- What is there emergency protocol like?
- Why would they transfer?
- What type of care can they provide to you in an emergency situation?
This could help you feel more comfortable giving birth in the out of hospital setting. If that is your choice
OR maybe you may decide that you do want to give birth in a hospital knowing that comfort of if something happens, you have more emergency care available to you.
In Molly’s birth story, she will be using the term “wifey” to refer to her midwives.
This is a common term that some midwives choose to use, and it is commonly used at the Monterey Birth and Wellness Center.
How was your first pregnancy in preparation for your very first birth?
Molly: So my husband and I, we started trying and then pretty quickly we got our positive pregnancy test and we were thrilled. We almost right away told our immediate family that we were pregnant and we just kind of jumped right into planning what life was going to be like with the baby.
But unfortunately, at about six weeks I started having some spotting and I called my OB’s office. Of course they were closed at the time, so they then sent me to the E.R., where at that point they confirmed that I was having a chemical pregnancy or a miscarriage.
So that was pretty devastating, both to me and my husband. Obviously me more so because I not only felt the emotional effects, but the physical effects of that as well.
And following that, I feel like I kind of fell into like a depressive slump or I just wasn’t myself. I was really, really down. I was doubting myself and my body. And, you know, they say like 85% of women get pregnant within those first three months after having a miscarriage. And when those that three month mark rolled around and I still wasn’t pregnant again, you know, it hit hard. I started feeling like, you know, my body was letting me down and I something was wrong with me.
But thankfully, at the four month mark, I got pregnant again, which was such a relief, a joy.
But this time around, we kind of kept to ourselves. We wanted to wait until we found, you know, got the confirmation we had until we had our first ultrasound.
Transferring care after miscarriage
Molly: And I should say I kind of skipped the whole part about how I ended up at the birth center through the miscarriage. I kind of felt dismissed by the OB I was with who I had previously really enjoyed my time with. I had immediately asked like, Can we run blood work or just do something? Just to be proactive, to make sure that there wasn’t a bigger problem going on.
And she was like, I think it’s fine that we can run your thyroid just in case. So she did and said, My numbers looked great.
Over the course of the few months in between the loss and getting pregnant again, I just felt like I needed a little extra TLC because I needed some help. And so I had scheduled a pre-conception appointment with the Monterey Birth and Wellness Center just to kind of touch base and see if they had any suggestions of things I could do to help me get pregnant.
I walked in there, I showed them the labs that my OB ran and within 3 seconds said, Oh, you need to be on thyroid medication. So sent me over to an endocrinologist, got me on thyroid medication, and then it was that next month that I got pregnant.
So through that I kind of made the decision to switch my care for my pregnancy from my OB to the Monterey Birth and Wellness Center, which is probably the best decision I could have made.
First Trimester Nausea, Blessing in Disguise
Molly: So throughout my pregnancy itself, I was pretty ill. It was pretty rough. So she that first trimester, I remember walking around with a box of just dry cereal and I just could munch on that all day. That was the only thing I could keep down. Water was nauseating. Any food was nauseating. But I kind of looked at the nausea as a blessing because on the days that I didn’t feel horrible, I immediately went into, Oh my gosh, something is wrong.
I might lose this pregnancy again also. So I feel like that was probably a blessing in disguise that I did feel so horrible.
But thankfully we did kind of come out of that into the second trimester through the end, had some major food aversions, but manageable.
I was pretty lethargic all the way through. I ended up with pregnancy induced anemia, but some minor supplementation helped with that. So that was good throughout pregnancy.
Mental Prep for Birth
Molly: I did do a lot to kind of get my mind, body spirit ready to deliver at the birth center because it was out of hospital. We don’t have the same options for any sort of pain medications with the exception of the nitrous oxide I think they offer. So I did do a lot of walking when I could tolerate exercise because I was pretty fatigued.
You know, I did a lot of the exercises. I think I was just a few weeks behind. Gina in my pregnancy, you were with Sophie, so whenever you would post a workout, I was like, okay, I can try to do that. So that was definitely helpful for me to get through. But then I did a lot of just like gentle yoga to help stretch, relax, a lot of massage, acupuncture.
I listened to just like Hypnobirthing tracks while I was doing stretching and stuff like that. Well, so do touch on. Help me out here.
How was Mamastefit a resource to you during your pregnancy?
The Wifeys were actually the ones who referred me to you guys. One of my first prenatal appointments, I was talking about what I could do for exercise and that sort of thing. And one of my midwives suggested your page, knowing that I was just a few weeks ahead of Gina in my pregnancy.
So I used your Instagram page pretty much daily for fitness tips for stretching tips, just to kind of help prep my body for labor and delivery.
Thank goodness for social media.
How was your birth?
Yes. So when I was about 39 weeks and five days, it was a day or two after I had gotten some acupuncture just to kind of help get things started, because I was really worried that I was going to go like weeks and weeks over. I don’t know why I had that in my head, but I thought it was going to be a full two weeks past my due date.
So I was doing things like evening primrose, oil, miles circuit, curb walking, all the things to try to induce labor on on its own.
So about 39 weeks and five days after like a long five mile walk, I got home and lost part of my mucus plug and I was so excited, texted my doula, but I was like, but I know it could still be weeks away.
Like, I’m not. I’m excited, but I don’t want to get too excited knowing it could still be a while.
But then I started having some stronger like Braxton Hicks like, what I thought were just Braxton Hicks contractions. So those kind of continued throughout the day and into the night.
And funny enough, that night my dog was like really clingy to me and I was like, Does she know something that I don’t know? And I was like, just kind of brushed it off. Hindsight was like, she definitely knew something was up that we also had our last date night, that night we went out to dinner and just kind of came home and relax. It was great.
The next day. So we are 39 weeks and six days, we just kind of had a nice day and my husband and I together took another really long walk.
And at this point I was kind of thought they were stronger. Braxton Hicks contractions. But I was I don’t want to get my hopes up, but like fears, definitely something happening. We went and had dinner with his family like we do every Sunday this whole time I’m still having again what I thought were just Braxton Hicks contractions.
Membrane Rupture
We got home to watch a show and when I got up off the couch, it’s about 9 p.m. on Sunday, I felt, I guess kind of like a pop, pretty high up.
And then I immediately thought I peed my pants. I got up off the couch and I peed my pants, and I was like, That’s a little weird. So I went to the bathroom and and now I don’t think that I peed. I guess that must have been my water. So at that point, I just got in the shower, and as I’m in the shower, I’m thinking I probably should tell someone.
And so I called my midwives and let them know and they just said, okay, just try to get some rest. Things could start picking up, but just keep us posted. We’ll check in in a couple hours.
So I had told my husband, you need to make sure you get some sleep, because about an hour prior to this, he was telling me that, you know, I really hope it’s not tonight because I’m tired. I got some work to do tomorrow, so not a great night.
So I said, okay, you should get some sleep and then we’ll just kind of see how it goes.
So at about 1030, I got in bed and I thought I was going to try to sleep, but I immediately just was having they weren’t uncomfortable, weren’t painful, but they were uncomfortable to the point where I couldn’t sleep through them, but I was able just to kind of breathe through them quietly.
So I did that in bed for about an hour, just after 11:00. Things were starting to pick up pretty quickly, so I moved to the bathroom just to kind of be able to have a little more range of motion.
I texted my doula at that point, just let her know that things were happening, but I’ll keep her posted because I wasn’t needing support just yet.
Labor Progressing!
And then by probably 1145, I started having a lot of diarrhea and vomiting and my body was just trying to make as much room as possible for this baby to come through. And unfortunately, that sickness, vomiting, diarrhea kind of lasted all the way up until baby was born. But by 12:00, I was definitely meeting some support. So I woke my husband up, let him know things are definitely picking up.
So he was just kind of helping me labor in the bathroom for a while as mostly just like leaned over the counter and he was at this point mostly just emotional support I would say, rather than physical support as well.
And at this point, I also texted my mom because she was planning to be at the birth, but she lives about two and a half hours away. So it was we knew we were going to have to do some timing there, but just let her know that something’s happening. I’m not sure how quickly it’s going to go, but just to, you know, keep your phone on you because we may be calling you saying it’s go time.
It was probably about one or 130. I spoke to my Midwifes again because giving birth at the birth center, you can’t get there too early necessarily because you know, you ideally will get there in active labor.
So she listened to me through a few contractions over the phone and said, you know, let’s give it a few more hours, but you may want to call your doula at this point, get her over there, because I was at this point having to vocalize nothing crazy but was having to vocalize to get through the contractions and needing more physical support.
And at this point, I’m still I was in the bathroom leaning over the counter, just felt really, really good because I think just to let my belly hang was probably the most comfortable I could get in and I could let my hips kind of sway through the contractions. That felt good as well.
Doula Arrives!
So thankfully my Doula, though, she arrived pretty quickly after that and she immediately kind of helped us move into some better position just to kind of help progress.
She put me on the toilet, which I didn’t love. I had some back labor for probably about 30 minutes while I was on the toilet, and I think Baby was just wiggling her way around there, thankfully. Back labor didn’t last much longer than that because it was it was rough, but yeah, so she helped us, Labor for the next few hours. She moved me from a toilet to facing backwards on the toilet, Back frontwards again.
Mind you, at this whole time I’m still throwing up, so it’s nice to be in bathroom. And then she moved us to the bed with the peanut ball, which I feel like helped a lot. It was nice to be able to, like, rest in between contractions at this point because I was definitely getting tired because, you know, it’s three in the morning about and I hadn’t slept since the day before.
And she was really good about, you know, directing my husband of, you know, how to physically support me as well as, you know, offering me hydration and snacks when I could can I could get them down and then subsequently holding the barf bag following that. And then my husband. And do I think we were able to be in contact with my midwives and my mom because I wasn’t really coherent at this point in between contractions.
You know, I could kind of snap out of it, but I was definitely exhausted. So they had touched base with kind of everyone agreed that we would all meet at the birth center at five in the morning. So this was Monday morning now. So we, you know, at 5:00 rolled around. We we started to head over.
Heading to the Birth Center
The drive was probably the worst part of the whole labor!
Thankfully, I feel like my body knew that I was going to be in a rough spot because I felt like the contractions slowed down during the car ride. I was I think I only it was probably about a 20 minute car ride and I think I only had three contractions where they were previously, about three or 4 minutes apart.
So that was rough. But we made it and we pulled into the parking lot and my mom was waiting for us there. So were the wifey is which was great. That was really nice.
My poor mom, though, she, you know, we get out of the car and the first thing she sees is just her daughter keeled over, vomiting and, you know, writhing in pain.
So I look up and she immediately just has tears down her eyes, I think, just from the emotion of seeing all of it.
But thankfully, she got it together to be able to be a supportive addition throughout the rest of the labor.
When when we arrived at the birth center, the wifey’s immediately asked if I wanted to be checked and I did. I just kind of wanted to know where I was at, just to make sure I was in fact making progress.
As they were checking me, though, I was telling myself like, they’re going to say, you’re only four. It’s going to be a four, but you’re going to be fine. It’s okay if you’re only at four.
But thankfully, though, I was at a seven and a half roughly, so that was a huge relief to feel that, you know, the last few hours that were really intense were, you know, making a lot of progress, which is great. But from there, I wasn’t quite ready to get into the tub because I thought that’s where I wanted to deliver.
So they had me kind of labor on the bed for a while. And at this point I was definitely in, I guess they call it labor land because I guess they kept asking me like, Do you want to get in the shower? Do you want to try the shower? And I have no recollection of them asking me. Apparently I just like grunted in response.
Pushing Begins in the Tub
Like, I guess my body knew something because it was on the bed. I just kind of my body just started pushing. I wasn’t trying to is kind of just happening.
So at that point they let me move into the tub. The tub initially felt felt really good. I felt like I had some relief during the contractions, but I also felt like I couldn’t get grounded enough in the tub.
And I felt like I was floating around too much. I contracted in the tub for a while. I labored in the tub for a while, just in different positions, trying to move around as best I could. The whole time my body was just pushing and pushing and pushing and I feel like nothing was really happening. And then at some point it had probably been, I would say probably about 2 hours I was in the tub.
I remember thinking like, someone’s going to have to get this baby out like I am. I’m done. I’m tired. I need someone to get this baby out right now. But then I thought about and I was like, You know what no. Because that means I don’t have to get back in the car and drive to the hospital and then go through the admittance process like that. And that sounds like way more work. We’re just going to get the baby out ourselves. We’re just going to do it.
But I do remember also looking on and like looking out the window on the curtains right down. But I could tell the sun was coming up and I was like, Oh, it’s morning now. Okay, it’s been long enough. It’s time for this baby to come out.
But again, I was still my body was still pushing, but I wasn’t really making any progress. So one of my midwives suggested getting out of the tub. We were going to drain the tub and refill because the tub I had been in for a while pushing, but other things were coming out besides baby.
So we were going to drain the tub, refill the tub with clean, warm water, and then I could get back in.
Rupture of Membranes Take 2
But in the meantime, they had put me on the birthing stool, so they had set me up with my husband behind me, holding me kind of under the arms. And then my midwives were in front of me at this point as well.
My midwives asked if she had wanted me to kind of or I had wanted her to kind of direct my pushing. So during contractions with her fingers, she would kind of tell me that like a push into my fingers, which is really helpful to have something to focus on of where to push.
But through this, she noticed that I still had a little bit of a bulging bag, so I guess my water had broken, you know, the night before but what we assumed was it was a high rupture. So there was still some down below. So Baby wasn’t able to descend all the way.
So she had asked if I wanted to have my waters broken, and at that point I was desperate for anything. So I did opt to have her do that, which was pretty. I mean, it wasn’t anything. It didn’t hurt or anything. It was pretty quick.
Crowning forever and Delivery!!
And immediately after she did that, there was intense pressure. And almost immediately I felt like baby started crowning, which was great. But she did crown for a very, very long time. It was slow, slow moving. So it was not the most fun, but it was a relief to be able to push and feel the progress of her moving.
Whereas before I was pushing, pushing, pushing and nothing was happening. So finally we were really close. I remember when I asked my husband, Do you want to catch the baby? Because that was something we had talked about prior. But at that point I was like, Nobody move, everyone stay right where you’re at. You’re not leaving from behind me.
We’re just going to get this baby out. So she finally did. Her head came out and then almost immediately her whole little body wiggled out after her. My midwife caught her, immediately handed it to me and placed around my chest and it was probably the best the best feeling ever. Yeah. And then she was here. We had a beautiful little baby girl.
Would you have another unmedicated birth?
Yes, absolutely. That experience, you know, it wasn’t fun, but it was probably like the coolest thing I’ve ever done. And I felt so strong and empowered.
Like, I never knew my body was capable of that. And even my husband said he always jokes, you know, whenever we go on hikes or something, I complain the whole way he looked at me. “You’re never allowed to complain about anything, ever again. I just watched you do that. You’re so much stronger than you think you are.”
Placenta...
Roxanne: So what happened after the baby was born? You know, normally, like the placenta comes in a couple of minutes and like, the placenta comes out, they put it in a bag just like next to you, and you just kind of hang out in the bed for a while. But what kind of happened for you?
Molly: Yeah, so that was my plan was to do that. But when baby came out, my midwives were a little concerned with the amount of bleeding, so they had suggested Pitocin to kind of help move things along, which I was already on board for. We had discussed this prior, knowing I was already anemic. I didn’t want to risk having any sort of postpartum hemorrhage and then feeling even more anemic with a newborn.
So they went ahead and gave me the shot of Pitocin. And then they suggested going ahead and working on getting the placenta out. You know, sooner than I probably would have liked. The cord had stopped pulsing at this point, so I was okay with it. So they clamped me quickly and then my husband went ahead and cut the cord and then they handed baby to my husband so they could help me get the placenta out.
They tried to do a little bit of manual traction on the placenta while I was pushing, but my midwife said that she could feel the cord kind of detach from the placenta. So they went ahead and had me flip over to my hands and knees and then they manually extracted it. I’m just to make sure that they got everything and part of it wasn’t left behind, which I had watched, like videos or like illustrations of this happening prior to birth.
And I was like, That seems so miserable to have someone literally elbow deep in you. I had no idea she had manually extracted it. I couldn’t feel it because I was already so dilated. I guess I really didn’t know what was happening. I was just focusing on pushing as best I could, but it wasn’t anything uncomfortable, especially compared to what just came out.
I couldn’t feel her, you know, pushing on like my spine or anything like that to get it out.
Gina: Did you have any issues with hemorrhage after that?
Molly: Thankfully I did not. Once the placenta was actually out and they kind of evaluated things, they realized it wasn’t as severe as they were concerned it might have been. And so thankfully, bleeding stopped pretty quickly after that. I think they were just trying to be proactive with making sure that nothing more serious arose.
How was postpartum in the birth center before you went home?
Molly: It was really great. Obviously, you only get to stay there for about 6 hours after delivery.
That first hour, all the midwives, there was three out that attended my birth. They were all just kind of hanging out in the room with us for that first hour. They would check me, check baby every few minutes, which is honestly just kind of great.
We kind of got to like rehash the last few hours we had together, gush over this beautiful little baby. And then after that first hour, they kind of just left me and my husband and my mom just to kind of relax, chill. They would come in every 30 or so minutes again, just to kind of check us out.
You know, we did all like the weighing of baby measuring and all of that when she was probably a couple hours old at that point. But that way we were able to have that skin to skin time. And then it was right about 6 hours after she was born. So she was born at 937 in the morning and by about three or 330 we were headed home.
But thankfully I had already had an appointment that was going to be my 40 week appointment the next day. So we just turned that into our postpartum visit. So we just came back the next morning. It was great and I really liked being able to be home in my own bed. I feel like I would have been so bored in a hospital, especially now because, you know, no one’s able to come visit you with all the COVID restrictions and stuff.
And we were able to have grand, you know, my husband’s parents and all that. Come, come meet our baby when she was home.
Roxanne: No, I think that that was like one of my favorite parts as well about the birth center is that you like left. And we delivered around early morning too. So we were back by late afternoon, and it’s like I left in the morning and came home and I was only gone for a couple hours for my daughter.
And then like everyone else was like, Oh, it’s like I went to work and had a baby and then came back home to go to sleep.
Molly: Oh yeah. I remember my doula said something about like what a great work day like is. Like, I just go home after a couple hours and get some sleep and it’s like nothing ever happened.
Roxanne: Exactly. And sleeping in your own bed is definitely a really nice benefit.
Postpartum Visits
Roxanne: I know with the birth center they do a ton more appointments in the postpartum more often than you would normally get with an OB, whereas normally it’s like 6 to 8 weeks. You go in, they check the boxes and make sure you’re doing okay and then send you off in like a 15-20 minute appointment.
But with the wifeys you got multiple appointments during the postpartum that were an hour long where they not just checked on you, but they also checked on baby. And how did you feel like with that support postpartum that that either benefited you or didn’t benefit you?
Molly: Yeah, I feel like that was hugely helpful, not only for me but for my husband as well. You know, I’m the patient, but they like you said, they checked on baby. They checked in with my husband just to make sure we’re all okay because it’s a lot bringing home a newborn and, you know, they give you as much information as they can when you leave, like what to look for if you know, X, Y and Z happens with the baby, but there’s no manual that comes with this baby.
So it was really nice to have because we saw them, I guess I want to say twice the first week and then every week after for the first six weeks. So it was really great to know that, you know, I had this a running list of questions. So it was so nice to know that I had them to, you know, kind of bounce off of those questions.
I knew I was going to see them to have those answered. And the wifeys, in that first six weeks period, were available to me via like text message, essentially 24 hours a day. So like I would send them pictures of babies umbilical core when it fell off and looked kind of funky.
And they would, you know, get back to me and says, Yeah, it looks normal, but if you want it looked at, come on in, that kind of thing. So I feel like that is one of the huge perks that comes with working with midwives versus an OB, just that level of care.
Gina: I think it’s specific to an out of hospital birth as opposed to midwife versus OB, because for my home birth I also had like a ton of postpartum visits and then for you with the birth center, you had tons of extra visits.
And I think it’s mostly due to a client load, like they just don’t have as many clients, so they can spend more of that one on one time with their patients.
But still, it’s awesome to have all that extra care postpartum.
Roxanne: And even if you for some, like if you have a complication during your pregnancy that kind of cancels out the option of having an out-of-hospital birth, some midwives will do what’s called concurrent care. And I know the wifeys do this, where they will follow you during your pregnancy, but you just won’t deliver with them and then they’ll follow you in the postpartum.
So you still get that continuous care. It’s just a little different for the delivery portion, which I think is really beneficial for a lot of people to have somebody that they can talk to, not just maybe about the medical portion, but like pregnancy and postpartum.
How do you feel about your birth?
What are things that contributed towards a more positive birth experience and what were things that you might have potentially done differently overall?
Well, I feel like it was like I said, like the coolest thing I’ve ever done. It was intense. It did hurt, but it was, it was so cool to know that my body was capable of that. We are not ready for a second child, but I am so actually I’m looking forward to getting to go through that again just because, you know, our bodies are amazing and it’s so great to be able to kind of push the limits and see that, yes, I am capable of doing this.
So overall, love the experience. I do think a huge portion of why I loved the experience so much was because of the team I had behind me between my husband, my doula and my midwives and my mom who was there, of course, for the labor that was I couldn’t have asked for a better team. And with like the wife is two like you said, do they spend so much time with you?
Not only of course partum, but all of my prenatal appointments were a full hour long where they would check in on me. They would get to know me and get to know my husband. So I felt like, you know, there wasn’t a stranger in the room with me while I was at my most vulnerable time. It was people there that truly cared and support.
And one of the best for me and my baby.
What advice do you have for others?
What advice do you have for others who might be searching for either potentially an out-of-hospital birth or just navigating pregnancy after a previous loss? What would be some advice that you would give them or potentially yourself in the past?
In regards to the pregnancy after loss and just loss in general, I would say to myself, you’re not broken, there’s nothing wrong with you. Unfortunately, these things happen. It was probably in the long run for the best. Usually that’s, you know, it’s nature’s way of making sure that the baby that you are growing is going to be sustainable and grow into a healthy baby.
I would say it’s okay to feel the feelings that you’re having. It’s all normal. It’s okay to feel sad about the life you never got to me. But at the same time, at the other end of that is a beautiful baby who is waiting to meet you and have your love and and love you back. And that is that’s all I can really ask for.
I would say, in regards to searching for your care team or possible out of hospital labor delivery, you know, just kind of do your research. It’s okay to meet with someone and not like them and decide not to continue care with them. You need someone who’s going to who you feel comfortable with and who you feel is going to support what you want.
However that may look, it may be someone that meets with a midwife and finds that an OB is a better fit for them. And that’s okay. It’s just going to come down to whatever feels right to you.
Education Corner: What is Retained Placenta?
In Molly’s birth story, she had a retained placenta and because of some risk factors that she had during pregnancy with the anemia, they did more of an active management of her placenta as well. They wanted to minimize the amount of postpartum bleeding that she was having so that she didn’t have complications associated with her anemia.
They did more of an active management style where they gave Pitocin and then they did some manual traction on the umbilical cord to see if they could encourage the placenta to detach and be born a little bit quicker than if they were waiting for the placenta to detach on its own. And there are benefits to doing an active management style if there are risk factors to avoid a postpartum hemorrhage.
With Molly’s case, she had heavier bleeding and they needed to do a manual extraction because that placenta was not detaching and they don’t want to leave pieces of the placenta. If they were able to get part of the placenta out, that still leads to an increased risk with postpartum hemorrhage because the uterus is not able to fully contract down if there are still placental fragments inside.
So they had to do a manual extraction where they insert their hand into the uterus and kind of pull and manually pull off the placenta from the uterine wall and then pull all of the pieces out. This is not usually a comfortable, but in Molly’s case, she did not really notice the pain, it could have been because the placenta was already starting to detach once the midwives got in there, or it could have been the position that she was in was a little bit more comfortable where she did not notice the discomfort.
In some cases, they will wait as long as 30 minutes for that placenta to detach and be born on its own.
But in some cases, where there are risk factors for postpartum hemorrhage or risk factors and complications potentially that could happen from increased bleeding, they want to get that placenta out sooner rather than later to decrease the amount of postpartum bleeding that they’re having.
Typically in a hospital, they’re going to do a more active management style of your placenta anyway. But it is important to know if you have risk factors for postpartum hemorrhage or increased bleeding complications. Having that discussion with your provider in a prenatal appointment and asking questions about how they will manage that care can be helpful for planning what your third stage of labor will be like.
Conclusion
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