birth- delivering the placenta


Has anyone got any tips/ experience of delivering the placenta, with a uterine prolapse? My midwife's not worried about the birth- she's confident i can breathe baby out, but she is concerned about pushing the placenta out. She's suggested I have the oxytocin shot as bubs is born, wait 5 mins for the placenta to detach and then expel the placenta with some gentle cord traction from her. This makes sense to me, as I guess there's less pushing, but I don't want to pull my uterus down or out either!

Also, what position have people birthed the placenta in? Presumably it'll come out while I'm having skin to skin/ first feed with my baby, so how can i do the two things at once without reclining and shooting everything out my vag???

I'm sure others will feed in here but i don't remember birthing the placenta as being anything major. With number one they gave me an injection and I got horribly ill from it--not fun when you just gave birth. With number 2 the placenta just came, probably at that point i was sitting down snuggling baby.

I'm interested that she is more worried about the placenta than the birth...any reason why she thinks it could cause more problems?
Look forward to hearing more on this, as nothing i ever thought about re POP.

I am wondering why she is wanting to get the placenta out in 5 minutes? It can take longer than that for the cord to stop pulsating and pumping blood into the baby, let alone the next stage of the placenta separating and coming out.

If she gives pitocin while you are birthing the baby you could find that the uterus is clamping down while the baby is still getting its full blood supply. The placenta and cord can contain 35% to 55% of the baby's blood volume! Why the hurry? The baby's sucking will make your uterus clamp down. I cannot remember even birthing the placenta at all for my second and third babies. It just happened by itself. No trying involved. I may have had pitocin, but I really cannot remember. No cord traction either. I was just busy being enthralled with this new baby!

I guess that if there is an unexpected change in what happens you need to be open to the birth staff wanting to intervenewith pitocin, if that is what they normally do. It might be about preventing excessive maternal bleeding. I would check again on the standard procedure and be clear in your own head about what is acceptable to you, and at the other end of the spectrum what is dangerous for you and for the baby, and in the middle, 'what they do just in case'.

a midwife applying traction on your cord is a terrible idea. It's the best way to rip it, yank your uterus and cause you unnecessary pain and extra bleeding.
With our 4th birth the placenta was still inside my uterus at 2 and a half hours post birth. In my birth plan that was the longest I was gonna let it stay in there before I tried something to get it out.
With the baby attached to the cord I traced the cord up and through my cervix (which was clamping down on my fingers) to be sure that it was actually in my uterus and not just suctioned in my vagina (that happens sometimes). Once I figured out it was still attached to my uterine wall I cut the baby off the cord and gave him to his dad (after we had plenty of time to enjoy that blissful first bonding). The I squatted down and provided light traction on the cord (grasping inside my vagina to do this) I felt it (really awesome feeling) come loose after about 10 seconds or so and quit pulling. Then I stood up from squatting took some deep breaths, and squatted again over a bowl and out it came. It was a wonderful relief.
I believe it was my intention that caused it to detach. Your thoughts are powerful. There is no rush to have your placenta out. None. After a few hours though your cervix begins to clamp down and seal off and then you have problems. Give yourself plenty of time. Keep your baby attached to the placenta for a while, at least half and hour or so, it's really good for you and the baby. Nursing after the birth will help your uterus contract and that will help expel the placenta. Moving around a bit will help too, so get up to go pee often after the birth.
Don't buy into the fear. You trust your midwife and that is very important. However, there is no need to fear, no need to plan an intervention. You are not broken, your placenta will come out just like any other woman's placenta.

Aza, I hope you are going to weigh in on this.

Makes absolutely no sense to me at all. Google physiological third stage vs managed third stage or here is a decent article:

"She's suggested I have the oxytocin shot as bubs is born, wait 5 mins for the placenta to detach and then expel the placenta with some gentle cord traction from her."

Huge red flag...why on earth would anyone want to artificial stimulating the organ you are trying to protect (the uterus) and then manually tearing the placenta off the uterine wall? 'Gentle cord traction' is a pretty way to describe what is a risky medical intervention. Clearly, your care-provider has not seen many normal placental births or she would realise how simple the process actually is. Also, babies who have had their life line severed are often in need of resuscitation! Babies are built to make the transition from fetal circulation (placenta) to newborn circulation (breathing). They do this very efficiently and gently and are optimally oxygenated as the cord slowly stops pulsing and newborn breathing takes over. What she is recommending is very dangerous to the baby.

Some times it might be a valid option to use pitocin - if you have already had an augmented labour, your natural physiology has been altered and continued use of oxytocin may be a good idea. Also - if bleeding is an issue, this is a place for switching from physiological third stage (baby born, skin to skin, cord left pulsing til drained and flaccid which can take 20+ minutes, baby nuzzling your breasts which then creates minor uterine cramps and this crampiness detaches the placenta) to managed third stage (cord is clamped and cut so that a shot of oxytocin can be given which causes very strong contractions of the uterus and traction is applied to detach the placenta). If bleeding is an issue and the placenta needs to come out, this method is very helpful but this is certainly not done immediately at birth.

It also sounds to me like she is recommending giving the shot 'as bubs is born' I have not heard of anyone using this archaic method for ages. It used to be done because they thought it would prevent shoulder dystocia but the dangers to women and the baby were too great.

What is normal is to have some crampiness about 10+ minutes or so after birth, a detachment bleed, and the placenta works it's way out in the next few minutes or may also just settle down into the curve of the sacrum and stay there for hours. It is not always obvious if the placenta has detached or not (which is why traction is so dangerous) though alemama's method is great...just follow the cord up and see if you feel the placenta sitting right there. Theoretically the cervix can clamp down, sure, but I have never seen it and I have seen some looong placentas (5+ hours).

Often women like sitting up on their knees, baby laying down right in front of you, cord still attached and use the gravity of that position to help it slide out. Going for a wee or sitting on the toilet helps too (put a bowl in the toilet).

This is such a huge part of labour and has it's own stage! I think there is some other motive for wanting to artificially manage this part of your birth as the fear of worsening prolapse with pushing the placenta out is very illogical. You have managed to empty your bowels while keeping your POP in consideration...why should this be any different?

thanks for all our thoughts- it wasn't my normal midwife who suggested this- it was her relief MW, so i'll speak to the usual one about it too. she hasn't mentioned it before, so I should probably get her thoughts before I get too worried about it!

Good luck!
55 million years and thousands of species of placental mammals....
Synthetic oxytocics like pitocin or syntocinon have been around since the 1950's ;)

Have figured out that my pop definitely started during pregnancy, therefore I must have birthed the placenta with pop. Just so you can tell your mw at least this one woman with pop whom you know birthed her placenta in the following way ( and therefore pop is no automatic reason to panic)

I had in my birth plan that there was to be NO management of this stage unless I was hemorraging, that it was acceptable for me to spend the whole day with the placenta taking it's sweet natural time!
And, with that relaxed attitude, what happened was:

After birth I reclined and put baby to breast and she suckled for about 30 min (cord still intact).
I suddenly felt a little crampy and uncomfortable and said to my (surprised) mw that I felt ready to try for the placenta now.
I got onto a birthing stool and about 2 min later (WITH NO FIDDLING BY ANYONE) the placenta fell out onto the floor along with a surprising amount of blood that my mw panicked about for 30 sec until she realised there wasn't any more coming. I had relatively light lochia thereafter, so we figure that my lovely pop uterus just did a big single dump right then and there. NO PROBLEM!

(and fyi we then loaded placenta onto a pretty platter covered with a clean cloth, and waited for my son to arrive, and he and Dad cut the cord about 45 min after that. Really moving for everyone! NO RUSH!)

(and not the faintest sign of jaundice since she got ALL her blood back without anyone stealing any from her by clamping her cord. I'm a big believer that clamps should be a mere formality, otherwise you're cutting too soon!)

: ) God luck you wonderful woman. Make that birth yours, at every stage!

I won't go into all the details of my last delivery (VBAC - no pitocin but I did have an epidural), but I did have a totally shattered cervix and torn uterus. I didn't push the placenta out at all - it just fell out with barely a grunt from me. Could this be because I was torn to shreds? Maybe there was a totally open passage? What am I not understanding about this process?

When women birth according to their own physiology and not a pre-conceived idea of time frames and lengths and stages, placenta detachments and expulsions are incredibly varied and across the continuum. Some just fall out immediately after birth and so take lots encouragement and navigation by the mother to figure out what she needs to do to birth it.
Unless bleeding is an issue, honor the stage for how important it is.
I like how below you state that you just sort of knew it was time and probably didn't feel quite right. Women often just feel kind of crappy and want to get it out and focus 100% on enjoying their baby...clearly an instinctive need to let go of the organ once it's job is done!

After I gave birth, a nurse (?) pulled out my placenta, and placed my healthy placenta into a clear plastic bag, and quickly left the room. If I had only known then, what I know now, I would have resisted and my placenta would have been buried beneath a tree.

Placentas are usually burned along with all the other 'medical waste'.
This perception of the most incredible part of our bodies which enables the human race to survive is phenomenally ludicrous.
Buried under a tree or made into medicine is also a fantastic use. Humans are the only mammal that don't consume at least part of the placenta...yet we are also the only mammals with such a high rate of death from bleeding after birth, and also the only ones with a high dependance on pharmaceuticals to prevent or treat post-partum depression.

Aza, is there something significant about eating the placenta? I think sometimes our sheep might eat them, but we really don't know what does eat them. If I was a fox I would hang around for a placenta, especially if I had just missed out on a nice juicy newborn lamb. I have never actually seen a ewe eating one, but I have seen quite a few lying around in the paddock. The ewe will nibble and lick the membranes off the lamb but I don't know if she actually consumes them.


Placentas are full of so much amazingness. Some women say that it has helped their post natal depression, others stop getting ill by taking placenta pills even years later, helps anemia etc etc... You can have your placenta encapsulated to take the pills as and when you need. It is amazing. I knew nothing about this at the time my kids were born but now keep hearing all sorts of amazing things!

google placentaphagy. That's what I meant about consuming it for medicinal benefit. Some species just eat the whole thing and others may lick, like you ewes. A small sliver placed in the cheek if bleeding is a problem is a great source of oxytocin (the mother's own hormone, not a synthetic form).

I know that this will bring up lots of emotion for many women. If this happens, I strongly encourage you to really look at where such repulsion comes from (now that always makes for some great conversations ;) though sometimes instinct overtakes intellect. i remember one woman who was totally disgusted by the thought, but she looked at me the day after the baby was born and said she just wanted to consume it, she had no idea why but said it just made sense and would complete the birth. Her mum made it into pate :) )

Then there is the connection to the baby which is very profound for some people. After all, one single cell after the egg is fertilised became both the baby and placenta, so there is a huge genetic link. Also, at certain times during pregnancy the placenta is actually the hormonal source of the pregnancy sustaining hormones, so the use of these hormones post birth must be in an ideal cocktail for that particular woman (placental remedies can be made for the children to take later in life for various maladies) Many cultures used the dried umbilical cord as a teething toy, wonder if there is a link?

and spoke with a nurse and found out .... at that time placenta's were commonly sent to cosmetic firms and mine was most likely one of them.

Interesting website:

"Placenta is best known as an anti-aging product."

Otherwise, yes, my placenta would have been incinerated. Hot damn!

About eating one's placenta, lots of websites about that, positive ones.

Have to move on right?

interesting about the cosmetic firms. bet they paid the hospital plenty, too, for what belonged to u and your baba!

it makes me think of how they strip vitamins off rice and wheat, sell you the 'refined' grains and then sell you the vitmins you lack from eating 'refined' foods. they steal your placenta calling it 'medical waste'and then sell it back to you as 'state of the art cosmetic technology'

while we're on the topic apparently human foreskin is also a big moneyspinning cosmetic ingredient. thats right folks, innocent baby boys are being taumatised (have you seen footage of hospital circumcision?) and mutilated bcos their loving parents are sold a b***t story about 'hygiene' and cancer (pls note i'm not talking religion here, i do feel that is different), so that more lucrative 'medical waste' can be sold for cosmetic purposes. makes me sick

my wrinkles vs your suffering, hmmm....

'We' are way worse than the romans of old.