Posted by My OB said WHAT?!?.
Aug
19
Posted by My OB said WHAT?!?.
“We Have To Pull The Placenta Out…”
“We have to pull the placenta out or else it won’t come out and you have to go back to the OR.” – OB
There are 46 comments to this post.
Oh, because our bodies don’t have contractions to expel the placenta on their own? Must be a flaw in the design!
My aunt had this happen to her actually. She told me me how she vividly remembers the dr up to his elbow yanking the placenta out as soon as my cousin was born, without any drugs whatsoever. She said that that was one of the reasons my cousin was her last baby.
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Lindsey had this to say,
Aug 19, 2011 @ 6:54 pm (Quote)
Back to the OR? Why were they in the OR in the first place? If this was a section the placenta should have been delivered at that time… I’m curious to hear from the OP.
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Aron Reply:
August 20th, 2011 at 5:46 am (Quote)
I took that to mean “go to the back of the unit where the OR is located” as opposed to “we will return to our previous location in the OR.” But maybe I misunderstood? It’s not uncommon for doctors (and even midwives) to get so caught up in there list of tasks to check off and their desire to get said tasks accomplished as fast as possible that they completely ignore the physiologic process and just yank out the healthy placentas of women who vaginally birthed mere minutes ago. They always say it’s because the placenta was delayed, but reality is that a placenta can’t be judged delayed for at least the first hour. Normal placental birth times are usually within that time limit. If mom is stable, no need to yank on it and risk her destabilizing rapidly.
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Happened to me,too. With my first, as soon as the doc cut the cord( immediately after my son was born) the doc wraqpped the cord around his hand several times and pulled the placenta out. I hemorrhaged pretty bad, and couldnt sit up for 8 hours without passing out.Because of that, they refused to bring the baby to me until I could sit unassisted.
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sarah Reply:
August 20th, 2011 at 3:09 am (Quote)
You poor thing- that sounds absolutely hideous. Hope you are recovered now.
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SherryJ Reply:
August 20th, 2011 at 7:11 am (Quote)
Physically, I’m long since recovered. My oldest son is now 31 years old. But emotionally? Not so much. This was one of the things(one of many) that convinced me that Western medicine wasn’t as trustworthy as I was raised to believe it was.
I went on to educate myself, and slowly learn to assert myself. I ened up having three disastrous hospital births before I finally had two wonderful homebirths. The homebirths were what made me see just how horribly my babies, and myself, had been treated in even my best hospital birth.
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Giesen had this to say,
Aug 19, 2011 @ 6:59 pm (Quote)
Ahh! This happened to me, too! Horrid. Morphine does nothing to mask the horribleness! Almost makes me want to consider an epidural this time. Almost..
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Lisa in Texas had this to say,
Aug 19, 2011 @ 7:22 pm (Quote)
A friend of mine had a doctor pull on her cord to “help” the placenta along. Her kneejerk reaction to the pain (totally unmedicated birth) was to kick her foot — she kicked him pretty hard in the chest. That’s one way to stop an OB!
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Rach had this to say,
Aug 20, 2011 @ 2:50 am (Quote)
Docs don’t EVER see a physiological 3rd stage so they wouldn’t have a clue what it entails (ie watch and wait) and even if they did they wouldn’t be able to stop themselves from interfering!!
(Although last one I had did have a PPH about an hour later…)
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Gemma had this to say,
Aug 20, 2011 @ 3:38 am (Quote)
So women in the UK who have given birth are all carrying their placentas still, except those who had c-sections of course.
One thing that is stated EVERYWHERE here is DO NOT pull on the cord!!!
Why is the system so f*cked up in the US? 
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Nicci P Reply:
August 20th, 2011 at 8:02 am (Quote)
I’m in the UK and the midwife pulled on my cord. I screamed at her to stop and she told me she WASN’T pulling on it. My mum, who was watching her said “yes you are”… she only stoped when I screamed at her several times to get off me.
But yeah, I guess here it is a lot less common, I just happen to live near a hospital with an awful labour ward. Thats why my 2nd birth was unassisted at home, which was so fantastic that hopefully all my other births will be too 
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alice Reply:
August 20th, 2011 at 2:47 pm (Quote)
Unless a woman is having a physiological 3rd stage it is highly likely she *will* have the cord pulled on to ensure the placenta is out before the ergometrine in the syntometrine injection kicks in and clamps down on the cervix, trapping the placenta.
The difference is a midwife will wait for signs that the placenta has seperated *before* pulling on the on the cord (Modified Brandt-Andrews manoeuvre) rather than a doctor who just pulls on it (Controlled cord traction).
The latter is far more likely to cause pph or even worse an inverted uterus.
Its very common practice, even in the UK.
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BACK to the OR??? You mean she was in for a C-Section and they did a half-baked job? They didn’t finish the first time around? Or did they just say, “How can we charge her more money for giving birth? I know! We won’t do it right the first time so she will have to come back…”
Creepy Evil “Medical” People….
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Lynn Reply:
August 20th, 2011 at 10:44 pm (Quote)
Here, I think they mean go to the back, to the OR, not go back, or return, to the OR. The OR is often (always?) tucked away in the back of the labor unit, so when a women needs to go there for any reason, the med-talk is “going to the back.” So, I think that was what was meant here.
And, no the cord should not be pulled on if the placenta hasn’t detached yet; however, sometimes if the placenta hasn’t come out on its own (30 minutes- 1 hour is what the CNMs around here usually go with), then it is a question of manual extraction, and if that doesn’t work, going to the OR for a D&C. Manual extractions are highly invasive and should not be done except absolutely necessary, but a retained placenta can cause problems of its own.
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Lil had this to say,
Aug 20, 2011 @ 5:44 am (Quote)
This one sends shivers down my spine this happened to one of my sisters. The midwife wrapped the cord around her arm and yanked, using her feet against the table to brace herself…my sister ended up with a prolapsed womb as a direct result and was told she couldn’t have any children for at least 5 years, whilst her body repaired itself. Over that time, my sister suffered from prolonged bleeding, and it was too uncomfortable to have intercourse for 3 years, which in turn put a strain on her marriage. By the time she got the all clear to try for more children, her husband had already left her. The doctor’s attitude was that any marriage that broke down that easily, would have broken down sooner or later anyway, and they shouldn’t have had more children…but she’ll never know, and had planned to have more. If the midwife had had a little more patience, my sister’s life could have been very different.
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The OB pulled the placenta out too quickly after I delivered my first baby. A piece stayed inside and NO LIE… without having had any drugs, he wrapped gauze around his arm to the elbow and scraped my uterus out with his hand 3 or 4 times to make sure he got it all out. That hurt more than the labor had.
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Pulling on a placenta BEFORE it has detatched = dangerous. Pulling AFTER = maybe helpful. It doesn’t say which the doctor meant.
My midwife has only ever seen two placentas come completely on their own without SOME gentle cord traction. All she does is pull very gently while mom is pushing to help it slide out.
With the context we are given it is QUITE possible that’s all this doctor meant. Why are you all jumping on it thinking he/she means forced separation?
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jaed Reply:
August 20th, 2011 at 8:40 am (Quote)
Well, primarily because yanking a still-attached placenta out by the cord (“active management of the third stage of labor”) is commonly accepted as the standard of care. So it is likely that an OB would do this, and would claim that it’s necessary.
Also, this quote is here. It’s not Thursday. This means it is most unlikely that the context is “helpful, knowledgeable OB merely doing something that is BENEFICIAL and NECESSARY and what’s WRONG with all you women”, and more likely that the context indicates something wrong, or at best odd and bizarre.
Perhaps the OP will be along to tell us more. But in the meantime I don’t think it’s unreasonable to think the OB is talking about yanking a still-attached placenta out by the cord.
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Nicole Reply:
August 20th, 2011 at 9:51 am (Quote)
It is most definitely NOT standard of care to pull on a still-attached placenta unless it is retained, which is defined as still being attached an hour after the birth of the baby. Do some doctors do it? Sure. But that doesn’t make it standard of care. I know of NO hospital or practice where that is considered standard, and any doctor who DOES consider it standard is wildly irresponsible, since this is a HUGE risk for uterine prolapse.
Thinking that it’s standard of care is another example of what I’m talking about. OBs have been so demonized here (and in some other groups I belong to) that every little thing they do or say causes an uproar. A great many of the entries here are truly deserving of an asshat award (90-95%). But some of them are just jokes said to the wrong woman, or a doctor trying to explain something in a way a woman could understand, which she then misinterprets. Some of it is even stuff that’s backed up by evidence and science and is TRUE (the twins being mature faster one comes to mind), and it’s STILL jumped on and attacked.
I’m really starting to feel like this site isn’t helping anyone. Just inciting more hatred and anger.
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Aron Reply:
August 20th, 2011 at 12:26 pm (Quote)
I suspect that what many people call “standard of care” is not a written policy but a typical way of acting. Notice, the profession of OB is not demonized by this. People who put their own selfish interests ahead of what is best for their clients are – and rightly so. Sure, there are lots of good and decent people in the obstetric industry, but it’s naive at best to say that most are amazing and practice only evidence-based care. For instance, here in my location, as a doula, I have only had the pleasure of meeting ONE doctor who believed episiotomies should be avoided – the rest all think they are no big deal and that the potential few minutes pushing time is worth the laceration of their clients’ genitals with or without their permission. Only one OB I’ve met prefers women to push in the position of their choosing – the rest all want their clients in the c-curl because it’s easier on the doctor. And yes, cutting the cord the moment babe emerges then immediately pulling on it without waiting even for it to lengthen and pale is typical here. I too have witnessed a doctor plant his feet on the bed to gain better purchase before hauling on the cord like he was pulling a boat to shore. Fortunately, that clients placenta surrendered before the uterus prolapsed. I could go on. Of course none of this is written in the policy handbook! That’s not the point. The point is, it is the habitual method of managing clients in this area. People who are willing to support births differently are uncommon. People willing to PROMOTE supporting births differently are rare. Hatred and anger towards lying and manipulation are always well-deserved. But few people are willing to admit there is a specific reason this country’s maternal and infant mortality rates are as wretched as they are. It’s easier to just shush the women being damaged by the typical, quick, convenient actions of their erstwhile “care” providers than to acknowledge that the situation is grim and in need of overhaul.
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Aron Reply:
August 20th, 2011 at 12:36 pm (Quote)
Also, I’d be really interested to read the study suggesting that fetal cells proliferate at a faster rate in multiples than in singletons. Fascinating! It is my understanding that the shorter average gestation is due to the stretching of the uterus (and this varies widely by individual), but that the babies themselves were no different than any other neonate. Otherwise, wouldn’t we expect to score their gestational age on the Ballard scale a bit differently than their singleton peers?
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I had the OB pull on the cord and the placenta ended up breaking apart in to many pieces inside my uterus.
You know how they get it out?
The Doc shoves his WHOLE HAND and most of his arm up there to literally dig around and pull the pieces out. They gave me meds before to help with the pain but they never kicked in til after the doc was done – so I felt the whole thing.
Of course I needed more meds to stop the bleeding and I was stoned when they were ready to bring the baby back to me thanks to the pain medication finally kicking in.
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My placenta was pulled out 20 minutes after the birth – ended up with retained parts of amniotic sac and lost 2 l of blood + had the doc scrape inside of my uterus with her hand. Did not have anesthetic, but must admit that I did not feel a thing – the baby was way bigger than the docs hand. What buggs me though is that now I am considered high risk and I could have problems booking my next home birth.
I also did warn the midwife not to pull, because I have experience from my first birth that my placenta stays attached quite long and it tends to bleed if someone pulls on the cord even gently (my HB midwife tried). The HB midwife waited till the placenta detached even if it took 18 hours and in the end she had to take it out manually (due to other reasons not the placenta itself). It did hurt more than the childbirth, but I did not bleed and did not have any complications. In the hospital 20 minutes was all they were prepared to wait and I am still trying to recover as my hemoglobin dropped right down.
I believe every placenta deserves 2 hours after the birth, or 1 hour after the cord stops pulsating. Pulling it out by force is dangerous. Doctors should wait and observe and act if bleeding starts, but the should not be the cause of the bleeding just because they got tired of waiting.
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This happened to me as well. 2 minutes after birth and doc was already yanking on the cord. Well, unlike the other ladies here, no one caught that I had ended up retaining a massive amount of placental tissue even though I was in the hospital. Went home and nearly became septic a week later, had an emergency D&C, and then got another re-occurring uterine infection 2 weeks after that. I have birth center births now… and no one yanks on the cord right after birth, and they only apply gentle traction after they’re sure it’s detached.
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Angie Reply:
August 21st, 2011 at 5:58 pm (Quote)
How does a care provider know when the placenta is detached and it is time to apply gentle traction? (I really do want to know, not trying to give attitude!) I’ve only had c-sections, but I am preparing for a VBAC and I would really like to know what to expect in that regard.
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Laura Reply:
August 21st, 2011 at 8:38 pm (Quote)
I wouldn’t think that you’re giving attitude! It’s a very logical question. My midwives have me give a small push. If the cord moves downward and lengthens and doesn’t retract, it generally indicates that the placenta has detached and is just hanging out either on the cervix or in the birth canal. Then generally I push while she very gently guides it along.
It’s so important for providers to be patient and wait until they are absolutely sure that the placenta is detached.
Good luck with your VBAC!! I hope you have a lovely birth!
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After my baby was born my doctor was holding the cord up (it had been clamped and cut about 5-7 minutes after the birth). My husband, afraid she was pulling on it, said, “Don’t pull on the cord” to her several times. She calmly explained she was just holding it up (something about elevating it, its all fuzzy to me) but she definitely was not pulling on it. I had had no drugs and could clearly feel she was not putting any pressure at all. But he kept saying over and over not to pull.
Finally she just said, “Only idiots do that. And we’re not idiots here.” That finally made him feel better (and shut up) about it, haha. Loved my OB she was the best!
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One of my friends from college quit her job and gave up her career as a nurse the day after she watched an OB forcibly pull out the placenta and the mother subsequently bled to death. He told the family her death was just one of those things that happened. They didn’t know he actually caused it to happen.
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cottonlily had this to say,
Sep 7, 2011 @ 7:24 pm (Quote)
How did US obstetrics get so screwed up? Like they’re all also taught to give pit to make the uterus clamp down. NOTHING can be left to the body’s own devices anymore. This comment makes me sick, literally.
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valerie had this to say,
Dec 14, 2011 @ 3:15 pm (Quote)
so thats what happened to me! An hour after birth I had two nurses (yes, I said nurses, Dr was gone) hold me down and shove her arm up my vagina (that had already went back down a good bit) w/ no pain meds. SHe pulled out huge clots. They screamed at me to be still or I would probably DIE. It was terrifying. I was traumatized. They also waited till my husband was gone. He came down the hall and heard my screams but security held him back. I was scared to get pregnant again. I switched OBs. My new OB was FURIOUS when I told him. It didnt happen the next time. No one, NO ONE explained what happened or why they had to do that to me.
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And people wonder why PPH exists…it exists because of all of these Sadomasochist Butcher wannabe Medical staff thats why.. They claim they are all high and mighty and know it all yet their neanderthal tactics due to their impatience bewilders me…”Oh dear Betty my shift is finishing, I better YANK on the placenta causing that mother to hemmorhage (i dont care how its spelt you can’t even save lives properly so how is my spelling even an issue..) and bleed to death causing her son to not have a mother because heavens to betsy my SHIFT IS OVER!!!!!!” I swear if I see anything remotely like impatience and someone yanking on my partners cord I will grab a scalpel and Hannibal Lector the lot of them after a few Muay Thai knee strikes and elbows to their throats. Yes I am serious because nobody should be subject to Mediocre Neanderthal Sadomasichist “expert” medical care.. The medical field is a total rort..Its all time and money for them. And for those who are in the medical field (including me, yes I can spell hemorrhage Dr Savant). I have given up faith on the field a long time ago, to the point where I work on engineering instead as it is alot more stimulating and I don’t have to deal with grumpy old retarded doctors and midwives who worry more about their own time and money than the very reason they are suppose to be working in the stupid field which is to SAVE PEOPLES LIVES… One day they are going to yank the cord of the wrong mother and the husband is going to C-Section the lot of them…We have all seen Law Abiding Citizen yeah? It is time to start really looking after people and worrying less about a “shift ending” that just shows you love your time and money than someones LIFE…
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You mean pulling my placenta out could land me in the OR, right? Right?
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