Re: [ozmidwifery] managed versus physiological 3rd stage, was: after birth pains

[Nikki Macfarlane]

Title: Message

When you were with the mother who had the physiological third stage Nicole, was there any touching, pulling or tugging on the umbilical cord? If a caregiver is not commonly practicing a physiological third stage they may be putting cord traction on the cord (pulling gently) anf this can cause the pain you spoke of. I have had four physiological third stages and none have been overtly painful. I have seen hundreds and the only time the woman has mentioned pain is when the caregiver is pulling on the cord or putting pressure on the top of the uterus.   There is no reason why, if everything else is normal, you cannot decline synt until a time has been reached. A physiological third stage can take a lot longer - anything between a few minutes to 2 hours is still normal - although most hospitals would be uncomfortable waiting more than 30 minutes. There is no increased risk after 30 minutes - sadly, they are smply used to seeing a placenta come a lot quicker than that because managed care is the norm now. You can always choose to have the synt.   As with every other intervention, and with the option of expectant care, there are pros and cons and only you can now the acceptable option for you and your baby.   Nikki Macfarlane Childbirth International www.childbirthinternational.com