Managed or physiological third stage?

What did you choose? Or what are you opting for?

I wasn't given an option when I had Harry so it was interesting to be asked. My decision (physiological with the option to change my mind) is predicated on:

1. Home birth, not hospital, no complications

2. Fairly quick labour etc (as Harry was)

Because I see it as a way of slowing the whole process down, giving me time with Baxter and hubby in between, and keeping things as natural as possible. I'm certainly no earth mother but I would prefer to have as little (what I perceive as) intervention as possible, but am very open-minded about it.

Hubby was surprised as he was sure I'd be far more 'done and dusted' about it, but I suspect he isn't fully aware of how attached I am to the whole home birth experience. I don't think I was even aware until it got close.

Interesting to hear what others decided.



  • I'm having a managed because I'm high risk, I'm not sure I get the option

  • I have to have a managed 3rd stage but if I had the choice I think I'd go for physiological as like you would like as little intervention as possible.

  • I had delayed cord clamping

  • Rose

    I had delayed cord clamping

    Rose, how long was that? My MW said they delay as standard, but said that honestly there was a difference between the time they would do this for, followed by a managed third stage, and if it was a physiological third stage. Which confused me as I would expect DCC to be until pulsating has stopped?

  • I had delayed cord clamping too. However my placenta wouldn't deliver naturally and I ended up haemorrhaging. Next time I have to be managed.

  • 1st and 2nd time I had the injection pretty much straight away.  3rd time they delayed clamping as that was now standard practice but then the paed told them they needed to test babies blood so the cord was clamped to get blood from it and I had the injection after that

  • I had delayed clamping (this was v important to us unless baby was poorly etc) but I had to have injection for placenta as they were concerned I was losing a fair bit of blood

  • I want delayed cord clamping but will have the injection to get rid of the placenta ASAP.

    I had the injection with p and still had a couple of issues with placenta not coming out as quickly as it should. A friend who had the same and then heamorraged said that in her post birth review of what went wrong the consultant said that sometimes after a fast delivery the body can go into shock and shut down. Then not delivering placenta fully or as it should. This fits with my birth. In that light...
  • ....I just want it out. I don't see any benefits to slowing down the 3rd phase once cord is cut.
  • I'll be having the injection. I just want it out so I can go home as soon as possible. I have no desire to go to the post labour ward.

  • I have to have the third stage managed as with Molly they could not stop my womb from contracting and I nearly eneded up in theatre (and in fact ended up with severe tearing when I had got through labour virtually fine!). this time they will manage the 3rd stage so that I deliver the placenta and then they control any bleeding.  This is much prerable to me and what happened last time was really frightening for us all

  • Both times I've had the injection although I let the cord stop pulsating first and tried to deliver the placenta naturally but it just wasn't happening so in opted for the injection.

    With Z she was attached to the cord for ages as they didn't have any cord clamps in the home birth kit so they had to go to the birth centre for some. Even though I was breastfeeding at the time and tried to push it out I really couldn't so asked for the injection as I was ready to get a shower etc by that point.

  • I had planned with my 1st birth to not have the injection and just let it happen naturally but when it came to it, I'd had a 48 hour difficult labour followed by a 3rd degree tear which I needed to go into surgery for so I quickly agreed when they offered me the injection to deliver the placenta quickly. I then opted for the injection for my following 2 labours as well.

  • Counter, I had a water birth so I think it must have been a good 20-30 minutes after I was out of the water before the cord finished pulsating and they gave me the injection to get the placenta out. It's a bit hazy to be honest!

  • Sorry reading that back it's a bit confusing- I think the cord had done it's business a fair bit before I had the injection, but it took longer because I was in the water and they needed me on dry land IYSWIM

  • The pulsating goes on for quite some time then...

    I like that I can go with the option to leave it, but change my mind at any point. That's reassuring. Some scary stories of haemorrhaging, I've never read up on that and it's never been discussed with the midwife.

  • I had the injection with M, I knew I'd want it all over by that stage, and for me delivering baby safely was all that was important.

    After my ERPC I bled heavily due to womb not contracting. If C had been a natural delivery then I'd have had the injection straight away to minimize risk of haemorrhage. As it was, it was a GA section so I've no idea what they did, but I assume they gave me the injection, as the reason for the GA was the risk of bleeding after the baby was delivered

  • I had the injection. It took me 39 hours to get to that point, I wasn't dragging it out any longer!

  • I had opted for the injection, but as they were getting it ready it appeared with a small contraction amd it was over in a flash. I did have a heammorage, but I think it was more down to the 3rd degree tear I had, although I'm not entirely clear on exactly why it happened..

  • I wrote on my birth plan that I wanted delayed cord clamping and that I was undecided about injection/natural 3rd stage and to ask me at the time. (The downside of injection is that it can cause sickness). In the end I decided to have injection - I remember saying 'ow' when they injected me and my husband was amazed that all those contractions I'd not complained but a jab, yes, ouch! LOL.

    Waiting for cord to stop pulsing took approx 20mins. It was amazing to just sit and hold him still attached
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