Manual extraction

ShandyLynnRN, BSN, RN · Mar 18, 2003

YOWSER!

I have actually seen a doc remove a placenta with nothing for the pain until afterwords. Talk about brutal!

KaroSnowQueen, RN · Mar 18, 2003

When I had my third one, the baby's head was just starting in the birth canal, and the cord was so tight she couldn't go any farther. The doc reached up with both hands and pulled baby and placenta both at once. I had an epidural going and it still hurt!!!!!!!!!!!!!!!!!!! And I remember it still, that was over 19 years ago.

I did heal up just fine, better than with the other kids and got a good healthy intelligent baby out of the deal, so didn't hold any grudges. HOWEVER, if it had turned out badly, I think I would feel much differently about the whole experience.

WHY would a doc do this without pain medication, as Shandy said? Are they crazy? Sadistic? Thoughtless? Looks like they would be afraid of lawsuits.

SmilingBluEyes · Mar 18, 2003

I saw one on a poor lady have to have manual extraction of a stubborn placenta w/o benefit of anesthesia. It was weird; she was a 25 year old healthy G3P2 and had NO risk factors that would make anyone believe such a problem would occur.

Fortunately, the MD was kind enough to call Anesthesia personnel and arrange conscious sedation to make it easier for her. Still, she moaned and groaned a bit when the manual extraction of her very fragmented placenta was happening. The doctor pulled out no fragment larger than a quarter. It was laborious and awful. Yes, it was a gross, horrible thing to see, making me shudder from head to toe. We had PLENTY Of cytotec waiting for immediate administration following the extraction.

And, thankfully, the patient neither remembered any of the procedure nor did she hemorrhage at all. The MD was very skillful and thorough in the extraction and we were very vigilant for any complications afterward. Luck and skill; those worked together in favor of this lady. I will never forget the images, though. OUCH.

renerian, BSN, RN · Mar 18, 2003

OMG I am horrified...............

renerian

OBNURSEHEATHER · Mar 18, 2003

Ditto that renerian. I have, thankfully, never had to witness this procedure.

Heather

frannybee · Mar 19, 2003

You know when you hear about some procedures that make you just a teensy bit scared to move into a new area of nursing? This is one of them. :stone

renerian, BSN, RN · Mar 19, 2003

Franny I agree that would scare me..............I don't scare easy..........gulp.

renerian

mark_LD_RN · Mar 19, 2003

i have witnessed this procedure a few times yes it is pretty brutal. last one i saw done they just gane her 50mg demerol 25mg phenergan iv and did it. she was a tough girl she took it very well.

sbic56, BSN, RN · Mar 19, 2003

I have seen a different response to manual extraction procedure from each woman I've assisted with. I can remember one that just gave sort of a grimace through the entire thing. And, then, like Dayray's experience....eeeek!! This is not one of the high points of OB nursing!

**canoehead, BSN, RN** · Mar 19, 2003

I saw one, as a student, and that was the only time in my nursing career that I felt I might pass out. It was brutal, and the woman was begging the doc to stop for 30 min or more. I still don't understand how he could do that, or why no one stopped him so she could be put out.

SmilingBluEyes · Mar 19, 2003

Originally posted by canoehead
I saw one, as a student, and that was the only time in my nursing career that I felt I might pass out. It was brutal, and the woman was begging the doc to stop for 30 min or more. I still don't understand how he could do that, or why no one stopped him so she could be put out.

Perhaps it was an emergent, life-or-death hemorrage situation? Just a guess. I agree, it is a brutal thing to do to an un-medicated or un-anethesized woman, period.