Extraction of a retained placenta

[Meloday]

Hello - I am a first year nursing student and will actually be starting my OB 'rotation' next week. But this is my question: This past September I had a baby girl and had a retained placenta. I was induced and had Staidol. After my baby was born the doc withdrew some cord blood (I had it banked), then he tugged on the cord. (not hard). He had this slightly shocked 'oops' look on his face that made me think he had done something wrong. He tried to remove it manually and was not successful the first time. He had the nurse give me a"shot" of the Staidol then tried again. I was VERY close to kicking him while he was doing it!!!!!!!!!!!!!!!!!!!! Is this how retained placentas are usually removed??? It's been 6 months now but I am having trouble "letting go" of this experience and would appreciate your guys' expertise! Thank you! Melody

[FrumDoula]

Hey, here's a wild and crazy thought. How about training the doc to be a little more patient and not pull on cords and create problems?!?!?

I can understand extraction if the placenta has separated on its own, or there are complications. But this doc seemed to cause the problem, and ergo, a lot of pain. It's hearing stories like this that make me slightly nuts. :angryfire

Alison

[SmilingBluEyes]

Hey, here's a wild and crazy thought. How about training the doc to be a little more patient and not pull on cords and create problems?!?!?

I can understand extraction if the placenta has separated on its own, or there are complications. But this doc seemed to cause the problem, and ergo, a lot of pain. It's hearing stories like this that make me slightly nuts. :angryfire

Alison

It depends on where you are, Alison. our doctors tend to be very patient, waiting for the placenta to come by itself. They seem to understand, it will much more likely come intact this way. And 99.9% of the time, it does spontaneously deliver, with little work/intervention on the parts of our practicioners.

Sadly, the doctors that would practice this way, are NOT going to take tutelage from a doula or RN too awfully well. It's not easy to change their ways, you know? They are not likely to listen to US telling them how to practice.

[kmrmom42]

It's hearing stories like this that make me slightly nuts. :angryfire Alison

Only slightly Allison?! LOL

Patience is something a lot of docs don't have. Tugging excessively on the cord CAN cause manual extraction to become necessary.

It is important to note that shortly after delivering a 7 lb baby (for example) it isn't contraindicated to do a manual extraction without sedation. However, if it takes too long it is necessary to take the mother back to the OR for conscious sedation and basically a D & C is performed (although not much D is needed!)