How long to wait for Madame Placenta??

Specialties Ob/Gyn

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Specializes in Community, OB, Nursery.

Just wondering how long your docs/midwives allow for the placenta to deliver...

...attended a staff mtg yesterday & found that our staff wants her out in 3-5 minutes! They of course help her out by hanging Pit & PULLING! :angryfire :trout:

No freaking wonder we have so many PPHs for retained frags/membranes! And I'm surprised we don't have more inversions.

I think this is ridiculous. What do your facilities do?

(I did of course bring up that the Pit would probably not be necessary if healthy babes were put to mom's breast immediately...preaching to the choir....)

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Our docs will wait 30 minutes. Some of them are impatient, and pull and tug on the cord, but for the most part, it either comes on it's own, or at the 30 minute mark, they will start to think about taking the patient to the OR for curettage or manual extraction.

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Specializes in med-surg.

my daughters doc didnt wait. once baby was out she pulled on the cord and the cord broke. so guess what, she went in up to her elbow, no lie, i was standing right there and manually extracted it. no pain medicine. OUCH!!!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

They wait patiently. Usually the placenta separates and delivers within 30 minutes, tops.

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Specializes in midwifery, NICU.
my daughters doc didnt wait. once baby was out she pulled on the cord and the cord broke. so guess what, she went in up to her elbow, no lie, i was standing right there and manually extracted it. no pain medicine. OUCH!!!

OOOWWWWWW!!! That is barbaric! Your poor, poor daughter! Manual extraction should be done with some pain meds/ anaesthetic, never like this. Is your dd ok??? I'm a midwife and never saw anything as cruel carried out, thankfully!

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Specializes in Community, OB, Nursery.
They wait patiently. Usually the placenta separates and delivers within 30 minutes, tops.

Ahhh, in my wildest dreams....

What I think it boils down down to is

1) 9-5 obstetrics, or

2) wanting to get back to the sleep room

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Specializes in Case Management.
They wait patiently. Usually the placenta separates and delivers within 30 minutes, tops.

You must work with some really good Docs. I did my 3rd year nursing project in the delivery room and witnessed many doctors pulling on the placentas.

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OOOWWWWWW!!! That is barbaric! Your poor, poor daughter! Manual extraction should be done with some pain meds/ anaesthetic, never like this. Is your dd ok??? I'm a midwife and never saw anything as cruel carried out, thankfully!

I did, & then for good measure Dr Ogre stuck in a 10" hemostat with guaze and swept it around her uterus "to make sure he got everything". Barbaric is right!

Could a nurse do something (report the ob?) in a case like that?

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Specializes in midwifery, NICU.
I did, & then for good measure Dr Ogre stuck in a 10" hemostat with guaze and swept it around her uterus "to make sure he got everything". Barbaric is right!

Could a nurse do something (report the ob?) in a case like that?

tinyscrafts.OMG!!!! imagine the pain and fear of this poor new mammy! Makes my blood boil! PTSD here we come!!!!

In our place of work, we would talk to the manager if we observed anyone, (be it doc or midwife!), and then follow it up with something called an IR1, basically an incident report. Don't think I would ever work easily again with someone who had such disregard for human pain and emotion though! what did you do when you saw this horrible thing happen, I feel for you being witness to it!

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Specializes in Community, OB, Nursery.

Manual removal of frag/placenta has occurred at least twice where I work with no pain meds. Horrible. Once I wasn't physically present. The other time I was. I swore to myself I would never participate in that again without premedding.

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Ours will wait for 60 minutes. Anything longer and it's a manual removal and 24 hours of abx, unless mom has a hx of retained placentas then they only get 30 minutes.

The vast majority will be delivered within 30 minutes so it's generally not an issue.

I see doctors giving gentle traction but have never seen a doctor pull out a placenta.

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Specializes in midwifery, NICU.

When I practised midwifery....good few years ago, well, seven this year,(now NICU Midwife) we had a lot of old school midwives. These women had soo much experience, if you had a retained placenta, and if they were around..you called for them, and it was out! NO extreme force, NO extreme pain to the mother..how did they do it? Years and years of experience, nowadays, the majority of them are gone, we are in a culture of university trained midwives. It's not always a bad thing, but, the women with the hands on gained knowledge have gone. My childbearing days are gone, but my daughters are nearly 20 & 18, so one day it will be their turn in the labour room. I know that I would rather have someone take care of them who could provide total and safe care, rather than write a good essay. BTW...I AM a university trained midwife, I am in NO way disrespecting anyones skills, but rather, lamenting on the loss these older skilled midwives.

OK, just my tuppence worth guys!

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