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    Questions? Ask Henci!


    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Archived User

    In the event that a placenta does not birth in the time allowed by protocols, this one was physiological and my hospital protocols say 2 hours, how long does one wait, especially if there is no bleeding and the woman remains in good health and declines intervention. What does the literature say?

    Cheers

    Judy

    Archived User

    I should also have said that it was a homebirth.

    Cheers

    Judy

    Henci Goer

    The medical literature is not our friend in this. When I was researching the chapter on 3rd stage for the new edition of Ob Myths (book is now 2/3 written), I found two studies looking at the relationship of 3rd stage duration and hemorrhage. Both studies found that it was not linear. There was a spike in hemorrhage incidence at about 30 min. The authors concluded that this was the safe limit for waiting. But if you think about it, you will see that extraction at whatever point in time would precipitate hemorrhage either as a consequence of the underlying reason why the placenta hadn't delivered, i.e. abnormally adherent placenta, or consequent to the procedure itself. The apparent threshold merely represents how long the typical practitioner was willing to wait before trying manual extraction. I think what does make sense, though, is don't try to get a stubborn placenta out at home. You want to be in an environment prepared to deal with it if all hell breaks loose along with the placenta. 

    -- Henci


    All Times America/New_York

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