What I knew about placental birth that my obstetrician friend didn’t…

A few years ago, I was sitting in my garden on a summer’s evening with an obstetrician friend. We had just opened a bottle of wine and were settling in for a long chat.

“So,” said my friend. “I have a question for you. What do you know about placental birth as a home birth midwife that I don’t know as an obstetrician?”

Ooooh. That WAS a good question, and I allowed myself a few sips of wine while I pondered it. But I knew the answer within a minute or so.

Here’s how I answered…

“What I know that you might not,” I told her, “is that the textbook explanations of why women sometimes bleed after birth and why placentas sometimes take longer to get born are incomplete.”

“It’s not always about physical causes,” I said, “like lack of tone. I’ve seen women bleed and I’ve seen placentas take longer to be born as a result of emotional and social issues. The technocratic viewpoint doesn’t account for that.”

I went on to tell her a few stories to illustrate my point.

The value of stories

I told her about a woman who I sat with in the hospital bathroom for hours while she processed the trauma of her previous birth before finally letting her placenta go.

Then I described Judy Edmunds’ story of the woman who bled when her birth supporters all left the room after the birth of her baby (because they were hungry for soup) without realising that she still needed their support until the placenta was born. Her midwife had to hurriedly call them back.

I shared the story of the woman who needed the cayenne pepper treatment … which in this case had nothing to do with any therapeutic value of the pepper itself, but with the space that cleared for her to birth her placenta when her mother-in-law disappeared off in the car on a midwife-recommended mission to go and get organic cayenne pepper from the health food store on the other side of town. In rush hour.

Evidence isn’t enough

Evidence is important, but it isn’t enough. We need to learn from stories as well as science. It’s also important that we don’t just take the science at face value and that we’re able to make our own assessment of the value of the results.

You’ll find more on this, and many other topics, in my upcoming book on midwifery knowledge.

I’ll be sharing more details in September, and my email subscribers always get the earliest, juiciest, and most extensive details!

If you’re not on my email list and would like to be, sign up here, and then check for the confirmation email.

And if you’d like to know more about the birth of the placenta…

Photo by Jeremy Bishop on Unsplash

About the Author: Dr Sara Wickham is an author, speaker, and researcher specialising in pregnancy, birth and maternity care. Her work focuses on evidence-based, woman-centred information and informed decision-making, drawing on more than 30 years of midwifery knowledge and experience.


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