Can I buy Methergine online without a prescription or license? Hemorrhage advice...

[boogiebearlove]

Hi!
I am 37 weeks pregnant with my third child, and planning my second "unassisted" home birth. I say unassisted in quotes, because I do have a large support group of women, and one even has quite a bit of medical emergency experience, but licensed midwifes are illegal for home birth in Ohio, so she is unable to carry anything like pitocin or IV lines.
I had retained placenta after my last home birth, and we didn't really realize it, so after 8 days of being incredibly sick I finally went to the hospital and had to have a D and C to remove the remainder. After that I had such severe blood loss from the surgery and the first week postpartum that I had been passing huge clots, that my hemaglobin was around a 7, so they gave me a blood transfusion.

This time, I am anemic (after about 2 months of using a few different herbal tinctures and iron supplements I have been unable to raise my hemaglobin to a 10 or higher). I am actually planning to start an IV iron therapy next week, and it's a last resort to get my iron to a good level because I know that being anemic can raise your risk of hemorrhage. That is the only slight fear I have of the birth, and while I'm not that concerned about it in reality I feel like it might not be totally responsible to go into the home birth without emergency medical supplies knowing that I may be at an increased risk of hemorrhage. But after having a home birth, and knowing what I know now, I just can't go to the hospital.

We have some shepherd's purse, and I know that Tabasco sauce on the tongue might help with bleeding as well as eating a piece of the placenta. But I don't know when those methods would work, or when to really be concerned about hemorrhage. I was told by a midwife friend last year that you could purchase Methergine tablets online without needing a medical license, but I can't reach her to find out where that is and the sites I'm finding just look very fishy. Does anyone know about this or have any advice?

[mitintraining]

In my opinion if you do not have the expertise to use a powerful oxytoxic drug like methergine than I would not purchase it, especially from an online source. Who is to say you are getting what you think you are getting. I would personally recommend that you read Susan Weed's Wise Woman Herbal for the Childbearing Year. It has great information on using herbs to staunch blood loss and other things. Most often I hear of women who are anemic actually bleeding less, the body 'knows' it has less to use so it doesn't lose much. I would you not use anything stronger at home. Educate yourself on what you need and practice visualizing the birth you want, ie the placenta completely releasing from the uterus after the birth of your baby, very little bleeding. Also I would caution against mashing against the uterus after the birth in order to get the placenta to release. This action can actually cause the placenta to be retained in areas. I would not do anything after the birth of the baby before the placenta if you are not bleeding, even herbs can cause a premature release of placenta that can result in the blood exchange not being completely shut down. When in doubt do nothing, just watch and use common sense. Good luck. Again this is totally my opinion after researching and being around births as both a doula and student midwife, and giving birth 5 times too.

[medicinemansgirl]

I also have dealt with this to some extent and am feeling very prepraed after having done months of research. Due to the fact I have thrombocytotenia (low platelets) and every pregnancy deal wiith an iron count that consistently hangs around a 9 we treat the anemia aggressively and are prepared for any risk of hemorrhage...low as the risk may be. Since I have the platelet issue along with carrying twins and a larger number of previous pregnanices we found this was one of the huge areas we really wanted to be well prepared for and educated in.


For iron....I take both a Slow FE and a Hematenic tablet morning and night...which comes out to 4 iron tablets a day. This was approved and recommended by my mw when I had one during this pregnancy. It is the first time in any of my pregnancies I have been able to keep my iron at an 11.5...which is HUGE for me. Every other pregnancy I have always been on one supplement, which does raise it to some extent but never high enough to have everyone satisfied with it. And this is, by far, the best I have felt in any pregnancy. I am also on 3 capsules of RR and Alfalfa 3 x's a day both for iron and the RR to also help tone the uterus to prevent any excessive bleeding after delivery.

In all of my research I found that Angelica (Dong Quai) is used very well for expelling all of the placenta, getting rid of anything retained, getting the uterus to contract and also to stop any excessive bleeding. Sabina also works very well for these purposes. Shepherd's Purse is not supposed to be taken until after the delivery of the placenta but is also used very very well for hemorrhage. Homeopathic Ipecac also works well for retained placenta and hemorrhage. We have all 4 of the Angelica, Sabina, Ipecac and Shepherd's Purse on hand and ready for delivery. The only 2 I plan on using as a preventative are the Angelica (after 2nd baby arrives but before placenta is expelled) and Shepherd's Purse (after placenta is delivered). The other 2 are just to have on hand for good measure in the event we are not achieving desired results with the 1st two. We live very rurally so it's imperative that we know what to do and can treat it well in the event any problems occur.

I feel very very comfortable with this though and am confident we have everything covered and have taken responsibility for it all....not going into anything "blindly". Originally it was my desire to have pitocin on hand, as my dh is a paramedic and can administer it appropriately, but after researchig all that we have we both feel these 4things are what need to be on hand in our emergency kit and we are both fine without anything stronger.

[MsBlack]

Originally Posted by mitintraining

In my opinion if you do not have the expertise to use a powerful oxytoxic drug like methergine than I would not purchase it, especially from an online source. Who is to say you are getting what you think you are getting. I would personally recommend that you read Susan Weed's Wise Woman Herbal for the Childbearing Year. It has great information on using herbs to staunch blood loss and other things. Most often I hear of women who are anemic actually bleeding less, the body 'knows' it has less to use so it doesn't lose much. I would you not use anything stronger at home. Educate yourself on what you need and practice visualizing the birth you want, ie the placenta completely releasing from the uterus after the birth of your baby, very little bleeding. Also I would caution against mashing against the uterus after the birth in order to get the placenta to release. This action can actually cause the placenta to be retained in areas. I would not do anything after the birth of the baby before the placenta if you are not bleeding, even herbs can cause a premature release of placenta that can result in the blood exchange not being completely shut down. When in doubt do nothing, just watch and use common sense. Good luck. Again this is totally my opinion after researching and being around births as both a doula and student midwife, and giving birth 5 times too.

I much agree with these comments--except for one small thing: methergine is not really an oxytocic, although some drug websites do call it that. Methergine acts directly on uterine muscle, prompting contractions; true oxytocics stimulate a woman's release of her own naturally-occurring oxytocin--which then stimulates contrax (blue cohosh is a true oxytocic, signalling the pituitary gland for release of oxytocin into mama's bloodstream). I'm not sure why, but this point bugged me..

Main point about methergine, tho, is that it does cause contrax--can cause very strong, long lasting contrax, and so it can be used for pph. Best for use after placenta is out. I agree that it's important to be careful about the source of any drug--to be sure you're getting a high quality product that is what it says it is!

I also agree that timely use of herbs, nipple stim/nursing, gentle massage of uterus (GENTLE)--along with avoidance of disruption of the natural flow of things after the birth--are just as good as pitocin. First you avoid pph if at all possible--then you be prepared with herbs and other to stop it if it gets underway. I think a lot of pph are caused/contributed by usual 3rd stage care by most birth pros--certainly in hospitals, but also at home w/mws. Too much interference!

[mitintraining]

sorry, got caught up in what I was saying. I was thinking pit, not methergine when I wrote that. I agree that the contractions it causes are pretty intense also. I blame the 9th month of pregnancy brain!!

[basje]

Personally if I knew that I had low platelets walking into the birth if I started to hemorrhage I would immediately transfer, even if it was slight. My choice is of course influenced by my experience of hemorrhaging after my birth, and because of my low platelets (which is what helps you clot) bleeding out, and having a 19 liter blood transfusion (+ platelets). That experience has changed my understanding of how important platelets are. Of course you should do what you feel comfortable with.

[MsBlack]

Originally Posted by mitintraining

I blame the 9th month of pregnancy brain!!

Oh that ol' pregnancy brain!

[boogiebearlove]

Thank you so much for your replies! I do feel a little weird about buying it online without really knowing how to use it or where it's coming from. I loved the information about herbs - thank you so much!! I will have those on hand as well.

I've been told by a couple of midwives that being anemic (hemoglobin below 10) puts me at an increased risk of pph, but I can't seem to find any info on how much it's increased (I know that pph is a risk, albeit a rare on, but still an existing risk to any woman in birth, and that's something I accept. If being anemic only raises the tiny risk a tiny bit more, than it wouldn't be as worrisome). Or at what levels exactly - if I can get my iron to a 10 what is my risk compared to an 11? One midwife told me she wouldn't attend a home birth of a woman that was under12. So I just haven't been able to get good information on this, and I've been trying to decide for myself what my "safe level" will be. If I'm only at 10 when I go into labor, will I stay home? I really want to, but I don't want to be irresponsible. I really don't want to give up my home birth either. If anyone would like to share their links or books so that I can find more information I'd really appreciate it.

I also do think that transferring is a good possibility if I or any of my team members feel like I've lost too much and we're not sure if we can get it under control - knowing that I'm low going into it will definitely affect that decision. I was severely anemic after my last home birth due to retained placenta, and I remember how awful that felt, and then I was hospitalized and given a blood transfusion. It was a terrible first 2 weeks of my baby's life, for me, and I don't want to experience that again.

[Mamatoabunch]

Cytotec is another option.

[medicinemansgirl]

I've been given a cytotec suppository after the birth of #6 and #8 by my mw who was in great fear of the platelet issue. I found it to be horrific and did fine with the UC of #7 in which we had none. We do have some oral pills of cytotec on hand but they take 20 minutes to work and I will do anything to avoid taking that route. The contractions it gave were worse than transition...and it was all right after baby and the time you want to be the most fulfilled and just reveling in the joy of having baby here. It's here but I don't plan on using it AT ALL unless I'm on death's bed.

As far as the platelet issue...a medical report was issued in July or August and there is new research that proves it is not the issue everybody seems to think it is, stating that it only becomes dangerously low at 20,000 or less. This is due to the fact that in pregnancy the platelet count itself may drop but the platelets a pregnant woman does have are greatly enlarged. Due to blood volume increase some women do not have the same count as they did pre pregnancy but they do develop much, much larger platelets as their body adjusts and makes up for the lack in numbers. So, it pretty much just works out evenly and dr's and midwives are just now beginning to really understand this. A normal count is 350,000-450,000. My sister in law had a c/s with her 1st baby due to a count of 150,000 when I had our 1st UC only 2 months earlier with a count of only 65,000. My mw at the time said the cutoff for a homebirth was 50,000. Mine consistently hang around 62,000-95,000 when pregnant. But the medical journal report stating that anything above 20,000 is safe makes a ton of sense based on what we have learned over my last 4 pregnancies dealing with gestational platelet issues. You really had an ordeal. Was your's strictly gestational or did it exists before pregnancy? And do you know what your count was right before delivery? Just curious since this is also an issue we have had to deal with when considering everything. We will definitely transfer if it becomes that great of an issue but we also need to have everything on hand to deal with it in order to buy us time to get to the hospital since we live 35 miles away from the closest one.

But there again, between having a tendency to be anemic, the platetes, the number of previous pregnancies and a larger than average uterus we feel we have the bases covered in the event something were to happen.

[Wittyone]

Originally Posted by boogiebearlove

I've been told by a couple of midwives that being anemic (hemoglobin below 10) puts me at an increased risk of pph, but I can't seem to find any info on how much it's increased (I know that pph is a risk, albeit a rare on, but still an existing risk to any woman in birth, and that's something I accept. If being anemic only raises the tiny risk a tiny bit more, than it wouldn't be as worrisome). Or at what levels exactly - if I can get my iron to a 10 what is my risk compared to an 11? One midwife told me she wouldn't attend a home birth of a woman that was under12. So I just haven't been able to get good information on this, and I've been trying to decide for myself what my "safe level" will be. If I'm only at 10 when I go into labor, will I stay home? I really want to, but I don't want to be irresponsible. I really don't want to give up my home birth either. If anyone would like to share their links or books so that I can find more information I'd really appreciate it.

You are actually NOT at greater risk of hemorrhage if your hemoglobin is low/you are anemic. You ARE at greater risk of complications from a hemorrhage should one occur simply because you don't have that "cushion" that a higher hemoglobin provides. I'm surprised at the cutoff of 12 for a homebirth, that seems really high. When I worked (and birthed) at a freestanding birth center the cutoff was 10. I now work in a hospital and no one is too concerned as long as we go into birth above 10, though being above 11 is nice. During pregnancy we recommend supplementation for hemoglobin under 11, if it's above 11 we simply counsel plenty of iron rich foods.