Pitocin after birth?? - Page 2

[lunarlady]

Originally Posted by mwherbs 

AWow! I had heard they used higher doses post section but I have never heard 30/60 as standard. Wow. I know if pit doesn't work there are some other things to go to, like methergin or cytotec

That was for a vaginal birth. I had a retained placenta after my HB, and started hemorrhaging. My MW gave me 20 units, which is all she had, then I went in an ambulance to the hospital where they hung 30 more in my IV right away. I also received cytotec, but didn't realize that was also a PPH drug. I received quite a few things via my two IV lines in that first half hour in the hospital. I'm all for drugs in case of PPH. As my mother said, in the 1800's I would have died. The drugs, manual placenta removal, and transfusion I received really were a miracle for me. I would still HB again, but with much more awareness and respect for the forth stage.

[carepear]

I passed on it. I knew to expect it and asked that they only administer it if there was a problem with hemorrhaging. I had already discussed it wot my midwife and she was fine with it. The nurses seemed confused but it was fine.
Breastfeeding was enough to cause contractions to shrink my uterus and slow post partum bleeding.

[EllisH]

Just found out passing isn't really an option for me.  My ob told me the benefits are so evident, apparently, that not taking the shot isn't done.  I am quite comfortable with the hospital and the care I've received so far, so I'll comply (esp. as it's post-birth anyway)...

[carepear]

Not questioning your decision but I wonder if there are any statistics out there that show the rates of hemorrhaging with and without pitocin.

I'm honestly wondering if I put myself at risk by basically going by the no (routine) intervention is a good intervention philosophy.

My CNM didn't seem bothered that I said no and didn't give me any reasons why I should allow it.

[HappyMommy2]

Originally Posted by EllisH 

Just found out passing isn't really an option for me.  My ob told me the benefits are so evident, apparently, that not taking the shot isn't done.  I am quite comfortable with the hospital and the care I've received so far, so I'll comply (esp. as it's post-birth anyway)...

OB's think this about a LOT of things, that many of us MDC mama's strongly disagree with. 

Read your post again, mama ....   is that REALLY a good reason to be injected with something that may be unnecessary or even harmful?

Saying no IS ALWAYS an option.  You are agreeing to something just because other people do it, not because it is necessary for your care.

[carepear]

HappyMommy2 - good point - a quick google shows that a lot of places do not do it routinely.  I used hypnobabies and they recommend against it and I didn't really research it further at the time.

And I doubt they would refuse to treat you if you asked to not have it.  You would have to be on top of your game to remember to bypass it.  It was in my birthplan but they were still loading up a syringe while I was pushing.  My midwife had to remind the nurses that I didn't want it.

It might not be a hill to die on for the OP but I didn't see any point in having it if I made it through my whole labor without it.

[mwherbs]

I don't know how to copy and paste between this iPad and the new format
Here is a discussion we had on birth professionals not long ago

http://www.mothering.com/community/forum/thread/1278037/regarding-active-management-of-3rd-stage.

So the study in Austraila had to do with " low risk" for hemorrhage, active management increase risk of hemorrhage. High risk would be things like multiples, c- section, previous hemorrhage, anemic, high blood pressure, induction ,
So there are rates listed. I guess my biggest concern is that a provider who is not use to doing physiologic management may not know how to safely provide it, and may actually do things to increase chances of a hemorrhage or not respond proptly to a hemorrhage thinking that you object to pit use at all cost , or not have a trained watchful eye. A doc is just there for a matter of minutes to an hour or so depending on how much repair a mom needs, the later postpartum bleeding is usually evaluated by nurses .

[starrlamia]

hi I'm new but i thought id jump right in.

Pit is given to precipitate placental delivery, it is also used to prevent/stop PPH. However, many studies show that active management of labour actually causes more problems then physiological third stage labour (in low risk moms, with no indication of PPH). When allowed to deliver the placenta with no management or intervention most women do so with a short period of time and as long as they do there is generally no issues, the only time there is issue is if the placenta doesn't deliver in a certain time frame, risk then goes up (i cant remember exact numbers but i think its 1 hour). PPH is currently considered blood loss in excess of 500ml, however the average woman loses 650ml after a normal birth. Most studies show that PPH should be considered at 1000ml or more (in comparison all other surgeries have no set amount that determines blood loss hemmorhage). Many people consider blood loss during third stage labour as the body's way of shedding some of the excess blood volume obtained during pregnancy (blood volume is increased 50%). The chance of PPH happening in the first place is quite low.

I don't have the studies handy, but I can post them if interested.

I just read Evidence-based Care for Normal Labour and Birth: Skills and best practice for midwives by Denis Walsh, which is an incredible book and that is where the info above is based on, she backs everything in the book with actual studies done and explains her reasoning.

I'm an aspiring midwife (applying for next year in Ontario) So I have been cramming my little brain with all things birth.

[AlexisT]

FYI, Denis Walsh is a man.

[starrlamia]

Originally Posted by AlexisT 

FYI, Denis Walsh is a man.

haha whoops!