Oxytocin during delivery

[abemom2]

Some of my births have been quite quick, and 2/4 times, I needed medication after delivery, due to very heavy bleeding that wasn't stopping.

My doctor told me that my hospital likes to give an oxytocin injection at the beginning of the delivery to prevent the heavy bleeding, and help the body do it right. It's a routine thing they do, that I could refuse.

I normally don't do any interventions, no epidural..., but considering my situation would it be better to do the oxytocin that is probably healthier than the medication? (My 4th needed the medication.)

Thanks.

[katelove]

Do you know what he mean by "the beginning of delivery"? Syntocinon to reduce bleeding is usually given as the first shoulder is born or immediately after the baby is born. It is standard practice at most hospitals.

It is also most likely the medication you were given to stop the bleeding on the previous two occasions as it is usually the first line treatment for excessive bleeding after birth.

Whether you choose to have it preventative my this time is, obviously, entirely up to you. The questions I would ask myself are what caused the bleeding the other two times? Is it something which is treatable with syntocinon? Is that situation predictable this time? How much blood did I actually lose last time and how did it affect my recovery?

Sorry to pose more questions than answers.

[hustvik]

Oxytocin is best known for its roles in sexual reproduction, in particular during and after childbirthOxytocin exerts a selective action on the smooth musculature of the uterus, particularly toward the end of pregnancy, during labor

[sunshine28]

Katelove: I appreciate your questions.

The dr. mentioned that it's when the shoulder comes out. I don't know much about this, since I heard about this for the first time at my last appt. and wanted to check here first.

What caused the bleeding is the baby coming out very quickly.Not a lot of time between head and everything else.  Nothing I could prevent, and no tearing on my part. They wanted to give it right after the birth but I wanted to make sure I really needed it. They gave it to me about 30 minutes later, because it was obvious that the bleeding was  strong, and my doula - who is very natural told me to get it at that point. (I was ready to push before arriving, but held myself in, to birth at the hospital and not on the way, so as soon as I got on the bed, the baby was out, and the nurse was telling me to wait for the doctor.             By the time she arrived the baby was halfway out already. My other births were also pretty quick though.)

The dr. told me it's the hormone Oxytocin that would be given earlier. Not the medication I received after. I don't remember the actual name, it's in my file which is at home now.

Hustvik: Therefore, you recommend it or not?

I just googled it: Is this what is used as an induction in birth?
 

Thanks again.

[katelove]

Yep, same drug as is used for induction but different dose and usually given imtramuscularly rather than IV. It causes uterine contraction which, after birth, helps to stop bleeding which originates from the placental site on the uterine wall. The blood vessels which fed the placenta are entwined with the uterine muscle fibres so when those fibres contract they clamp off the blood vessels and reduce bleeding.

Based on what you've said I probably would be inclined to get it. Precipitous delivery is, as you say, not something you can control and is a known risk factor for postpartum haemorrhage. It's also not something you can really predict except to say that as its happened twice before there's a good chance it could happen again. As the syntocinon (synthetic oxytocin) hastens the separation of the placenta from the uterine wall you could consider delaying administration until the cord has stopped pulsating if that was important to you.

[rnra]

It's not entirely certain you were given an oxytocin injection with the bleeding after your births.  It may have been methergine or hemabate.

[sunshine28]

The medication I received is:  Ergo .25 mg. I don't remember what the main ingredient was.
 

[major_mama11]

Was it cytotec? Some docs/midwives give rectal cytotec rather than intramuscular pitocin. That's what I received with my newest baby, and it seemed to work just as well as the pitocin I was given for my pph with my first child. 

[starrlamia]

sunshine, that is probably ergometrine

Evidence shows that active management of the third stage reduces PPH, so oxytocin during delivery (as shoulder is delivered or just after) and controlled cord traction to deliver the placenta.

here are a few articles

http://www.sogc.org/guidelines/documents/gui235CPG0910.pdf

http://www.ncbi.nlm.nih.gov/pubmed/10908457

Personally I am like you and dont like interventions (i dont even like taking tylenol lol) but when there are indications such as past PPH than it is worth considering having them.

Good luck Mama!

[sunshine28]

Starrlamia: Thanks. I nurse right away, so that helps with nipple stimulation. The dr. did give minor pressure on my stomach to help with the placenta delivery. No major force there. I also wait a few minutes (about 5-7) before clamping - I don't know how much that helps. There never was a need to remove the placenta manually. (Just some slight traction.)

It's interesting that with my 2 US births (1,3) no need for this added stuff, but my 2 Canadian ones (2,4) I needed it. I think there was more respect and believing me, in the US. Here...

I hope they don't make me crazy with all their questions the way they like too when I come to the hospital. I need to convince them to give me a room right away without the triage room first. They don't seem to realize that experienced mothers know their bodies a bit.     They don't believe me that I'll be giving birth within the next few minutes, because I don't make any shows, or grand scenes when I enter the hospital. That would probably help too! With both CAD births I was holding myself in from pushing, because I needed someone standing next to me to catch the baby.

I'll go for the Oxytocin, if they'll be quick enough - usually they're not ready, even though I warn them.