Pitocin after birth??

[Heavenly]

I am having a homebirth, well, any day now. Today my midwife informed me that as soon as the baby is born they cut the cord and give you pitocin shot to make the placenta come out. I said no to the immediate cutting of the cord and they said they could delay cutting the cord but they give everyone a shot of pitocin as soon as baby is born. Is this normal? I have never heard of this before! Doesn't the placenta come out on it's own and on it's own time? Why would you need an artificial substance to get it to come out when you've just gone through an entire labour and birth with no artificial substances? I need some info about this so I can decide whether or not to comply with this advice.

[indigolilybear]

wow!! i've never heard of this as a standard practice. you're right, the placenta is almost always expeled spontaneously and really, there's no rush for it. USUALLY, MW's are more patient w/this kind of thing too.....

i'd definitely put up a stink. i got a shot of pit. at my attended homebirth but this was only because i threatened to hemorrage.

really, i can't begin to say how shocking this practice is to me and i've lived in three different communities of mama's where many homebirthed.....:

[MammaV]

From what I understand, the pit is used to help the uterus clamp down. This should be unnecessary if you breastfeed. Breastfeeding causes the uterus to clamp down and firm up really quickly. Remember that you hired your midwife. You can fire her as well. You can also refuse treatment. Do you really think she'll hold you down to force the shot? Probably not. I think a good open dialog and your wishes strongly communicated will determine whether or not you and the midwife are on the same page. You may want to talk over any other concerns to ensure she isn't too intervention happy. Take a look at the newest issue of Midwifery Today, it's dedicated to medical intervention prevention and points out that many modern midwives intervene unnecessarily (strip the membranes, shots of pit, etc). The research the articles support encourage midwives to take a step back and let the body birth naturally. Good luck. I don't think you need the pit...

edited for horrible spelling errors...

[smeta]

I was given a pitocin shot after dd was born - the midwife (at a hospital) said it was to slow down my bleeding. I thought it was kind of weird too since you always hear about using pitocin to start labor! But really I was not going to argue about it at that point. It is strange that your midwife is planning on it from the get-go. Can't they just wait and see if the placenta does it's job first?!

[Gagesmom]

I know they give you pitocin in the hospital to get your placenta out, just in case any might be "retained" or whatever garbage they use as their excuse...
My midwives don't cut the cord until the placenta is delivered and the cord has stopped pumping. With both of my births, the placenta was delivered in less than 15 mn, tho I've heard it can take up to an hour. (?) Are you seeing a CNM? I've never heard of a midwife carrying pitocin around with her...in fact, I thought it was illegal for them to have it? All states are different when it comes to midwifery laws, of course.
I see no reason why you'd need the shot of pitocin, it seems so pointless. Good luck trying to talk your midwife out of it. Maybe she will come up with a special waiver for you to sign, if she does it for malpractice suit reasons.

[AutumnMoonfire]

I had pit after delivery in the hospital but not until after I had delivered the placenta, I was bleeding, the midwife tried external massage first then the shot of pit, when the massage didn't work.

I didn't have it after my second baby though...

[mammastar]

I had a homebirth, with a pitocin shot (after I had delivered the placenta). I think my midwife was a bit concerned about my bleeding, but I know that she had also had a bad experience just a week or two before with another client who hemhorraged after a homebirth and ended up in the hospital. It took a lot out of her emotionally, and I understand why she would have been inclined to 'play it safe' with me. We had discussed beforehand that, if she was concerned about the bleeding, she would ask me if she could give me the pitocin, and what she would say exactly, so I knew what was going on.

The only real issue is that I'm crazy-phobic about needles! I had told her this before, and she told me that no one really minds about a little needle after they've just given birth. But I was still reluctant when she actually asked to give me the pitocin, and asked if it was really necessary, because of the needle. She and dh convinced me to give it a go but he had to hold my hand. They both thought this was pretty weird, following on hard labour!!

[guestmama9924]

THe only thing I can think of is they have in their mind that you are a bleeder. The only time in my 5 years of being a homebirth midwife asst that we give pitocin as a preventative is if mom has a history of bleeding, retaining the placenta, or has had many many babies and or a low hematocrit ( iron count).

It is NOT a normal routine, it is not needed by everyone and it is invasive!

I would ask why YOU need it, and if the answer they maintain is just 'routine" I would refuse it.

Or, you can say that you will accept Pit after say 30 min with no placenta, but no before.

Again, make sure that they are not afraid you are a bleeder . Do you have red hair? Get them to be straight with you.

Good luck mama!

[leafylady]

My midwife said the same thing as KeysMama. She also said that it was becoming standard practice in the UK. We talked a lot about it with my 2nd because I had hemorrhaged after my first and did not want to do it again with the 2nd.

[Nee Nee]

pit before placenta

I live in the same area as heavenly and unfortunately it does seem to be a routine procedure now...but I have already put it in my birthplan that I dont want it done, unless after 1/2 hr I still havent delivered placenta!! My midwives are fine with that!!

[GruppieGirl]

My placenta just wouldn't deliver in my hospital birth. I really started bleedin gand they gave ma some pit. Unfortunately it didn't work and I needed a D and C.

Good luck to you! Stick with what your instinct says.

[Axis]

I have never heard of this as a "normal" part of a midwives or even an OB's protocal....you are definitely being smart to question this procedure. I woulndn't agree with anything you are not comfortable with.

[cottonwood]

I agree with KeysMama. I want to add that if your placenta doesn't come out right away it is NOT in itself evidence that something is wrong, they just start worrying because you could be internally hemorrhaging and they wouldn't know it until you began to show symptoms of going into shock. Personally, I can tell by how I feel what is normal for me, but a midwife is on the outside and doesn't have that direct information, and is going to be getting nervous because she is ultimately (legally) responsible for your safety.

So if it were me I would sign a waiver and allow my body to do its work unencumbered. Something that helps a lot is to make sure you are warm (if you are still totally exposed after the birth, you will begin to feel the cold and will involuntarily tighten up) and squat, squat, squat. I'm one of those women who has very mild contractions after the birth, so the squatting is essential to getting the placenta out without "help". I also twiddled my nipples. Even so, mine still take at LEAST a half an hour to come naturally.

My suggestion is to not start worrying about the placenta as soon as you give birth, but rather have the midwife leave the room for a while while you sit back, snuggle into some blankets, drink some water/have something to eat, have some private time with your husband, relax, admire your baby, latch on if s/he is interested, cut the cord when it is cold and limp, hand the baby to husband, then get up and squat over a bowl and give a few soft pushes.

Betcha it works.

[Greaseball]

It's your body; it should be your choice. I understand a lot of midwives are now doing almost everything an OB does.

Hospitals have "time limits" set for the placenta just as they have them set for the baby. They may give the placenta 10 minutes to come out, then give you pit. In my case they gave me pit right away, which I didn't mind too much because the baby was out, but if you don't like the idea you should not have to do it.

What do you suppose women did thousands of years ago? I know they did not all die because they didn't have pit, that's for sure. Healthy placentas have been delivered up to 13 hours after birth. I believe the body gets it out when it is supposed to be out, which may not be when the doctor or midwife wants it out. Someone should tell them they can't always have what they want.

[Kirsten]

I would definitely do some more talking to your midwife about that. It is not routine and there is no need (that I can see) why it should be. Even if you needed it before, that does not mean you will need it now. I pushed for two hours with dd1 (most of that time not feeling like I "had" to push but doing so because I was a 10) so by the time she was born, my uterus was apparently (20 hours of labor) tired and did not clamp down. After trying natural methods, I was on the verge of hemorrage (no matter how I spell that it looks wrong) so I reluctantly agreed to the shot of pitocin (I am also anti-needle which is one the things that led me to natural birth to begin with - avoiding the epidural and IV). This was in hospital with a nurse-midwife. Dd2 was born out of hospital with a certified midwife. I only pushed when I felt like it (ended up being 14 minutes this time) and my bleeding was minimal. I would only push when YOU feel the urge to, not just because you are fully dilated.
I can appreciate your midwife's fear if she has had prior bad experiences with women bleeding after birth. But they are not you and that should not cause you to have interventions in YOUR birth! I thought that was a big draw of homebirth - avoiding all those interventions...
Hope it works out well for you. Keep us posted.
Kirsten