Why pitocin after the birth?

[~*max*~]

After my last birth (all natural VBAC) my OB gave me a shot od pitocin in the leg. I was unprepared for this, and too caught up in the moment to question it/refuse. (My previous births were a c-section and an epidural VBAC, so I had pitocin during the births, and I believe they kept it going after.)

This time, I am planning for another med-free, minimal intervention VBAC. I do not want the pitocin. I know it is to help the uterus contract back into shape, but shouldn't the uterus be allowed to do it's job naturally first? How did others handle this situation? I will talk to my OB about it, but want to prepare as much as possible first.

TIA mamas.

[TeaBag]

It is routine in a hospital birth. And for the reasons you stated. I just told my m/w up front that I was refusing it and she didn't question it. Of course, she knew even before then how I felt about routine hospital procedures, We refused vit K, antibiotics in baby's eyes, HepB, etc....so it wasn't really a surprise to her. I think communication about these types of things are so important.

[danav]

I haven't had a hospital birth so I don't know about routine pitocin. I did have both a methargin IM and pitocin IM in my thigh and a pitocin IV drip started after my first birth because I was hemorrhaging (the midwife got it under control quickly and I was fine, home a few hours later). I had nothing after my second birth because there was no need.

[sapphire_chan]

Mom: Why did you inject me with pitocin, I thought the baby nursing would help the uterus clamp down.
Doctor: (laconically) Yep, would have. Would have bleed death first.

Now, I view this as a mildly amusing story since, 1. Mom probably didn't specify no pit. 2. doctor in the story was a terrific gp, 3. this was after a VBAC in 1985, and 4. Mom presented it as funny, and really, how the mother feels about a birth is important.

Oh, and slightly more on topic, to my understanding the pit. was unusual, not a routine procedure.

[paquerette]

I think it's routine b/c they're not used to moms nursing, ie, normal natural childbirth. I adamantly refused consent and they forced it on me (IV).

[courtenay_e]

Routine? To my understanding, this depends on the doctor and the hospital. If you have a natural childbirth, have baby delivered to chest/belly, and nurse immediately, typically this is both unneccessary and painful! The best way to address this w/future ob is to say something like, "I will be nursing immediately when the child is born. THis will cause the uterus to clamp down on it's own. I expect that, IF you feel it necessary to use pit, I will be consulted about it first." Don't give them the option. Some hospitals "allow" you to labor w/o an IV, too, so you can avoid having it just shoved in there. You are the consumer. It is their responsibility to monitor your health after the birth, and if after MONITORING you, they don't feel your belly firming up, then they can look at giving you pit. They DON'T have to do it automatically, either. They can try manually massaging you first (painful as it can be, it's not drugs in your system!). Try finding a CNM. Although many can be as "hospitalized" as an ob, the fact that they sought out midwifery at all means that you might have a better chance of having discussions like these go your way!

[lizabird]

Don't want to freak anyone out with my reply, but here goes. I had the pitocin shot after the birth. I readily accepted it. My great grandmother died from hemmoraging after the birth of one of her babies, and my mother hemmoraged and was in the hospital for a week after I was born. I don't have a personal history of heavy bleeding, but heck, I planned to go home with my baby within a few hours of birth so I just wanted to be safe (not sorry) with my not so great family history of post-partum hemmorage (sp?). So that would be one reason to get the pitocin after birth...

-lizabird

[WC_hapamama]

After nearly needing a blood transfusion after my first birth (vaginal, no pitocin), I've accepted IM pitocin after births the next 2 pregnancies. I'd rather not feel the way I did after the first birth again... it took me weeks to recover from my first birth, mere days for the others.

[USAmma]

I had an epidural birth but no other meds. When the nurse got out the syringe of pit as I was pushing out dd, I told her I didn't want it unless I started bleeding heavily. As it turned out I hardly bled at all.

[Cookie5765]

For both my labours I had pitocin IM after the birth. The first was a birthing center birth with a midwife and I started bleeding heavily. The second was a home birth and I had a massive hemorrhage and had pitocin IM, methargine IM and a pitocin IV (or 4) and ended up with an emergency transfer. So in my case at least in the last instance pitocin was necessary (with the first I wish I'd been consulted as in the end the bleeding was only a little above normal)....the second no doubt I would have bled to death (as we had Morgaine nursing the Pit going and the whole works and I lost a lot still to the point where I was pretty much confined to bed for 3 weeks and I am still recovery over two months later).

Katrina

[Moon Faerie]

Originally Posted by courtenay_e

If you have a natural childbirth, have baby delivered to chest/belly, and nurse immediately, typically this is both unneccessary and painful!

I didn't have any pit with my dd's birth, and I didn't nurse her for around 20 mins or so. There were some complications, and the cord was cut before her body was even out of me. My midwife took her straight to the cart and gave her oxygen. I was just kinda hanging out because labor was so fast that the nurses hadn't even gotten to the birth center. I had no porblems pushing out the placenta and no hemorrhage issues even though it was so long before I held her and nursed her.

[Sagesgirl]

I had IV Pit after my last birth; in my case it was a matter of I was bleeding too much even after nursing immediately.

[Pariah]

We're having a homebirth, and I plan to tell our midwife that I refuse the pitocin shot unless it's absolutely necessary as a last resort. While asking about my mom's and aunt's births since I got pregnant, I found out that both of them refused the pitocin after both of their babies. They just used massage, and that worked fine for them.

[carriedaway]

we had a homebirth and my mw gave me a pitocin shot after reagan was born. i was bleeding a lot and, of course, my mw asked if it was ok and of course DH and i said yes. at least i think she asked, it was all such a blur. i wish i hadn't had to make that decision in the heat of the moment, but i'd never even thought about it and therefore never discussed it with my mw.

i had a mw i trust, so while i might have refused it unless it was absolutely necessary, i'm not going to be sad about it. she wouldn't have done it if she hadn't thought it necessary. next time, i'll be better prepared to make that decision.

i don't know if how my labor progressed had to do with how much bleeding there was; i was in labor for 24 hours, mostly dilated for 6-7 hours, extraordinarly exhausted, and DS had been crowning for 15 minutes! i need to research it to see if there was a particular reason i was bleeding so much.

looking back, i wish i'd put DS to my breast right away, but i didn't. i think i was too shy ridiculous considering my mother, MIL, mw, and mw assistants had all seen the rest of my private parts! i will definitely be putting our next child to the breast immediately.

carrie

[Skrimpy]

I had a shot of pit after the birth of my first (at home). She latched on almost immediatly, my doula was stimulating the nipple that DD wasn't on, and I was still bleeding heavily. I trust my mw's choice completely.

I didn't need it after either of my Ds's births though, and my mw didn't give it. I think that if it's needed, then it's needed, but otherwise I don't agree with the routine use of it.

[EmmalinesMom]

I had a pit shot after one birth, but not the other. I was bleeding more than my midwife was comfortable with, and was a bit light headed from all that had gone on, so she asked, I consented, and that was that. Hospitals all vary in what is standard procedure and what is not. I had a completely natural, non-medicated birth in a huge "baby factory" hospital this spring and didn't even have an IV. I can't imagine trying to effectively labor and push with a needle in my hand.