Pitocin being administered after birth to reduce hemorraging

[~patty]

I have to give birth in the hospital because of some previous losses. Anyhow...my doctor told me today that even though I am planning to give birth without drugs, she is still going to give me pitocin after the birth to prevent hemorraging. Apparently, this is shown to be effective 40% of the time.

This is the first time I have heard this....someone please explain this to me, because I am sick of my doctors pushing stuff on me.

[queenjulie]

As far as I understand it, pitocin is commonly given after birth because it causes contractions, which squeeze the uterus down and thus, stop the bleeding sooner. However, I would refuse it unless you already happen to be getting pitocin (hopefully with an epidural, because that stuff HURTS!)--I mean, why would they hook you up to an IV and administer drugs *after* the birth is finished? That just seems ridiculous. And you can refuse it, just firmly tell your OB that you will not be consenting to that.

[angelpie545]

I think it's kind of ridiculous to administer it routinely unless there is a medical indication for it. My midwives did end up giving me some after my first birth because my uterus wasn't contracting properly and I was bleeding a lot, so in that case it was needed. Pitocin given after the birth is usually given in a shot and doesn't really cause that much cramping-at least in my experience. Every woman is different however, and some may experience more pain with it than others.

[crazydiamond]

I don't think I'd agree to it as a routine measure, but at the same time I'd be grateful for it if I started hemorraging. In other words, I'd want to wait and see if it's needed before using it.

[Qerratsmom]

I started to hemmorage after my first and they did hook me up to an IV of pitocin. Not sure what would have happened if they didn't but it did stop the bleeding. That being said, I'm not sure I would agree to it as a routine prevention if it wasn't necessary.

[paphia]

When I gave birth at the hospital, they administered a shot of pitocin into my thigh muscle and the OB used some traction to pull out the placenta. Ugh. I was not educated about third stage labor management and just figured it would all go fine and there was nothing to worry about as long as I got the baby out okay.

Well, there's a lot going on after you push that baby out! The lights are on, there are extra people in the room, you're often shaky from the hormones and they throw some warm blankets on you because you're often cold after sweating and pushing. It's really not the ideal environment for the natural hormone process that releases the placenta and causes the uterus to clamp down to take place. Maybe it is better if you can't be alone, quiet, in a dark, warm and calm environment to get the pitocin shot. I'm not saying that it's necessary, but I don't know how harmful it is either, considering the birth environment. Personally I would be most vocal about no cord traction for placental removal.

[Kidzaplenty]

With one of my children, the MW (that only delivered in hospitals) said that it was not optional at all. And I WOULD get it after the birth, not matter what.

I did not argue because I was planning a UC, but she made it seem as if I never had a choice, so I would say it is pretty standard practice.

[mkmoro311]

Pitocin should not be the norm! Breast feeding right away will help start contractions to deliver the placenta which will lower the chance of Hemorrhaging! Also, eating the placenta works too! Do not let Dr's use words like "standard and policy" scare you into thinking you need something you don't!

[turtlewomyn]

I remember discussing this with my CNM (It didn't matter, she and her doctor coerced me into a scheduled c-section for fetal macrosomia, so I ended up with the pitocin anyway).

I told her that I planned to nurse as soon as possible after the birth, to avoid being given pitocin. What she indicated to me was that it would be likely I might need pitocin anyway, but she still had a "we will see" attitude.

I would not accept automatic pitocin, get the baby on the breast ASAP after birth instead.

[~patty]

Thanks for the advise. She said that I would have to have a heparin lock in my arm, but no IV initially (so that is her tactic to give me the pitocin in an IV later). I don't even want that thing, because it HURTS. I guess it is easier to have the IV ready to go in a more calmer situation, then trying to insert it during an emergency. What is the difference between a heparin and a saline lock?

Regarding the pitocin, it is still bothering me that it is "standard procedure." I was thinking that the breastfeeding should help with uterine stimulation. My mom hemorraged with me when I was 6 weeks old, so I definitely don't want that to happen but I hate all these hidden scare tactics too.

So..can you refuse all these things in the hospital? How do you go about it? I feel like if I cause a big scene, I will be delivering in a straight jacket. I still need to have a sit-down with my doula and maybe she can help me shed light on some of this too.

[~patty]

I found this article that you might be interested in: http://www.aafp.org/afp/20060315/1025.pdf

It is interesting to note that only 4% of vaginal births end in hemorraging, but the pitocin does help reduce the risk of hemorraging....

I guess one way I need to look at this too is that I am not giving birth in a natural setting, even though I am hoping for a "natural birth." There are plenty of things that can make your hormones go into panic mode and not work the body correctly.

[Limabean1975]

Redheads and pit after birth?

May I add a question to this thread? My midwife suggested (totally optional) that I get a pitocin injection after birth because I am a redhead - she said redheads bleed more. I consented to the injection (ahead of time), but now, looking back, I am wondering about it - I have never heard this redhead thing anywhere else.

[cj'smommy]

I didn't need it to help my contractions, but I did have it after my son was born. It wasn't routine but the doctor said I was hemorrhaging more than he liked so I was given it via my IV.

[MyBoysBlue]

When I had DS 1 in hospital, just after he was born and they were still looking him over, they gave me a shot in my leg. I hadn't even gotten to see DS yet. They told me it was to get the placenta out. I didn't know what it was they gave me and can only guess that it was pitocin. 10 mins later I had contractions and pushed out the placenta. I don't remember if there was cord traction or not I was pretty uninformed about such things then. I do wonder if the docs give the pit just so they don't have to wait for the placenta. With my UC it took over 40 mins for the placenta to come out.

[nashvillemidwife]

Limabean, I have always heard that about redheads but have not found it to be true and can find no corroborating evidence. I think it is a myth, and that it can be a self-fulfilling prophecy; when a midwife believes it, she is going to be quicker to give pit and call it a hemorrhage.

[queenjulie]

Originally Posted by Limabean1975

May I add a question to this thread? My midwife suggested (totally optional) that I get a pitocin injection after birth because I am a redhead - she said redheads bleed more.

Wow, that is the most ridiculous thing I have ever heard. I wonder if she things blonds are dumb and men with big noses have big penises, too?

[christifav]

The doctor can't leave until the placenta is out...therefore, s/he uses the pitocin to speed delivery of the placenta so s/he can get on with the business of sewing you up and placing your catheter so s/he can move on to the next pt or tee time or what have you.

Pitocin is fabulous if you are one of the 4% who hemorrhage. If not, it is BRUTAL. Decline it unless your hemorrhaging and make sure you and your doc come to an understanding about what constitutes hemorrhage and what, in his/her opinion, is a placenta taking "too long" to deliver.

I believe only Saline locks are used now, but because they used to be Heparin locks, the med community still refers to all of them as "hep locks".

IMO, if a medical professional can't place an IV in an emergency, then they have no business working at a hospital. The "pre-placement" of a hep-lock just opens the door to the non-emergency, non CONSENSUAL use of pitocin after delivery while you are too enamored over your baby to notice.

[chandasz]

I agree with the above.

I suppose that we could avoid the possibility of breast cancer if we all agreed to preventative masectomies too....

It's ridiculous!

I did have trouble with bleeding after my first birth and did oral methergine... no problem

[crazydiamond]

Originally Posted by queenjulie

Wow, that is the most ridiculous thing I have ever heard. I wonder if she things blonds are dumb and men with big noses have big penises, too?

No kidding!

I'm a redhead and had zero problems with DD's delivery (which was a cesaerean, so an even high chance of hemorrhage). My midwife certainly doesn't have any problem with me being a redhead. In fact, my midwife was just telling me last week a crazy story about how some OB was insisting that this redheaded woman she knows should get a scheduled cesarean because "redheads are unable to birth large babies".

[jeninejessica]

I also wantd to comment on the IV "just in case". One of my favorite pieces of reading is a list of "things that make you go huh" written by a doula.

10. You need an IV in labor…just in case something goes wrong, we MUST have access to your vein!
Rather than question this statement, I’m simply going to relay what happened with some students I taught a childbirth series to many years ago. He (the expectant father) happened to be an EMT-Paramedic. This couple was doing a hospital tour so that they could become familiar with the hospital they intended to have their baby in. The nurse showed them the triage area, then showed them the labor and delivery rooms, explained that this is when they would get their IV…
The EMT dad said, "Umm, what if we don’t want an IV?"
Nurse replied, "It’s standard…what if something goes wrong? We must have access to your vein and what if it takes a while to get the IV started? It can be difficult sometimes to get it started…what if we can’t get it started and we’re trying to get an IV in while your baby is having problems??"
The EMT dad looked her straight in the eye and said, "Are you telling me that I can start an IV in the field, at night, in the rain, inside a vehicle that has been flipped over on a patient who is critical and bleeding out…and you are concerned about starting an IV on my healthy wife in your brightly lit hospital??? That frightens me."
Hee hee. I’ll just let that story sit with you for a while.