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So I'm a new doula, and the last 2 births I've attended, the moms received pit afterward, even though they didn't have significant bleeding. One was already on pit through the last few hours of labor, and they kept it dripping at 4 milliunits/min (is that the correct terminology? I'm no nurse...) for HOURS after the baby was born. This was the mother's 4th preg, second live birth (2mc's in the middle). And she was having BAD afterpains. She got some IV meds to help w/ it. I asked her if she knew she was still on the pit and she said yes, so I didn't say anything more.

The other mother had a completely natural birth in the hospital, minimal bleeding, and w/i minutes they gave her a shot in the leg of pit! We were all surprised, and they didn't even give her a minute to ask about it. They just said "Since you don't have an iv we're going to give it in your leg" I whispered to her "you don't have to get this" and she asked the nurse "Do I have to?" And she said "Yes, dear" as she was sticking her thigh. Ugh.... I just didn't want her to experience unnecessarily rough afterpains w/ her first baby. Thankfully she didn't.

As I'm writing this, I'm thinking maybe they do it just to have the placenta born fast....??? Could this be the MAIN reason? I thought it was used to stop bleeding. My only complaint about her family practice MD was his eagerness to get the placenta out, kind of gently pulling. But every time she did it she'd say "ouch" or "what are you doing" so he would stop.

ANYWAY.....sorry to be so rambly. Please tell me WHY they do this and what info I need to give clients in the future about this added procedure.

THANKS!!!
 

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Pitocin is given after the birth when the practioner is going "active management of third stage". Active management is typically standard policy in many hospitals. In studies of hospital births, using active management stastistically lowers the amount of blood lost and reduces the risk of hemmhorhage.
 

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That is true, and I wholeheartedly disagree with it. The hosp I work in does not do it routinely, but they do it kinda quickly sometimes.. it is warranted in cases of anemia or obvious bleeding, but I am all for giving the woman time to clamp down.
AND, VERY IMPORTANT: in hosp the baby is often taken soon after birth for all those bullsh*t "checks" when he could be uninterruptedly cuddling and nursing with mom and stimulating her to clamp down very effectively... grr
Baby or drugs? I think they should get their babies!
 

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Yeah, I just attended a birth in a hospital where its routine. It was my sil's birth, in a different state. Anyway, I was shocked at how minimally she was bleeding (compared to the other births I've seen) but apparently because she didn't expel the placenta IMMEDIATELY after birth, the doc ordered pitocin and TUGGED ON THE CORD. I was like freaking out (internally).

Luckily it's been about 2 months since the birth, and recently my sister said to me, "Why did they give me pitocin?!?!?! I don't want pitocin at any more births!" And I explained (over)active management of the third stage. So hopefully she'll understand more for her next baby.
 

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It's standard here in the hospital, and even in the homebirth practice I used to work with had it at every birth and would use it maybe 40% of the time. I think, get the baby to the breast, and if baby isn't latching on well, try nipple stimulation.
 

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I found out with baby #3 that they give pit after the birth to help get the placenta out faster. I did not have an IV for that birth and was told by the nurse that the reason my placenta was taking longer (like 20 mintues) was cause I did not have an IV and did not get pitocin to make things move along faster. Luckily they were in no hurry and I did not have to have any pit.

Stupid practice if you ask me.
 

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The doctor tried to give me pit with my second baby right after she was born. My after pains were so bad that I said, "I don't need that!" My mom was there and tried to explain why they did it and I said, "I know, I said I don't need it!" They never did give it to me. I don't really understand their impatience either.
 

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Hmmm, that's a toughie... either put the baby to the breast or give them a shot... Well, you know they have to take the baby away to scrub it's head and put a hat on it and give it eye ointment and vitamin K so the only other option is to give mom pit so her uterus will clamp down. (note major sarcasm in that paragraph)

*rolling eyes*
 

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I delivered my son at a freestanding birth center and this was one of the things that made me pretty mad afterwards. I had NO IDEA they were going to do that. It happened before I even knew it. "We're giving you a shot of pitocin to stop the bleeding," prick. Just like that. I didn't even know I needed to tell them in advance not to do it, the whole point of being at the birth center was to be drug-free
:.
 

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In our unit, we don't take the babies away from mom, they do BF immediately with most vag deliveries, and we do still have big bleeds. I'm not a fan of pit (misoprostol works faster and better for most bleeds), but given a choice between IM pit and a bleed, I'd take the pit. Not prophylactically (I have mixed feelings on active management of third stage) necessarily, but even with breast stimulation and uterine massage, some women bleed.

Regardless of whether pit's used, a lot of multips will have very strong afterpains. I've seen it in completely unmedicated births, including no PP pit.
 
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