This is something we talk about in my Hypnobabies Classes. Many careproviders give ALL their moms pitocin after birth, with the purpose of speeding up the third stage of birth. (Delivery of the placenta) There are certainly times when it is medically necessary (excessive bleeding) but to give it routinely to every mom is not neccessary. I did not get it after my 3rd birth and was fine. The OB did note I was bleeding a bit more than expected. She did some fundal massage and that helped, so I didn’t need any pitocin.
I have had nurses tell moms “You WILL hemmorage if you don’t get this.” The nurses honestly think that a mom NEEDS it. If this was true, then how did the human race survive before pitocin?
Some of my students question, “Does it really matter? The baby is born, so it won’t effect them.” I didn’t really know what to say to that before. So I said, “Talk with your care provider and decide what you want.”
Well, now I have found this study which links the use of pitocin in third stage to decrease in breastfeeding rates. This article explains more studies need to be done, but it does give a good reason to question the ROUTINE use of pitocin during third stage.
With all due respect, active management 3rd stage has strong evidence to support it (in Cochrane, for example) and is recommended by the World Health Organization. To make a blanket statement that it’s not necessary is a pretty big oversimplification.
Anemia due to PPH ruined a babymoon for me, even though I got my shot of pit as soon as they saw the hemorrhage. By that time, I had already lost over 1000cc very quickly, and it took me months to recover. I went back to active management for my home births, and had a much much much easier recovery. So, yes. Getting pitocin after birth absolutely mattered for me.
It’s an objective fact that active management 3rd stage decreases average blood loss for the mom, and decreases the number of women who will have blood loss high enough to constitute a PPH. It’s unbalanced to discuss one study whose value is somewhat undetermined at this point without also citing the benefits of the intervention being discussed.
I had a doula client who was told by the nurse that she was just giving her fluids to “help her have energy and feel better” after giving birth. I looked at the bag and saw that she had just hung a 2nd bag of pitocin. The nurse looked at me after she said that and saw that I looked. She said, “You saw what that was.” I said, “Yes.” Her reply was, “I’m all about healthy moms.” I just held my tongue and nodded and my clients were confused. What went through my head was, “Yeah, well I’m all about being honest to moms!”, but I didn’t say it. The nurse left soon after that and my clients asked what that was about, so I told them what was in the bag and explained what it was used for and so on. I visited her a few days later and her legs were SO swollen and uncomfortable. I told her that it was a side effect of the pitocin which I learned from a CNM friend. She had seen women who needed to wear compression socks after to reduce the swelling. As with any drug, there can be side effects for the one receiving it. I found a listing of some side effects http://www.drugwatch.com/pitocin/side-effects.php
I know that pitocin especially when needed for true postpartum hemorrhage is a great blessing to have, but when it’s just given just “because that’s what we do” “it’s protocol” or “just in case” and there is NO medical indication doesn’t seem right to me.
I’ll step off my soap box now 🙂
I think there are times when it is important, but to give it to every mom is not always necessary. A low risk, un-medicated mom will probably be fine with a natural 3rd stage.
That is SO wrong. Be honest, let them choose!!!!
Interesting about that side effect of swelling.
It’s definitely an area where women deserve the right to make an informed decision, being made aware of the potential drawbacks and benefits of the proposed intervention. I just think we can’t simultaneously pay attention to WHO recommendations when we like them (5-15% c-section rate) and ignore them when we don’t like them.
On an absolute, population based level, you see less maternal anemia if there is active management in 3rd stage. The evidence is very clear. What decisions a mother makes based on the evidence is up to her, and it’s not a situation like a placenta previa where there is a clear “right” or “wrong” answer, but if we’re demanding evidence based medical practices regarding induction, c-section rates, etc we also need to be willing to go with or at least speak candidly about the intervention when the evidence says it offers more benefit than harm.
Thank you for bringing up these points! Indeed moms should be told of the pros and cons and the benefits and drawbacks. Then have the right to chose what they want for themselves! Informed consent all the way.