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#11
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pitocin to induce placenta delivery?
Ericka Kammerer wrote: cjra wrote: How commonly is this given in the US? Very. So is it really necessary? I mean, I can see it'd be useful in some cases, just wondering if it's so important it needs to be there all the time? FWIW - my uterus was contracting and I did push a lot, but like the baby, the placenta didn't want to budge. SIL in Switzerland was telling an MD friend about us (homebirth) and the woman went on about how there, a drug is given after birth to prevent hemorrhage, but that midwives don't do it and therefore there's a higher rate of maternal death due to hemorrhage after homebirths. (no idea if she had any data on that - but in the US there's plenty of research showing the opposite) Many midwives, particularly CNMs, carry pitocin to homebirths. Some use it routinely. Others only use it when necessary. Upon clarification, seems she said midwives *refuse* to give it insisting instead on a 'natural' procedure and therefore endanger women's lives, etc.... I suspect relaying this info was SIL's way of saying she was concerned about our homebirth. Someone on another board identified it as pitocin, and it does make sense to have it available, but is it commonly used in the US? I did end up giving birth in hospital and did have major trouble getting the placenta out, but no mention of pitocin was made - the OB just stuck her arm up and used pressure from the outside (ouch!). Are you sure they didn't give you any? It's so routine that they might not even have mentioned it. If you had an IV, they could have just put it in there without sticking you separately. They often do it immediately following the birth, well before it's known whether there will be any problems with the placenta. The IV had ripped out during pushing. A nurse tried to insert one again, multiple times, and failed and just gave up, so there was no IV in from about 30 mins before DD was born until after the placenta came out. Another nurse did come later and put one in for fluids, etc. |
#12
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pitocin to induce placenta delivery?
Dagny wrote: "cjra" wrote in message ups.com... I am sure drugs were close at hand given we were in hospital. It was 30 mins. She said something like "it's been 30 minutes, we need to get this out now!" No mention of drugs. Yes, well. Sounds like the standard of care, but many people, after reviewing the evidence, do not elect to do anything at the 30-minute mark if they have not birthed their placentas. The time frame may have been standard, but it was also just when she got done dealing with DD. See, when DD was born the chief OB immediately went to working on her and stayed with her while the NICU staff was working until they took her away. Then she came back to me. All told that was about 20+ minutes. Meanwhile the resident OB was attending to me and no placenta was emerging, tho I was pushing. The chief OB waited a bit, talked with my midwife, and then decided to go for it. I'll have to ask my midwife more, but at the time when I asked her about it, she also seemed to think they needed to be proactive in removing it - possibly given my 3 hrs of pushing to deliver DD (following 10 hrs of active labor) she thought it just wasn't going to come on its own, no matter how strong the contractions. Neither of my placentas took much time, but I was over at a friend's third stage that was pretty unhindered and she birthed the placenta at about 90 minutes. You could barely find blood where she birthed and there was almost none with the placenta. I just checked on whether she seemed happy/healthy once in a while and tried to bother her very little. I only hindered her by doing things like suggesting maybe it would fall out once she was able to pee. Wish in hindsight I'd just kept my mouth shut but fear is so ..., even us UCers. Oh yeah, I couldn't pee. They had to catheterize me - which I *think* was done in the 10 min window between the chief OB returning to me and when they decided to go after it.But I could be wrong about the timing. My midwife had already done it once just before I started pushing. Peeing was *not* working for me! |
#13
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pitocin to induce placenta delivery?
So is it really necessary? I mean, I can see it'd be useful in some
cases, just wondering if it's so important it needs to be there all the time? no, it's not "necessary", the research I've seen does give it a better outcome in terms of PPH, but only in terms of loosing more than a certain volume of blood, not seen any details comparison of what happens after that, so you could say does it matter if you lose 750ml without the drug, but likely would have lost under 500ml without it, if there is no further difference. The numbers you are talking about are in a totally different range to when a PPH becomes a problem. But all this comes with a side effect, increase in retained placenta, I don't know if this is the same with pitocin alone, but I'm guessing it may not be, but then the decrease in PPH with pitocin alone is probably going to be less than that when ergometrine is also given. It's definitely not necessary to give it routinely, heck the human race survived without it, that's why it's something that ought to be personal choice, not physician imposed, some people will have a bigger fear or concern about bleeding and will choose to have the drug. It is one intervention that a proportion of pro natural birth people choose, for whatever reason, but if they do, they usually choose to delay administration, allow the cord to stop pulsing, cut the cord, then inject. But, it is a necessary drug to be available, even on delivery units, it's often a case of having it in the room, rather than in the drugs cupboard down the corridor. Cheers Anne |
#14
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pitocin to induce placenta delivery?
Upon clarification, seems she said midwives *refuse* to give it insisting instead on a 'natural' procedure and therefore endanger women's lives, etc.... they may refuse to give women the choice of giving it automatically, perhaps on the premise that in having a midwifery led birth at home, you've chosen a natural delivery and that is what you are going to do, every homebirth midwife I've spoken to would recommend natural delivery of the placenta as the first plan of action, along with not clamping the cord, presuming baby is well that time delay is a fantastic time for mum and baby, encourages initiation of breastfeeding (and there is research that backs up the earlier the first breastfeed the better). By not giving it automatically, they do not endanger anyones lives about the only think you could say for sure, is that they increase the chance of a bit more mess and decrease the chance of retained placenta, if they then continue to refuse to give it if problems develop, then that would be negligent and they shouldn't be attending births, yes there are other techniques to cut down bleeding and there may be people out there that would want to try all these first, but they'd have to admit that sometimes without availability of further more medicalised intervention, that women would die. Anne |
#15
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pitocin to induce placenta delivery?
cjra wrote:
Ericka Kammerer wrote: cjra wrote: How commonly is this given in the US? Very. So is it really necessary? I mean, I can see it'd be useful in some cases, just wondering if it's so important it needs to be there all the time? I don't think it is that necessary. I went without it all three times (no troubles getting the placenta out or excessive bleeding). I think it is certainly necessary *some* times, but not always. On the other hand, when something becomes this routine, you get sort of a chicken and egg effect where if you waved a magic wand and stopped its routine use, it might be more dangerous because current caregiver aren't used to working without it. Many midwives, particularly CNMs, carry pitocin to homebirths. Some use it routinely. Others only use it when necessary. Upon clarification, seems she said midwives *refuse* to give it insisting instead on a 'natural' procedure and therefore endanger women's lives, etc.... Eh. I think most midwives are quite aware of the pros and cons and many clients (like me) prefer a natural third stage when possible. As far as I'm aware, study results are a little hard to interpret. Some seem to suggest a slightly increased risk of PPH with home births, but when you look closer, the studies don't necessarily say that. I suspect relaying this info was SIL's way of saying she was concerned about our homebirth. Probably. People have many back-handed ways of saying that ;-) Are you sure they didn't give you any? It's so routine that they might not even have mentioned it. If you had an IV, they could have just put it in there without sticking you separately. They often do it immediately following the birth, well before it's known whether there will be any problems with the placenta. The IV had ripped out during pushing. A nurse tried to insert one again, multiple times, and failed and just gave up, so there was no IV in from about 30 mins before DD was born until after the placenta came out. Another nurse did come later and put one in for fluids, etc. It's also possible they gave you a quick jab and you didn't notice it. It would be interesting to check your charts and see. It's hard for me to imagine not noticing being jabbed, but many women apparently don't notice it. Best wishes, Ericka |
#16
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pitocin to induce placenta delivery?
It's also possible they gave you a quick jab and
you didn't notice it. It would be interesting to check your charts and see. It's hard for me to imagine not noticing being jabbed, but many women apparently don't notice it. can't remember where on earth I heard this, but as this injection in the leg is one that causes significant bruising, it seems some people only notice when they find a bruise on their leg and wonder what it is however I hope this is a case of something that happened in the past and wouldn't happen now, talking to my mum and other women who had babies at a similar times, it seems everything was done as a matter of course, with no explanation, or even any information about what was being done, same with vit K injections in newborns, my mum thought it was some new thing, but it turns out it's been around for a lot longer and people just didn't know it was being done, unless they found a plaster and asked why it was there. Anne |
#17
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pitocin to induce placenta delivery?
Anne Rogers wrote:
It's also possible they gave you a quick jab and you didn't notice it. It would be interesting to check your charts and see. It's hard for me to imagine not noticing being jabbed, but many women apparently don't notice it. can't remember where on earth I heard this, but as this injection in the leg is one that causes significant bruising, it seems some people only notice when they find a bruise on their leg and wonder what it is however I hope this is a case of something that happened in the past and wouldn't happen now, Sure it happens now. Sad, but true. Best wishes, Ericka |
#18
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pitocin to induce placenta delivery?
"Anne Rogers" wrote in message ... It's also possible they gave you a quick jab and you didn't notice it. It would be interesting to check your charts and see. It's hard for me to imagine not noticing being jabbed, but many women apparently don't notice it. can't remember where on earth I heard this, but as this injection in the leg is one that causes significant bruising, it seems some people only notice when they find a bruise on their leg and wonder what it is Funny, if it typically causes bruising, cause I bruise really easily, and I never had a bruise from the injection either time. And no, I didn't notice it being done, but dh saw them do it. He told me that he'd seen it done (it was on my birthplan) when I commented that it hadn't been done. I bruise extra easily during pregnancy and for about 6 weeks afterwards too. Debbie |
#19
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pitocin to induce placenta delivery?
Funny, if it typically causes bruising, cause I bruise really easily, and
I never had a bruise from the injection either time. And no, I didn't notice it being done, but dh saw them do it. He told me that he'd seen it done (it was on my birthplan) when I commented that it hadn't been done. I bruise extra easily during pregnancy and for about 6 weeks afterwards too. dunno how true the bruising thing is, but we were told it in antenatal class and I remember my HV saying something about it too. I can't offhand think of any reason why you wouldn't bruise in this one instance, but I bet there is some explaination, I don't know what the reason for the bruising is in general, you'd think that all IM injections would do the same, but they definitely done, there is one ketoprofen, an antimflamatory that really hurts at the injection site, sometimes for a really long time, I think one time I had it I still had pain in my buttock 3 months later. A one off shot of pethidine doesn't seem to do much to the area, but multiple and you really feel like a pincushion, but once you stop it heals up pretty fast, odd really, I doubt it's the kind of thing that google will show up a friendly explaination of! Anne |
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