Pitocin post-delivery
So my doctor gives pitocin post-delivery as standard procedure. I don't know how I feel about this. She's pretty cool with just about everything else with a med-free birth. I can have just the hep-lock, I can have intermittent monitoring, etc. I'm not concerned about the actual delivery. But part of me has issues with the standard pitocin shot (or bag through the IV) afterwards. I had DS completely med-free and never got pitocin afterwards and was fine. I don't anticipate bleeding out this time either (though I suppose nobody really does anticipate that). But she claims she's seen "too many women bleed out" and believes it (the pitocin) is absolutely necessary. She iterated that she'll hear folks talking about a new mom and how she's very tired the few days after delivery but that that is normal when you're taking care of a newborn, but that she "knows it isn't because of being a new mom but because she lost too much blood during the birth." I don't know. To me that seems far fetched. You can't really KNOW that every mom that is tired lost too much blood. And I thought hemorrhage wasn't something that happened to the majority of women. But she makes it sound like every single woman hemorrhages.
Truthfully, she's not my favorite OB. But I live overseas and have to go to a military hospital and she's my only choice. So it isn't like I can just up and switch.
So what are your thoughts? Stand my ground and insist on no pitocin unless it truly becomes necessary (which I may end up being told, you're losing too much blood we need to give you pitocin anyway since she clearly thinks every woman bleeds too much as it is) or just save myself the headache of fighting her and get the pitocin. I'm less prone to fight meds after the birth simply because it would just be affecting me at that point as the baby would already be born and I'll probably be too hyped up enjoying my new baby girl anyway to really care what they're putting in my IV. But the other part of me really hates this whole "medicate everybody even though only a few of them are really going to need it" mentality. To me it is like taking a tylenol when you don't actually have a headache, ya know? Or taking antibiotics when you don't have an infection? Why are we so anti-meds when we don't need them for everything else in life, but for childbirth we're all about using as many drugs as possible in the off chance that something might go wrong but it hasn't actually gone wrong yet?
Re: Pitocin post-delivery
I was given IV pit following my birth because I was losing more blood than my MW would like to have seen, but not hemorrhaging. It was annoying to have to keep the IV in, but it really wasn't a big deal.
I would ask your OB to let it be a decision made at that time, but you are right they may say ok and then just do it anyway regardless of whether or not you actually need it.
I was jabbed in the leg with a shot of pitocin.
It was the only time I said "ouch" through my labour, but mostly because it was unexpected.
It was no big deal to me.
Elizabeth 5yrs old Jane 3yrs old
I had both babies at home. My midwives carry pit, but don't make a rule of administering it after birth, so I didn't have it with DD1. With DD2, though, my placenta would not detach. My mw tried a number of things to get it to come out, and the pit was her last resort. By the time she shot me up and the placenta came out, I had lost quite a lot of blood and ended up needing to be on bed rest for a week. But once she gave me the shot, it detached within a minute. So, if you do lose too much blood, they can give the pit then.
I am now pg again, and my mws have told me that it is very likely I will have another placenta detachment/pp hemorrhage issue. So if I choose to have another OOH birth (a big question right now because DH is scared after my hemorrhage), they will give me a shot immediately after the birth. Which, after my experience, is not something I mind. But I wouldn't have opted for "just-because" pit before I had that hemorrhage.
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I had a med free delivery at a hospital with a midwife and put in my birth plan that I only wanted the pit post-delivery if necessary. I ended up not needing it. I was tired after labor because it was 36 hours but after a good night's sleep I felt great the next day and had a really easy recovery and only needed the big pads for like a day and was down to one normal pad a day by 3 days postpartum. So clearly what your Dr. is saying wouldn't be true for me.
That being said, I'm not sure if it's worth a fight or not. Big question is whether you think the stress of having to fight for no pit unless necessary is better or worse than just getting it even if it may not have been necessary.
DS, May 2011
like one of the previous posters, i've had two homebirths -- one with a post-birth pitocin shot and one without. after dd1's birth, i bled a lot and my mw decided to administer the pitocin. it was a shot in the leg, but after just giving birth, i really didn't care since i was so focused on my baby.
for dd2's birth, i planned on receiving the pitocin as a precautionary measure, but the midwife arrived late and then determined that i hadn't bled enough to merit the pitocin.
the difference in how i felt after the two births was remarkable -- after losing a lot of blood i was in much worse shape than i felt after dd2's birth. without the blood loss, i recovered much faster and felt more able to care for my baby.
beyond all that background though, if i were in your shoes, i would try to negotiate for a "wait-and-see" approach but not stress out too much if you end up receiving the pitocin. i really don't like the routine administration of drugs, but this seems relatively harmless in the grand scheme...
My OB was basically the same as yours. She was like, "I've seen too many women..." and "there are reasons we do this..." etc etc. So, I ended up telling my doula about it and saying that I really, really would like them to evaluate my need for it AT THE TIME, and she completely agreed with me and will be putting it in her notes to say something at the time of delivery, asking the nurses to hold off until they know whether it's even necessary. FWIW, my doula has attended over 730 births in the area, and did a doula study with the hospital I'm at, so I have confidence they'll at least consider it more than if I were asking myself or asking beforehand.
Interestingly, my doula also mentioned that she's read articles that suggest perhaps doctors should be a little less concerned about the amount of blood lost immediately post-partum since our bodies store such an extra quantity of blood during pregnancy as it is, and it has to leave our bodies somehow. What is the big rush to stop it so immediately (obviously, I'm talking about normal, non-hemorraging blood loss) rather than over the week+ following birth? I don't know...makes sense to me.
This is my understanding, as well. I just had this exact conversation with my OB yesterday as it was the only thing in my birth plan he expressed concern over.
Long story short, I'm not thrilled at the idea of receiving synthetic oxytocin and what impact it may have on my natural supply. I would prefer to try fundal massage and breastfeeding immediately to help with controlling bleeding. If that's not working, then I'm willing to accept the Pitocin.
I took the shot.
It wasn't big deal. My doctor was fairly open to what I wanted, but I didn't want to push too hard on things I didn't care about that much - like this, which would not affect my baby at all and likely would have no bad effect on me.
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My MWs play it by ear, and we had discussed that prior to the big day. In the end she said she was going to give me the shot and I said, "okay." I have nothing to compare it to, but I didn't feel my bleeding PP was/is excessive, and I was home from the hospital and in decent shape 3 hours later.
As far as BF, DS had ZERO interest right after, for 3 days in fact, so I wouldn't count in this if I were bleeding enough for concern.
This for me, too. I was unable to get out of bed except to crawl - yes, crawl - to the bathroom for four days after DD2 was born. I don't know what we would have done if my parents hadn't lived nearby and been able to take DD1. DH had his hands more than full taking care of me and the baby. Definitely a huge difference from my first birth.
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Because postpartum hemorrhage is a leading cause of maternal death and Pitocin has been shown to be an effective way to reduce morbidity and mortality rates from PPH. The bolded just doesn't make sense. They aren't trying to stop all postpartum bleeding immediately, they are trying to stop a hemorrhage before it happens--so why would they wait a week or more?
Honestly this is one intervention I don't think is worth stressing over. It has been proven effective, it won't affect your baby and it has minimal side effects.
Thanks, Iris. I was actually hoping you'd weigh in on the discussion. I think I'm pretty much in agreement with you. While the basic principle of medicating everybody to save the few annoys me, at the same time I recognize that there are things I have the energy to fight my OB on and things I don't. And like I said before, since I already understand her philosophy, the chances are pretty good that I'll get the pitocin even if I were to tell her to not give it to me unless necessary - she's told me that she pretty much believes it is always necessary, so there's really no point in fighting a losing battle, ya know?
But what is this about it affecting breast feeding? A pp mentioned that I shouldn't count on nursing because their son wasn't interested in it for 3 days? I nursed DS exclusively for a year, so I wasn't anticipating problems (though again, I didn't get the post-delivery pit with him). I'm confused. I didn't think the two were connected. Anybody have more info on that?
All I can tell you is that I had the pitocin shot and had zero issues breastfeeding. My baby has always done just fine, as have I. I don't see how it could impact a baby's interest/ability, as none of it reaches the baby. I guess in theory it could impact me, but in my case it didn't.
I had normal post-partum bleeding for 3 weeks, so it sure didn't stop that either.
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I think she was saying that not all babies want to nurse right after birth, so you shouldn't count on breastfeeding to prevent PPH. I've never heard of a link between postpartum Pitocin and breastfeeding issues.
FTR, I didn't have any Pit with my VBAC, so I think skipping it unless there is excess bleeding is also a reasonable option. My personal opinion is there are so many other interventions that are ineffective and potentially harmful, so why worry about one that is effective and does not put baby and mom at much increased risk?
DD2 latched on immediately and it didn't stop the bleeding nor help my placenta detach. I lost nearly half my blood (I didn't know you could lose that much and still live) before I got the shot of pit, and she still nursed like a champ after that. It didn't affect my supply one bit.
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