Delivering the placenta w/ or w/out pitocin?

ncjulia12

I need to ask my ob about this again at my next appointment but wanted to see what you ladies were planning/had experienced.  

When I've talked about planning to go med-free to my obs and to the coordinator at the hospital, they've been (mostly- one ob is not as excited, but that's another story) on board with everything, but when I've asked about delivering the placenta, all three have automatically said, "Oh and then you'll have the pitocin."  Like it was absolutely necessary and automatic- even in an otherwise intervention-free birth.  (I will have the hep-lock already in "in case of emergency" so they've got a way in.)

This is not something I feel very strongly about (I guess because I haven't found a lot of research/discussion on this) and I'm willing to go along with if it is medically necessary or beneficial, but I just want to get some more information.  

Already-been-there NB moms, did you have pitocin or other interventions to deliver placenta?  FTM, have you discussed this and what are your plans?  Anybody got any research on the necessity/benefits of this?   

 

ridesbuttons

No.  It never came up.  I had never even heard about it 'til I came to the bump.

I delivered mine several minutes after babes born, no big deal.  Had a nice tour of them, they are interesting to look at.

pinksweetpea2

I delivered both of mine without pit.  In most cases it is completely unnecessary. 

nosoup4u

I did get Pitocin for the placenta after my son's birth, but it wasn't a big deal to me, either.

You can ask them to hold off and wait and see if your placenta comes out quickly or not.

LindseyJW

i believe that pitocin is administered to aid in the delivery of the placenta by keeping strong contractions going which force the uterus to shrink - thereby forcing placenta detachment and at the same time reducing the risk of hemorrhaging. 

if it were necessary to have pitocin in order to safely deliver the placenta, the human race would have long ago ceased to exist.

IMO, it is not a necessary intervention and should be used on a case by case basis when there is a present or predicted problem. 

FWIW, my placenta came out on its own after my HBAC baby was born, i did not hemorrhage and my ute shrank to its original size all on its own.

i bet your docs would find that shocking.  

Tash13

I delivered the placenta without pitocin but it was automatically given to me to help the uterus contract after the fact.  Apparently this is standard practice in my old MW's practice but I never knew to ask about it beforehand.  It's basically a small dose given to make sure no hemmorhage occurs instead of treating the bleed once it's started.  I won't be having it this time since i"m having a home birth and won't have an IV in place.

AshNish

I had an injection of oxytocin after the delivery of my son with an otherwise medication free birth. I had a midwife and at one of my appointments prior to birth we went over the reasons why and whether it was something I wanted done after the birth.  She said that the reason they offer it is because it significantly lowers the risk of hemorrhage after birth.  I decided to go ahead and get the injection as I knew there would be no risk to the baby as it would have been delivered and I thought the benefits outweighed any risk associated with the injection.  After the injection and delivery of the placenta I ended up having to get IV fluids with more oxytocin as I ended up with what they called "borderline hemorrhage".  I was glad I got the injection as it may have saved me from actually hemorrhaging.  I suspect I will get the injection after the birth of baby I am currently pregnant with too.

AmyRI

It is standard practice at the hospital where I delivered to use pitocin to shrink the uterus and help deliver the placenta. No one was in a rush to deliver the placenta even with the pit.

My goal in childbirth was to avoid anything that might cause harm to me or my baby. I was ok with a heplock, so long as there was nothing flowing through it. I did not want pain medication of any kind, I wanted to be in control of my body, and I wanted my body's hormones to deliver my baby so I had all of the natural cues to help me deliver, bond with, and feed my child. After delivery was over, I didn't care if they gave me pitocin. At that point, it's not going to impact the health of my baby in any way, and it will not impact my health negatively, so it's nbd to me and I would let them use the pit again next time. Same sort of philosophy I had with pain meds - nothing while the baby is inside of me, but once he was born and the cord was cut, I was happy to take my prescription strength ibuprofen for a couple days.

skyejo

I didn't have pitocin or anything else to delivery the placenta.  It just slid out all on it's own a few minutes after delivery.  My MW was aware of my birth plan and knew that I was planning to avoid drugs so we never discussed using meds to birth the placenta.

Jilybean17

I actually had this conversation with my MW prior to delivering #3. I had been given pitocin after #2 because I was bleeding more than they like to see and the placenta tore a bit on its way out. After a bit more reading, it seemed like this was becoming common practice just to "help" deliver the placenta. My MW confirmed this but assured me it isn't routine with her patients, but is with a lot of other OB's. I told her I didn't want it unless it was medically necessary. Following delivery she actually had to leave an order to only give the pitocin if I started bleeding excessively. 

I don't think it's necessary at all, unless there is excessive bleeding. Especially if you are planning to BF. That in itself will help the uterus contract and shrink back down on its own. GL and make sure to ask your OB!  

mkflower3000

I think you only need pitocin if the uterus fails to contract on its own and expel the placenta properly. Usually even doing something like BFing right after delivery can cause it to contract naturally, but your body is generally programmed to do this if everything is going well.

Bonidiebabe

Just as some other PP have mentioned, Its about prevention vs. treatment. I was very surprised to find out that my MW's in almost every case do give a tiny amount of PIT to get the placenta out with some nice, stong CTX. I can deny the shot, but I don't plan to. I could delay the shot, but that's where my MW said she would rather prevent than treat. I completely understand why my MW's need to be conservative at a free standing BC. For me, its not worth fighting against.

StefandTodd

It is standard practice to give it in my hospital, and I was told it was not something to argue about.

But I included it in my birth plan that I did not want it anyway, my H and my doula both knew to ask for it to not be given, and when the time came, the MW said, "okay, we have the syringe of pitocin here in case she needs it, but we'll wait and see." (I didn't not have an IV or heplock, so they would've had to inject it into my thigh if I'd needed it).  I did not need it.  I'll do the same with our next.

tokenhoser

I had a shot of pitocin in my thigh. I think it was after I delivered the placenta, but my uterus wasn't shrinking "fast enough" and I think there was more bleeding than my doctor liked. I was breastfeeding, but baby wasn't that into it right away.

I saw no reason to fight it too hard. It can't impact the baby and it does prevent hemorrhaging. Yes, it would probably be better if they did a "wait and see" like most midwives do, but this one wasn't a big deal to me.

ncjulia12

LindseyJW:

if it were necessary to have pitocin in order to safely deliver the placenta, the human race would have long ago ceased to exist.

IMO, it is not a necessary intervention and should be used on a case by case basis when there is a present or predicted problem. 

FWIW, my placenta came out on its own after my HBAC baby was born, i did not hemorrhage and my ute shrank to its original size all on its own.

i bet your docs would find that shocking.  

This is kind of what I thought- and the line about my doc being shocked made me laugh out loud.

Like many of the pp, this is not a big issue to me (baby will be out, no reason it should lead to other interventions) but I do plan to ask about it and see if we can just give me a chance to get it out unassisted and then only if necessary, get a low dose.  

Thanks for all the quick responses, ladies!  I love how I can post a simple question, go get something done, and then come back an hour or two later to multiple intelligent responses from people whose opinions I value!  This board is pretty much the best- just saying.  : )  

Sawyerplus1

Nope, after a birth center birth and a hospital birth I never had pitocin. I delivered the placenta on my own a few minutes after birth, and then the MW/nurses would massage my uterus to help empty is and getting going back down to size.

LindseyJW

ncjulia12:

LindseyJW:

if it were necessary to have pitocin in order to safely deliver the placenta, the human race would have long ago ceased to exist.

IMO, it is not a necessary intervention and should be used on a case by case basis when there is a present or predicted problem. 

FWIW, my placenta came out on its own after my HBAC baby was born, i did not hemorrhage and my ute shrank to its original size all on its own.

i bet your docs would find that shocking.  

This is kind of what I thought- and the line about my doc being shocked made me laugh out loud.

Like many of the pp, this is not a big issue to me (baby will be out, no reason it should lead to other interventions) but I do plan to ask about it and see if we can just give me a chance to get it out unassisted and then only if necessary, get a low dose.  

Thanks for all the quick responses, ladies!  I love how I can post a simple question, go get something done, and then come back an hour or two later to multiple intelligent responses from people whose opinions I value!  This board is pretty much the best- just saying.  : )  

alice2Bcheshire

It was in my birth plan that I wanted to avoid the routine use of Pitocin at any stage of labor. Apparently it's the norm at my hospital to administer Pit after delivery, but b/c I said I didn't want it, I didn't have to have it.

I delivered the placenta about 10 minutes after DS was born-- it just sort of slid out (strangest feeling). No one ever "massaged" my uterus to help it contract, either, and I don't remember any after-pains at all. Other than feeling every.single.stitch. I felt great after delivery.

My sister, on the other hand, was in a hospital with a similar policy; though she had a med-free birth, they forced Pitocin on her after delivery. 

annabelle.27

My midwife asked me what I wanted. I didn't have a preference, so the midwife recommended getting the pitocin since it is considered standard practice. I agreed. To me, it wasn't a big deal, and although I totally agree that women are capable of delivering the placenta without an extra shot of pitocin, I couldn't really see a downside so I figured I'd go for it if she recommended it. It wasn't a big deal, it was just a quick shot in my thigh. I've heard it can make the contractions when delivering the placenta more painful, but I didn't feel a single one. The placenta kind of just came out on its own.

HSartteach

I did not have pitocin to birth my placenta.  It came out a few minutes later.  I barely pushed to get it out.  I don't see why you would need a drug to get it out...you didn't need one to get out the baby...

pixieprincss

I did not want the pit for the placenta. I actually didn't come across any drawbacks, but I think our bodies are really smart and don't need it routinely. (I think meds are GREAT when the provide a distinct benefit).  The OB who delivered me couldn't accept this. I declined it on paper beforehand and in the moment. A minute later she said that I really should have it because she was getting concerned, so I agreed. I had many issues with this dr, so I ended up getting my medical records. There was no record of any sort of hemmorage or abnromal blood loss. I think she just wanted  to do what she wanted to do. 

We are doing a CPM birth this time and pit (or any meds) are not part of normal birth with them.

wheelsonthebus

I don't think so! Nobody ever said anything to me about it if they did. Would they have told me?

LadyMadrid08

I didn't have pitocin and delivered the placenta a few minutes after DD was born.

tokenhoser

wheelsonthebus:

I don't think so! Nobody ever said anything to me about it if they did. Would they have told me?

If you have an IV, they might have given it to you and not mentioned it. It's routine for most hospitals. If you didn't decline it and you had a hospital birth with an IV, you had pitocin.

If you didn't have an IV, it would have been a shot to the thigh. And contrary to what they told me when I was pushing, it did TOO hurt.

I've read some of the medical literature about why it's routine, and it's just not something I can work up any outrage against. It does save lives.

sschwege

It's not routine at the hospital I delivered at so I didn't get it because I didn't need it.  

WildcatPrincess

Both times I delivered the placenta very shortly after baby and with no pitocin, however when my blood pressure plummeted after DD they asked if they could give me a shot. Considering the number of times I heard "that's a lot of blood" I told them to go right ahead. I didn't have it with DS.

iris427

Pit in third stage is evidence-based and prevents hemorrhage.  Like token said, the baby is already out, so it won't affect them.  Personally I think it is NBD either way.  I did not have any Pit with my homebirth.  But if I were delivering in a hospital, this would not be one of the battles I picked.

InfinityDreamer

With my last was given the option of a pitocin injection after delivering the placenta and breastfeeding for about 20 minutes because my bleeding was a bit excessive and the MW's were getting ready to leave my house.

I think it's better to practice evidence based care vs. care based on hypothetical situations. 

Smurphette

With my first NB my midwife never even suggested that I needed pitocin to deliver the placenta.  The second time around the nurse and doctor on call both assumed I would allow pitocin (I had a hep lock already because I was GBS positive) after delivery to help deliver the placenta and with postpartum uterine contractions for shrinking my uterus but I refused.  They asked me a couple of times, but I was adamant in my refusal, so they left it alone.

TheQuietGrrrl

tokenhoser:

wheelsonthebus:

I don't think so! Nobody ever said anything to me about it if they did. Would they have told me?

If you have an IV, they might have given it to you and not mentioned it. It's routine for most hospitals. If you didn't decline it and you had a hospital birth with an IV, you had pitocin.

If you didn't have an IV, it would have been a shot to the thigh. And contrary to what they told me when I was pushing, it did TOO hurt.

I've read some of the medical literature about why it's routine, and it's just not something I can work up any outrage against. It does save lives.

I think this was one I didn't really bother to put up a fight as I could never really come up with a solid, better reason to refuse than "I wanted intervention-free, and that's an intervention."  

But I remembered that I got pit after I had delivered the placenta, not before.  Placenta pretty much came out on its own.

As far as the sneaking meds in, I had a heplock, and even during that post-birth afterglow, I knew when someone was coming after that hand, what they were going to give me.  I had enough opportunity to make that hand VERY inconvenient.  Granted, DH and I had also heard some stories of some potentially serious medication errors there that warranted some extra "what are you putting on that pole, why, and read me what's printed on that medication bag" vigilance. 

I know this is my own healthcare paradigm, but I'd MUCH rather treat calmly for the hypothetical that may never have happened than to risk the off chance that  the medical team react in a do-whatever-to-fix-it-NOW fashion to an emergency bleeding situation.

ncjulia12

Thanks again, ladies for all the thoughtful responses and your experiences.  I'm very interested to talk to my ob about this on Monday. 

ateal2490

I delivered my placenta RIGHT after I delivered LO. They sort of tugged on the cord and told me to push...one push and it was out.

I had a water-birth...not sure if that matters. But I can't imagine needing pitocin to get it out. It was really simple and fast.