for those refusing pitocin after birth

alybookgirl · August 2009

Do you have any good websites that I can show DH? I found thishttps://www.childbirth.org/articles/pit.html but I'm interested in learning more. My doc says they routinely do this and I told her I was not interested. She seemed pissed. I need some more info to get DH on my side and support me in the hospital...I'm beginning to think I may switch to a midwife.

mrs.schwery · August 2009

Shouldn't the fact that you don't agree with it be enough for your DH to support you???

And your doctor has to listen to your wishes, whether she likes it or not. Sorry I don't have anymore info about refusing pitocin after delivery.

AliciaSpring · August 2009

It is routine however not necessary. I would just keep googling look into natural childbirth websites

JCM083009 · August 2009

Sorry, I don't know of any sites, but I refused it (I didn't even have an IV or heplock so it wasn't easy to do it for me) with no problems at all. But really, if you are butting heads with your Dr. I'd strongly suggest switching and possibly switching to a midwife. You do not want to feel like you have to fight with them during your delivery - they should be on your team.

thailajo · August 2009

mrs.schwery:
Shouldn't the fact that you don't agree with it be enough for your DH to support you???

And your doctor has to listen to your wishes, whether she likes it or not. Sorry I don't have anymore info about refusing pitocin after delivery.

This...and why would they use pitocin AFTER delivery?

Becky262 · August 2009

thailajo:
mrs.schwery:

Shouldn't the fact that you don't agree with it be enough for your DH to support you???

And your doctor has to listen to your wishes, whether she likes it or not. Sorry I don't have anymore info about refusing pitocin after delivery.

This...and why would they use pitocin AFTER delivery?

To help deliver the placenta (the final stage of labor)

dragon_chica · August 2009

thailajo:
mrs.schwery:
Shouldn't the fact that you don't agree with it be enough for your DH to support you???

And your doctor has to listen to your wishes, whether she likes it or not. Sorry I don't have anymore info about refusing pitocin after delivery.
This...and why would they use pitocin AFTER delivery?

It's supposed to help deliver the placenta a lot faster and avoid possible hemorraghing.

prneyes3 · August 2009

I agree the fact that you don't want it should be reason enough for him to support you. I personally want no parts of pitocin for my own reasons. Have you told DH your reasons for not wanting it other than because you don't want it?

Megan7575 · August 2009

My sister bled uncontrolably after her delivery and they used pitocin to help contract her and stop it. Not all doctors just give it for no reason. You need to keep an open mind and understand that doctor's sometimes have a good reason for things.

ToledoDeux · August 2009

Pitocin is used after delivery to help the uterus contract, deliver the placenta, and prevent hemorrhage (not that the body can't you know, do these things on its own or anything).

I just asked my MW about this, because I have no idea if they gave it to me or not last time, since I had an epi and an IV - they could have easily done it without me knowing.

She said that they never use it prophylactically, only therapeutically - so it would only be needed if I was losing too much blood after delivering the placenta.

I'm trying to find some links for you - but there must be something about it in Henci Goer's "The Thinking Woman's Guide to a Better Birth," I would think.

And I second the move to a midwife. It is the best decision I ever made about pregnancy.

JCM083009 · August 2009

dragon_chica:
thailajo:
mrs.schwery:
Shouldn't the fact that you don't agree with it be enough for your DH to support you???

And your doctor has to listen to your wishes, whether she likes it or not. Sorry I don't have anymore info about refusing pitocin after delivery.
This...and why would they use pitocin AFTER delivery?
It's supposed to help deliver the placenta a lot faster and avoid possible hemorraghing.

Yup. Pitocin causes the uterus to contract. You need it to still do this after delivery of the baby and many doctors don't want to wait long enough for your body to do it on its own. I think I delivered the placenta within 10-15 min. with no Pit.

ToledoDeux · August 2009

Megan7575:
My sister bled uncontrolably after her delivery and they used pitocin to help contract her and stop it. Not all doctors just give it for no reason. You need to keep an open mind and understand that doctor's sometimes have a good reason for things.

And sometimes they don't - like when things like this are done "just because." And that's what OP is asking about - not about refusing it when it's actually needed.

EricaD521 · August 2009

i use midwives and love them! here's my take. if you're going for an epidural free delivery, then by all means, if you don't want pitocin at any point stand firm on it. BUT if you are willing to get pitocin during your labor to help strenghthen your contractions then it's pointless to have them turn it off right after you give birth, because the placenta comes out within minutes if not seconds after birth. in my case it was a 2 minutes. once that happens your body and the nurses help massage your uterus into contracting down quickly. i was off all IV's within 1 hour of giving birth.

now if i had had an unmedicated birth i would not have allowed them to give me pitocin after the birth. it seems silly that way.

so it's up to you, but in the moment, especially right after your baby is born, you're not thinkin about the IV's, you're just in awe of your child.

Jessalicious01 · August 2009

The main reason is to prevent bleeding out. The Dr is probably pissed because you can't predict something like that happening. Child birth is a natural process, yes, but sometimes things happen that you can't predict.

Pitocin helps the uterus contract which needs to continue happening after delivery otherwise you will bleed to death and your uterus will never return to it's pre-pregnancy size. The body naturally releases pitocin when you breastfeed. That's one reason they encourage breastfeeding as soon after delivery as possible.

ToledoDeux · August 2009

Jessalicious01:
The main reason is to prevent bleeding out. The Dr is probably pissed because you can't predict something like that happening. Child birth is a natural process, yes, but sometimes things happen that you can't predict.
Pitocin helps the uterus contract which needs to continue happening after delivery otherwise you will bleed to death and your uterus will never return to it's pre-pregnancy size. The body naturally releases pitocin when you breastfeed. That's one reason they encourage breastfeeding as soon after delivery as possible.

The body releases oxytocin after birth - pit is the artificial version. Which begs the question - why would pit be routinely "needed"?

Jessalicious01 · August 2009

They just do it routinely because those are the recommendations from the FACOG and Dr's (especially OB's) are extremely cautious these days due to the high amount of malpractice lawsuites.

farrellashleigh · August 2009

Ok first off I worked in L& D and I can tell you that administering Pitocin AFTER delivery is NO WAY STANDARD PRACTICE.... I could count on one hand the number of times this was done and it was only because of a more severe situation where the uterus isn't contracting the blood vessels itself and the mother is losing too much blood. It is only used in severe situations to prevent hemorrhaging. So I would DEFINITELY question the doc telling you that this is standard, it is not!

Yes it can help to contract the uterus to deliver the placenta but usually the placenta comes out very quickly with no med assistance, maybe 10-25 minutes... So by the time they even hooked up the Pit to the IV site and waited for it to take effect, the placenta would already be delivered. Only in rarer circumstances does it take a long time to deliver and in these rare cases they may use the assistance of Pitocin.

So please ask the doctor about this....

JCM083009 · August 2009

Jessalicious01:
Dr's (especially OB's) are extremely cautious these days due to the high amount of malpractice lawsuites.

ding ding ding!

Mrs.tlcS · August 2009

Jessalicious01:
They just do it routinely because those are the recommendations from the FACOG and Dr's (especially OB's) are extremely cautious these days due to the high amount of malpractice lawsuites.

IOW, introducing (often unnecessary) procedures into routine to protect their bottom line over their patient.

ToledoDeux · August 2009

Jessalicious01:
They just do it routinely because those are the recommendations from the FACOG and Dr's (especially OB's) are extremely cautious these days due to the high amount of malpractice lawsuites.

Exactly. I want medical decisions about my labor and delivery made based on science, not the law.

farrellashleigh · August 2009

And I can add that in the case of a "boggy uterus" (where it isn't contracting properly after delivery) the doctor will be massaging it vigorously to "wake" it up and get it contracting prior to using medical interventions. If this method doesn't work, THEN they go to Pit...

mtendere · August 2009

Mrs.tlcS:
Jessalicious01:
They just do it routinely because those are the recommendations from the FACOG and Dr's (especially OB's) are extremely cautious these days due to the high amount of malpractice lawsuites.
IOW, introducing (often unnecessary) procedures into routine to protect their bottom line over their patient.

OB's and anesthesiologists are the most sued doctors. It may be wrong, but please don't berate them - they have to factor these things into their decisions. Put the majority of blame on our legal system. If you did bleed out and have a negative outcome, he/she could be held liable, even if he offered pitocin and you refused it, or couldn't get it in quick enough when a problem presented.

If you do refuse it, don't be surprised if you have to sign a whole bunch of forms. DH is a physician and the hoops the hospitals and malpractice insurance providers make them jump through to avoid lawsuits can be astonishing, even if they don't think certain procedures, etc. are necessary.

I'm not denying the patient's right to refuse here, I'm just saying that we should not always bash the doctor... he may very well believe that this is important and have seen patients without this treatment have poor or tragic outcomes. Or he may be under an enormous amount of pressure to do it this way. He would not do it if he felt it was dangerous or would cause harm to you or your baby.

Think about all of that and write to your congressional representatives about health care reform and urge them to make some laws protecting doctors so that we can really bring down the cost of health care in our country.

Mrs.tlcS · August 2009

mtendere:

OB's and anesthesiologists are the most sued doctors. It may be wrong, but please don't berate them - they have to factor these things into their decisions. Put the majority of blame on our legal system. If you did bleed out and have a negative outcome, he/she could be held liable, even if he offered pitocin and you refused it, or couldn't get it in quick enough when a problem presented.
I'm not really berating them; however, as a health professional bound by evidence-based practice as ethical practice, it bothers me (as it should) that the evidence does not support STANDARD practices that obstetricians are using. I certainly understand that they get sued, but their obligation when they become physicians is to the patient - not to their wallet. The fact that ACOG delivers position statements that urge physicians to practice defensive medicine, sometimes In spite of their patients well being (routine unnecessary interventions) is disgusting.
Does the legal system carry some blame? Maybe. I understand that it's expensive to go to court (why many of the cases settle). I understand that medmal insurance is expensive. I'm not opposed to capping medmal payouts. But I'll place the blame squarely on the shoulders of the physician when the physician is causing iotrogenic problems, TYVM. I'll place the blame on the physician when practicing defensive medicine starts to get in the way of patient rights.
If you do refuse it, don't be surprised if you have to sign a whole bunch of forms. DH is a physician and the hoops the hospitals and malpractice insurance providers make them jump through to avoid lawsuits can be astonishing, even if they don't think certain procedures, etc. are necessary.
Hi. Been there, done that.
I'm not denying the patient's right to refuse here, I'm just saying that we should not always bash the doctor... he may very well believe that this is important and have seen patients without this treatment have poor or tragic outcomes. Or he may be under an enormous amount of pressure to do it this way. He would not do it if he felt it was dangerous or would cause harm to you or your baby.
Doing anything as a matter of routine in the face of a patient who has questioned the procedure is despicable. Are all physicians despicable? Hells to the no. I have plenty of physicians in my family. No doctor should ever get (or even just seem) "pissed off" - as the OP's seemed to be - when questioned about what she is told is a routine procedure. Tragic outcomes are part and parcel of being a physician. That's what happens when you become a physician. Enormous pressure to do a procedure as a matter of course, without taking the time to actually discuss it with a patient who has questioned it, is no reason to do it. Further, obstetrics is notorious for doing things that have been shown to not improve outcomes, and even have shown poor outcomes as a matter of routine.
Think about all of that and write to your congressional representatives about health care reform and urge them to make some laws protecting doctors so that we can really bring down the cost of health care in our country.
I prefer to write my congressional representatives regarding opening options for women and their birth choices, but thanks for your suggestion. I do worry that talk of reducing healthcare costs without talking about some kind of tort reform might be somewhat disingenuous (though not necessarily fruitless). However, the docs have plenty of lobbying groups on their side. The only one protecting me is me.

marciana · August 2009

Have your baby nurse IMMEDIATELY after delivery and that will help you uterus contract and deliver the placenta.

BakerMommy · August 2009

We talked about this in my birth class last night. Several people in the class work in hospitals where they pretty much automatically hook up pitocin after birth. The instructor had to alert the parents that someone was hooking up a bag to the mom's IV at the last birth she attended (as in they were starting pitocin even though the couple had it in the birth plan not to). It sounds like if you decide against it, you (or more likely DH) will need to be proactive and ask about whatever is going in to your IV (if you have one, which it sounds like most women do).

We also talked about BF as an alternative--pitocin could always be started if it doesn't work.

P.S. If your dr. is angered by your choices or you questioning procedures, I'd switch ASAP!

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