Pitocin AFTER birth

MsCrispy · October 2013

I'm looking on thoughts on the routine use of pitocin after birth, so during the third stage of labor, the delivery of the placenta.

I brought my birth plan to my last appointment and I really haven't done any research or looked at it since I had DD. I plan/hope for a natural labor and one of the things I have on the plan is to skip the pitocin after birth. It was the only part that my OB gave me push back on.

I had the same doctor last time and I think he said something then too, but I don't remember. The whole plan went out the window anyway since I ended up inducing with pitocin after my water broke.

So I'm trying to read up on it and I'd love any research that you ladies have done. I hated being on pit before, it sucks, but I also don't want to hemorrhage...that is obviously really bad. From what I've read, pitocin after labor reduces the risk of hemorrhaging by 60%, which is huge. However, I can't find where that number actually comes from, I would love a link to a reputable study. If the 60% number is really true, then I'll suck it up and accept the pitocin.

JaysonandKristin · October 2013

From everything I've read about Pit after birth, it plays a factor when immediate nipple stim (via BF'ing) and uterine massage isn't available.

So, if for some reason, you aren't able to have LO latch immediately and have your uterus massaged to begin contracting back down in size, Pit can be irreplaceable.

Also, I've read that it can be delivered as a quick shot to the leg in a pinch.

This is all from preparing for a NB, and reading from Birth Without Fear's blog.

mmm50 · October 2013

Our birth center practically requires pit after delivery, but they wait until the placenta is delivered and the cord has been cut. Also it's an intra-muscular shot in your leg/butt, as opposed to the IV pit that causes all the pain/contractions in labor. My MW said there are little to no side effects to the after birth IM shot (other than those of a regular shot-- like injection site pain) other than sometimes it causes your after-birth pain/cramps to be a little stronger.

My MW sold it to me this way-- once the placenta is delivered and cord is cut there is practically no risk to the baby. And if god forbid you have a bleeding problem, it's better to be proactive and take the shot before there is a problem then trying to treat the problem after abnormal bleeding is discovered.

For what it's worth we are refusing newborn eye ointment and are considering waiving the newborn Vitamin K shot. My MW says almost 100% of her patients refuse the eye ointment (unless they are GBS positive or have an STD or some other bacterial infection), about 80% refuse the Vitamin K shot for newborns, and only one patient in the last year has refused the after-delivery pitocin.

MsCrispy · October 2013

JaysonandKristin said:

From everything I've read about Pit after birth, it plays a factor when immediate nipple stim (via BF'ing) and uterine massage isn't available.

So, if for some reason, you aren't able to have LO latch immediately and have your uterus massaged to begin contracting back down in size, Pit can be irreplaceable.

Also, I've read that it can be delivered as a quick shot to the leg in a pinch.

This is all from preparing for a NB, and reading from Birth Without Fear's blog.

That would imply that they only give you the pit if you don't BF, but I'm pretty sure it is just standard practice to give it to everyone at my hospital.

I'm planning on BFing, so I'm wondering how needed the pit is if everything goes according to plan.

JaysonandKristin · October 2013

MsCrispy said:

JaysonandKristin said:

From everything I've read about Pit after birth, it plays a factor when immediate nipple stim (via BF'ing) and uterine massage isn't available.

So, if for some reason, you aren't able to have LO latch immediately and have your uterus massaged to begin contracting back down in size, Pit can be irreplaceable.

Also, I've read that it can be delivered as a quick shot to the leg in a pinch.

This is all from preparing for a NB, and reading from Birth Without Fear's blog.

That would imply that they only give you the pit if you don't BF, but I'm pretty sure it is just standard practice to give it to everyone at my hospital.
I'm planning on BFing, so I'm wondering how needed the pit is if everything goes according to plan.

There's no implication either way. You can get nipple stim from hands, fingers, breast pump (regardless as to whether or not you intend to give it to LO) OR from BF'ing.

It's standard practice just the same as Vit K, antibiotics when GBS positive, etc. There's a risk, and practitioners are trying to mitigate them with SOPs. Whether or not a woman will actually need any of these practices isn't a sure thing.

As for the bolded... a woman's famous last words, right?

cagoldi · October 2013

I am not going to refuse the pitocin after birth. My Mom hemorrhaged after she had me and that has my OB concerned so it really wasn't even a discussion.

We're erring on the side of caution on this one.

Kfran84 · October 2013

Eh... My doula is not a fan of this practice, but it is routine for my doctor. I am following my doc's lead on this and won't refuse it.

DebateThis · October 2013

Honestly, planning to decline Vit K and postpartum pitocin both seem pretty shortsighted to me. You have no idea how your delivery is going to go and those two things can be very, very dependent on how it all plays out. Have a conversation with your OB about avoiding it if you can but given the fact that postpartum pit reduces hemorrhage rates drastically, I don't get what the big deal is.

Same with vitamin k administration - it's all well and good to think you're going to decline it until you wind up with a 32 hr labor or a malpositioned baby who very well could wind up with intracranial bleeding without the Vit K. Hemorrhagic Disease of the Newborn isn't anything to take a gamble with, so why decide now that you'll refuse something that very well could save LO's life or your own?

Marinowski · October 2013

I had a preemie so no immediate skin to skin or breast feeding and had some bleeding so i got lots of pit post deliver... It cut down on cramping and postpartum bleeding though so i cant complain

SharonB222 · October 2013

I found out this week that Pitocin is routine at my hospital after birth. I didn't know that. I was given it with DD but I thought was b/c I was hemorrhaging - the placenta was retained and had to be manually extracted. I will be asking my MW about this during my next appt.

lobosabby · October 2013

I'll be honest, I have no links to actual research, but I know my mom said she had it with me and my sister.

Even with the help of the pitocin, her body didn't expel everything with my sister and she had to have a D&C a few weeks PP as she was still bleeding pretty heavily. My understanding is that her situation was rare - especially for women who do get the pictocin PP.

It's not 100% effective, but it does help.

mmm50 · October 2013

I would also add that if you are worried about pitocin's potential harm to the baby you can wait to get it after you deliver the placenta and cut the cord. That's what my birth center does-- unless for some reason you need it immediately or the placenta is taking a long time (I think she said more than an hour??) to come out.

Trollpup · October 2013

It was protocol with my last baby since I chose not to have IV as went the med free path. They gave it to me in my upper arm. It really wasent needed though.

So this time around I am doing a home birth and the midwife will have it available IF bleeding is heavy and cant be controlled well. The more babies the more risk of heavy bleeding.

Hope that helps.

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