Can I request a specific drug for 3rd stage of labour?

[RoomForALittleOne]

Or more importantly, if I request a specific will they honour my request/think I'm a total diva/refuse because of their protocols?

I had syntometrine after DD1 and hated it. I was sick and light headed. I had a PPH before the placenta even came out. It took an hour for the placenta to be delivered (it only took me 20 mins to push out DD1!) and I never felt another contraction after she was born so it didn't feel especially helpful. After DD2 and DS, I had an injection of syntocinon because the hospital had changed it's policy. I didn't feel ill, could feel the contraction for the placenta and it was out after about 10 mins with a normal blood loss.

We have moved area and I'm expecting DC4. I'd like syntocinon again but I think that syntometrine is generally used. I labour quickly and have visions of a midwife jabbing me before I can make it clear what I want and then having a fight on my hands.

[headlesshorseman]

you have every right to decline any medication
some hospitals have policies which dictate what drugs are to be given, so i suggest you ring the hospital you plan on birthing at and ask.
syntocin should be availble so make sure you make you wishes clear on arrival and then to all health care professionals (midwives and doctors) that care for you.
have you ever considered a physiological 3rd stage? It is possible to deliver the placenta without drug interventions, i did second time and it didnt seem to have any impact on my lochia post birth

[ZuleikaD]

I delivered both placentas without drugs, and my MLU has a policy of giving you half an hour or so after the cord has stopped pulsing and been cut to deliver the placenta before they even consider giving you a jab. I'd give a physiological 3rd stage a try, especially if all its blood is in your baby. I didn't even feel it last time.

[RoomForALittleOne]

It's not supposed to be advisable to have a physiological 3rd stage if you have a history of PPH. I'm also not convinced that I want to risk jaundice in the baby that is much more likely to happen with a physiological 3rd stage. I want a managed 3rd stage but with the drug of my choosing.

[headlesshorseman]

sorry i missed that you had a pph with your first.
as you are at risk of pph again, a managed third stage is the best option, so talk to the midwives about choosing the drug you want.
just consider that as you are at risk of pph they won't want to dither around looking for the drug of your choice, so you need to make sure they have it ready and waiting for when you deliver, otherwise they will do what is in your best interest and give the syntocin immediately.

[mayhew]

Syntometrine is a combination of ergometrine and syntocinon. Its the ergometrine that causes the symptoms you describe. The reason its used is that it keeps the uterus well-contracted for several hours after delivery, preventing relaxation and bleeding. However, it is possible to do a managed 3rd stage with just syntocinon, and is the normal practice in some places. Ergometrine raises the blood pressure, so we don't use it on women with high BP. so all uk mws have experience of syntocinon only.

So just say you previously had a bad reaction and would prefer to avoid ergometrine.