A bit upset at the language used in his leaflet - AIBU?

[StarlightMcKenzie]

www.bcf.nhs.uk/dl/9420_2400159727.pdf/as/Misoprostol.pdf?_ts=31375&_ts=31375

I had a pph with my first birth and due to an admin error was accepted to give birth at the EBC and did so, so I'm not fingers in ears la la about the reality of pph.

I just can't understand why it is necessary to talk about pph in terms of the choice a woman makes wrt third stage as it can happen either way, and the 'reasons' for pph are sadly not always anything to do with a woman's body but the way a birth is handled/managed.

Nappy, I think there are more risks to a natural 3rd stage if your body has had drugs. The benefits of it are also greatly reduced as there has already been interference with the hormones etc.

If I had had medical intervention I'd probably continue with it into 3rd stage tbh.

There is some research that suggests that there is more bleeding at the time if the birth with a natural 3rd stage as the blood vessels don't clamp shut, but it can be argued (and is) that the additional bloodloss with a natural 3rd stage is necessary and if not coming away then will come away over the next six weeks in heavier lochia.

Natural third stages are more likely to be the cause of pph when the mws are not experienced in them and aren't sure which interventions are fine, or if they feel anxious about the time taken and try and assist with a tug.

My worry would not be the wording, but that it might pave the way for acceptability of use of cytotec (which this is) for other obstetric uses, eg induction.

They mention it's cheap, one of the reasons it has been popular in the States for induction vs. Syntocinon, with sometimes worrying results.

I don't know much about the actual drug but I would have liked there to be a balanced part about what the alternatives are. The only thing mentioned really is maternal death.

I'm guessing the drug isn't used in homebirths though.

How is it used instead of synto though?

I mean for induction?

Sorry, I should have said instead of cervidil. If you google it you'll see a lot of information about it being dangerous for use in inductions partly due to the risk of increased uterine rupture risk. Not what you're talking about here so I don't know about it's use for the third stage.

Personally I also see the word "failure" in this context as meaning something didn't happen as opposed to meaning the mother/mother to be has failed in some way. I'm very much against negative phrases or insinuations but the way I read the leaflet didn't indicate anything like that to me.

Re off label drugs. I believe it is still the case that giving vit K orally to babies is not a licensed use. It is only approved for injection.