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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Oxytocin injection for placental delivery

96 replies

CoteDAzur · 10/03/2009 21:14

I found out today that our hospital is undergoing a six month trial where every woman is given an oxytocin injection before delivery of placenta.

I kind of remember that routine injection of oxytocin without even waiting to see if placenta will be delivered on its own is A Bad Thing, but can't remember why.

Can anyone help? I have a meeting with doctor tomorrow and would appreciate some pointers as to how I should argue my case - a scientific way of saying "I'm not your guinea pig and you are not pumping me with hormones for no good reason".

OP posts:

Are your children’s vaccines up to date?

Set a reminder

BoffinMum · 10/03/2009 22:54

Um, natural third stage takes a good half hour or thereabouts, does it not?

WTF was she pulling on the cord for???

BoffinMum · 10/03/2009 22:57

MP:

Pro natural third stage - Avoids risk of retained placenta and subsequent surgery and associated risks.

Anti natural third stage - Avoids risk of PPH.

Hospitals could deal with either situation OK, IMO.

morningpaper · 10/03/2009 22:58

statistically, what is the risk of retained placenta?

KingCanuteIAm · 10/03/2009 22:59

I had the injection with each of my children and, despite very fast labours, I took a very long time to deliver the placenta. Each time came dangerously close to going to theatre and had to miss the precious early moments with midwifes practically swinging off the cord . My second delivery I had retained products as a result and had to go for a D&C a week after birth - with a new baby I couldn't bf because I was so ill by then.

With the last labour I questioned my midwife who told me it was a "well known side effect of the injection coupled with fast labours and could drastically increase the danger of heavy bleeding and retained placenta. (Apparently not one midwife at any of my other births had heard this - or cared enough to apply the information to me ).

With my last labour I had no injection and the placenta was delivered very easily - just like the baby and only took about 20 minutes with minimal bleeding.

AFAIK the injection works well for the majority of women which is why it is used as standard in most hospitals - in fact most women are not even aware of it unless they read their notes and see the midwife has ticked the "patient agreed to injection after delivery" box . However, in the few kinds of labour which are outside the norm it can cause problems itself or make problems worse.

My honest advice for anyone would be to ask to try a natural 3rd stage with the understanding that you will discuss an injection should it become necessary. However I was told that it worked best given quickly after delivery (and women are less likely to argue at the point!).

As for your arguments for your doctor, I can't help much other than to give you my experience - I hope it is of some use to you?

SnowlightMcKenzie · 10/03/2009 23:01

'WTF was she pulling on the cord for??'

I don't know. She was the 'expert', I was just a complying patient (that time)!!

(2nd time was a natural 3rd stage whilst bfing in a pool, with the cord cut after placenta delivery.)

electra · 10/03/2009 23:03

How awful for you to have to put up with a system like that!

I had the injection during my first experience of childbirth. The hospital staff admitted they felt it may well be responsible for the hemorrhage I had afterwards. Apart from this, it made me very sick. I had had an epidural, couldn't get up to be sick -- it was hell.

DaisyMooSteiner · 10/03/2009 23:04

Syntometrine can also have nasty side effects MP, like headaches and vomiting - not much fun when you're trying to enjoy your new baby.

My personal view is that syntometrine is great to have on standby if you have risk factors like a long labour, previous PPH etc etc but it seems a bit of a shame to use it indiscriminately for every woman regardless of whether she bleeds heavily or not considering that it comes with its own set of risks.

electra · 10/03/2009 23:06

I also had massive clots afterwards. The second time I had physiological third stage, and very little bleeding afterwards...

SnowlightMcKenzie · 10/03/2009 23:06

Thing is DaisyMoo that the silly mw caused my pph, so the next time I had had a previous pph, so they were recommending the injection

KingCanuteIAm · 10/03/2009 23:09

Oh, Electra - I hadn't connected clots with the injection until you said that! I had huge clots with my first and third labours but none at all (well apart from the usual tiny ones) after my last! I wonder if it is the same thing - it would certainly make sense. Those clots were an awfully frightening experience after I had my first child - I was very young and had no idea what was normal or not!

electra · 10/03/2009 23:12

Me too! I was 21 at the time and I remember sitting in the bath and thinking WTF??

BoffinMum · 10/03/2009 23:13

0.1% without the injection in the west.
Can't find satisfactory data for with the injection - it's getting a bit late and I am tired. I might look tomorrow. It's likely to be higher though.

electra · 10/03/2009 23:14

I was not asked if I wanted the injection and was not in a position to speak at the time it was given. I would want to avoid that again!

KingCanuteIAm · 10/03/2009 23:18

I called the hospital (I was 19) I was so upset they told me to "bring it in". My thoughts were going from my womb had fallen out to I had delivered an undeveloped and unnoticed twin (I was young ).

Of course I took it in (in a taxi, with 2 babies [I was looking after my 6 mo niece that afternoon], in tears....) the mw took one glance and said "oh that's nothing" and went in her merry way. I could merrily have killed her at that stage

BoffinMum · 10/03/2009 23:24

That's so sensitive of them, King Canute.

KingCanuteIAm · 10/03/2009 23:29

Yes, I was really impressed with the MWs I met in my first hospital stay

I hope you get the information you need Cote. I do think it is wrong to administer drugs without information and choice.

Original poster

CoteDAzur · 11/03/2009 10:12

morningpaper - re "I don't understand the enthusiasm for an unmanaged third stage"

Mine isn't an enthusiasm for anything, just a strong desire to avoid the repetition of DD's birth where I wasn't told anything, nor asked for my approval on a variety of interventions, and ended up in agony for weeks.

Now that I have found that there is a policy of routine oxytocin injection for placental delivery at our hospital, for a six month trial period no less, I would like to know (1) whether this is necessary, (2) if it has potential side effects, and (3) why not leave nature take its course?

OP posts:

morningpaper · 11/03/2009 10:19

Hi Cote, I wasn't directing my confusion at you, I just wanted the position to be EXPLAINED (will read the thread in detail shortly)

I wonder if they are using oxytocin for six months INSTEAD of syntometrine? I.e. using the drug with less side effects - but perhaps it was always managed anyway?

DaisyMooSteiner · 11/03/2009 10:23

Yes, it might well be that MP. I know that our local maternity hospital recently switched to routine syntocinon (ie oxytocin) instead of routine syntometrine. They changed back sharpish when the PPH rate went through the roof .

spinspinsugar · 11/03/2009 10:39

This reply has been deleted

Message withdrawn at poster's request.

susie100 · 11/03/2009 10:42

I think site gives an interesting pro and cons list (it is for homebirth but can be apllied to any setting)

www.homebirth.org.uk/thirdstage.htm

I think as soon as there has been ANY intervention (waters broken, drugs) then a managed third stage is recommended. In a birth with no intervention, there is no reason to have a manged third stage but this means NOT TOUCHING the placenta, not having a good old pull (shudder!)

In hospital it is very unlikely you will have no intervention at all as that includes

Clement · 11/03/2009 10:46

i asked not to have injection. midwife thought i was bonkers. didn't have it anyway, she was keen on respecting my rights. third stage took one hour of constant trembling and shaking and pain and moving from bed to loo to bed while a student proffered my still-attached baby in front of me like an offering. i kind of wished id had it.

PinkTulips · 11/03/2009 10:54

it's routine over here to the point that the mw i had with ds1 had rarely done it without and the student mw who was in her final year had never seen a physiological third stage.

when i had ds2 a few weeks ago the doctor who was discharging me couldn't understand the concept at all... kept asking the mw 'but she has not had the medicine, but you always give the medicine, no?' and told me i could bleed to death without it (african doctor, he did turn out to be quite nice but his english was abrupt to say the least)

at the end of the day though it's your body and your choice,... they cannot force you to be injected with artificial hormones if you don't want to be so stick your guns and simply refuse.

Original poster

CoteDAzur · 11/03/2009 10:56

Is there really a high rate of PPH without the oxytocin injection?

How on earth did human race survive until its invention?

OP posts:

PinkTulips · 11/03/2009 11:06

also.... with dd i had the injection (unwanted but was jabbed while watching dd be resussitated and was too late to argue at that point!)

with her i had a pph requiring a drip and more drugs and i had a small chunk of retained placenta (passed naturally 3 days later so thankfully avoided surgery). i bled heavily (very heavily) for 5 weeks, trailed off by 6 weeks

with ds1 i was up and walking 10 mins after the placenta came out and bleeding had practically stopped by 2.5 weeks, although had light brown blood until 6 weeks

with ds2 i walked myself to the maternity ward right after the placenta delivered and again bleeding died down over a week ago, still need panty liners but it's not bleeding as such. ds2 is 4 weeks old.

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