Writing a birth plan, decisions, decisions!!

[NoTeaForMe]

Hi all,

Wondered if you can help me make a start on my birth plan - I'm 31 + 4.

I know that normally midwives give you an injection to speed up getting the placenta out, and a vitamin k injection for the baby. I also know that some people decide against these 2 injections. Why is this? I thought the vitamin k injection was vital for baby, and the injection to get the placenta out was so that it comes out quickly and to make sure that all of it comes out. I'm not disagreeing with peoples choices I truly don't know the ins and outs of the choices!

What else do I need to state on the birth plan?

Sorry I have no idea what I'm doing and friends who have had babies just say that plans are a waste of time as "things change"

Help!

Vitmain K is vital for the baby but you can have it orally instead of via injection. I'm not sure what the argument is for orally - the disadvantages are that they have to give two doses (I think) and also that they give higher doses because the uptake is more uncertain. For me personally I couldn't see any downsides to the vitamin K injection so I consented both times.

The injection for delivering the placenta is more of a complicated question as there are pros and cons on both sides. I'm not an expert but as far as I understand it...

Pros of having it - it gets the whole thing over quicker, it reduces the likelihood of excessive bleeding and helps the womb contract faster.

Cons of having it - I believe (not sure about this so happy to be corrected) that it can increase the likelihood of retained placenta if the womb clamps down too fast while the placenta is still in there.

Pros of not having it - you get an extra hour in the delivery room with your baby and partner while you deliver the placenta. Otherwise you may find yourself rushed off the labour ward and into postnatal which is a much less nice place to be! (usually)

I had it with my first baby and not with my second baby and tbh I was quite peeved at having to push the placenta out myself when I was so knackered! However I had a weird shivery thing and almost passed out in the shower after my first, and didn't have that with my second, so I am not sure whether I might have had some adverse reaction to the drug. I certainly felt very odd as soon as they'd given it.

Re vitamin K injection: this is quite a good run down of the why, where and how of it all:

www.womens-health.co.uk/vitk.asp

We've decided to go for the injection because we are convinced of the necessity to administer vit K to newborns, believe that injection is the much efficient method of administration, and do not believe that the injection causes increased childhood cancers (see the website above for discussion of the research on this).

You can have the best of both worlds in a way... I had on my birth plan that I would aim for a natural third stage, but I wanted the injection available in case it was taking too long or I was struggling.

As it turns out I didn't need the injection. :) My placenta came out in its entirety, with one little push, shortly after the cord had stopped pulsing, been clamped and cut.

As for the vitamin K, I couldn't really find a good reason for DD not to have it, aside from not wanting to subject her to an injection. But to be honest, given that her entire world had been uprooted by being born, a small injection was the least of her worries.

I just had to post to correct the dangerous, and frankly ignorant, comments by starlightmackenzie

As you can see from this information from Great Ormond Street, vitamin K is given to prevent bleeding in the 1 in 10,000 babies who will be born with Vitamin K deficiency.

Studies suggest that VKDB occurs in approximately 1:10,000 babies, and that in half of them the bleeding occurs late, that is, after the first week of life. In babies with this late VKDB, about half suffer intracranial bleeding, which leads to death in about 1/5th of these babies, and/or brain damage in many of those surviving.

The risk of harm is increased in babies who have had instrumental deliveries, but is still present in those who have had normal deliveries.

There are NO known side effects of Vitamin K.

As for syntometrin, the injection reduces the risk of PPH but slightly increases the risk of retained placenta.

I was happy for the midwives to decide at the time depending on how things were going and discussed that with them earlier. As it was, things went well so they didn't give me the Syntometrin initially. However, my uterus didn't contract down after I delivered the placenta and I started bleeding, so they gave it to me then.

Sorry to be stupid, but what is PPH?

It doesn't seem to mention the feeding method for these babies and as starlight said, colostrum is rich in Vit K.

the Vit K in formula and I am guestimating the injection and drops, may not be as bioavailable as the Vit K in colostrum so these are all factors a mother may want to consider.

here is what AIMS says about VitK.

if you google 'risks benefits syntometrin', a link comes up to the Third Stage of labour from the Home Birth website. It is also informative reading about your other question.

Assisted deliveries can be a sign that labour has not been optimally managed with regard to keeping things "normal", usually because we have pushed synto to keep to time limits and/or Mum has REQUESTED an epidural, as is her right.

At other times they can be absolutely life saving interventions. You only have to attned a few births in a developing country, where labour isn't medically interfered with at all, to see how life saving they can be.

Intercranial bleeding and/or VKDB can happen to any baby, Starlight. Please don't state things as facts when they aren't.