I am planning a home birth with a certified midwife. She is great and we are planning no interventions as far as possible. At our last visit she presented us with an option to have a shot of oxytocin (which is what Pitocin is called here in Canada) after the birth of the baby but before the placenta. I guess the idea is that it helps the uterus clamp down and prevents hemorrhage. I had never heard of this, only of using oxytocin to induce labour, which I know I want to avoid. Does anyone have any thoughts? Normally, I'd say no thanks, but I have flirted with low platelet levels toward the end of this pregnancy and in truth I am afraid of postpartum bleeding. The levels haven't been low enough to necessitate a hospital birth (in my province I can birth at home or in a hospital with my midwife, so the hospital option isn't as dramatically different from a home birth as is my impression about the US situation) but they have made me nervous. So now all of a sudden I'm presented with something that feels like it makes the whole thing less risky. Does anyone know if an "after the fact" shot of oxytocin will interfere with any good hormonal stuff going on?

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Putting your baby to breast immediately after birth will stimulate a natural release of oxytocin in to your bloodstream and will cause your uterus to contract. I believe that it is possible to wait and see if that is sufficient BEFORE getting the shot, which can be reserved as a backup.

However, because of your low platelet levels, I would seek council from your midwife to see what she thinks is best.

Often in hospital births if the mother's uterus is not contracting as much as they want after the delivery, they will give her an IV pit drip, and will usually let her finish the bag if she's been on pit throughout the labor, although this is usually not necessary.

I was(unnecessarily) on pit after both my previous deliveries and neither of my daughters had any problems. They went to breast immediately, milk came in right on schedule, everything went smoothly. But I know now I didn't need it, and I'd avoid putting anything synthetic and un-needed in to my body if I could. On the other hand, if you need it, it can help a great deal and all the midwives here (US) I know carry it specifically for that reason. Trust your midwife and her judgment. Good luck!
I think this would be a great plan. First allow your own body to produce oxytocin from being with baby, then if that doesn't work have pitocin as a back up. Studies have shown that using pitocin after birth does decrease the amount of hemorrhage, but I have a feeling that getting baby skin to skin would work also.
I received two shots of pit after my baby #2 was born. There was a bit of a scramble when he came out, he had no breath, and was soooooo pale. I kept my cool, I somehow knew he would be okay, but my midwife (being the responsible one) called the EMT's and my little guy ended up going to the ER with his dad just to make sure he was good. I stayed home and waited. And like KM said, there's nothing like putting your baby to breast to make that placenta come down, there's also something to be said for quiet and concentration to help too. I had none of those things. It took me a while to birth that sucker, and with lots of people around and that weird floppy feeling in my belly I couldn't wrap my head around how to push one more time. I did eventually of course.
I would say don't worry about it too much. If you need it, you need it and you won't feel badly about it. I needed it. If you don't need it, you'll know that too. Keep talking to your midwife, especially if you have fears about bleeding. It's important to talk those things out. God bless.
I feel the synthetic oxytocin is unnecessary, and I have read that it doesn't stimulate the feel-good hormone response that your body's natural oxytocin does. My 5th baby was born at home this year and it was my first experience delivering the placenta without any pitocin (even at my unmedicated births in the hospital I was given pitocin for the placenta). I didn't feel any contractions after the baby was out, but my midwife had me sit on the birthing stool as I held my baby skin-to-skin, and I gave a few pushes as I sat there and eventually with one of the pushes the whole thing came out. It only took a few minutes to come out, and the midwives were a bit surprised at how fast it went. I didn't need to breastfeed to stimulate the uterus, but would have tried that if it had taken longer.
This isn't really about what you were asking but I had a suggestion for the low platelets. I had this with my previous baby. My MW put me on a special diet that included proteins (meats), veggies, and fruit. I could not have any carbs. She was taking my blood once a week and nothing was happening with just the iron supplement she put me on (Floradix). When I was at my chiropractor later in that week, she muscles tested and found my B12 to very low. I started on supplements of B12 (standard process) a couple of weeks after this diet started. Within just a few days my platelets were up and she cleared me for a HB (she didn't want me birthing at because of the risk of hemorrhage.) I had a beautiful birth a week and a half later. And like everyone else said, I put baby to the breast immediately. My MW does keep it on hand if it's needed. I take comfort in that. But I prefer my body to make it naturally. God Bless.
In traditional societies a delayed third phase is sometimes managed by having the mother swallow some of her own hair; this induces vomiting, which naturally pushes the placenta down.

I don't know, but if nursing right away doesn't work, I think the shot might be preferable. Especially if you have short hair! But now you know you've got another option :)

Seriously, I hope you can just nurse right away and don't end up needing the shot. If the midwife has it in her bag and never uses it, great. And if you end up getting the shot I bet you anything you'll feel it was worth it. Enjoy your birth!
I had my son in the hosp w/a MW. She gave me that same shot seconds after he was delivered. By the time I realized what was happening it was already done. The effect? It made me have very strong contractions, just like it does if given prior to birth. It also made me shake violently, which is also a very common side effect of the drug. I actually shook so bad my hubby had to take the baby from my arms b/c he was afraid I would give him "shaken baby syndrome" (his exact words). I was able to briefly nurse him but it was interrrupted by my violent shaking! My current MW does not routinely give the shot. She said she will administer it only if it becomes necessary--otherwise she considers it an unecessary intervention, which she does not believe in.

As the other ladies have said, when the baby latches on and begins nursing your body naturally makes oxytocin that makes your uterus contract helping to remove the placenta (this connection is so strong that you will have mild contractions for 1-2 days after delivery every time you nurse, it helps uterus get back to prePG shape/size), . I am not sure if getting an artifical dose affects natural hormone production, but for me the effects of the shot inhibited the natural course of action (latching on and nursing) that would have allowed my body to make the natural hormone. Why get an artificial, imitation version of what your body can naturally create?

Low platelets at the end of PG is fairly common. Increase your intake of Vit D, K, Zinc, Magnesium, and protein (this is what my MW told me to do to prepare for my HB). That will help reduce your risk of blood loss. Give your body/uterus a chance to do what it is supposed to, stop bleeding on its own. If it doesn't then get a shot of oxytocin, its just as effective to correct the problem as it is to prevent it.
Because I'm not medical personnel and I don't know how low platelets can affect postpartum bleeding, I won't give you advice on that. But your questions about if a postpartum shot of pitocin can affect hormones, the answer is yes. There was a big study that came out recently that showed that postpartum pitocin does affect breastfeeding. Many midwives and even a lot of hospital docs where I live (US) will not give routine postpartum pitocin, but will only administer it if bleeding is excessive. You can find a lot of information about the pros and cons of routine pitocin after the birth by googling active management vs expectant management of the third stage.

Good luck with whatever you decide. :)
Have a read of this article, it explains into great detail about the natural approach of delivering the placenta -http://bellybelly.com.au/articles/birth/natural-approach-to-labour
Thanks for the thoughts and great advice, everyone! I'm late checking back in because Sam was born at home on Thursday in an extremely fast--and wickedly painful--labour! Everything went well--it was all rather amazing. I did have the shot on the advice of my midwife, in whom I had such confidence (she calmly delivered Sam arm first!) that I didn't hesitate for a second. It doesn't seem to have had any negative effect. We are all doing well! Thanks again--it was great to have this forum to ask this question and hear about others' experiences.



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