Re: [ozmidwifery] Induction and third stage labour

[Susan Cudlipp]

The reason given for hasty cord clamping AFTER (not before) administering synto is not to prevent synto entering baby's circulation, but to prevent over tranfusion due to the excessive contraction thus produced 'pushing' too much blood into baby due to squeezing the placenta.  Synto infusions are given all the time for induction and I have never heard of any concerns about it entering baby's circulation.  The synto bolus injection is justified as a means to prevent PPH, the baby's needs are not apparently considered important! I realise that IPM's only give synto if needed, and when cord has ceased pulsations, but the policies of most hospitals for ACTIVE management of 3rd stage says: 1). give oxytocic with anterior shoulder, 2). clamp and separate cord as soon as baby delivered, 3). commence controlled cord traction as soon as uterus felt to be contracted.   I hasten to add that I do not agree with this, but have had reason to research it quite a bit lately and have found, like Karen, that the textbooks and  policies are not crystal clear and many are very much opposed to each other.  Case in point being Obstetric guidelines vs Midwifery guidelines both in circulation in the KEMH policy manuals.   Sue  "The only thing necessary for the triumph of evil is for good men to do nothing" Edmund Burke ----- Original Message ----- From: Tanya Fleming To: ozmidwifery@acegraphics.com.au Sent: Wednesday, October 05, 2005 11:03 AM Subject: Re: [ozmidwifery] Induction and third stage labour I am taken by surprised of this too....i teach the very same as you Karen.  I also believe that the cord should be cut immediately before giving synto, to prevent passage of syntocinon into baby's circulation....if cord is still pulsating, one would think this is possible as synto act quickly.  I am interested to hear everyone elses beleifs and practices too! Cheers, Tanya Fleming ----- Original Message ----- From: karen shlegeris To: ozmidwifery@acegraphics.com.au Sent: Monday, October 03, 2005 6:21 PM Subject: [ozmidwifery] Induction and third stage labour Dear List, I’m a birth educator and prenatal yoga teacher in Townsville.  I hope these questions are appropriate for this list and would appreciate information from you:   Induction.  Andrea’s Preparing for Birth:Mothers book and the wall poster on cascade of intervention states that induction increases the risks of further intervention and ultimately caesarean, and that’s what I’ve always taught in my Active Birth classes.  However, when challenged for statistics by a client in a recent workshop, I looked up Enkin, Kierse etc. who stated that induction does not increase the risk of caesareans, recommending that induction is recommended soon after a women passes her EDD.  Can anyone clear this up for me?   Third stage of labour.  I was under the belief that if active management of third stage was chosen, the cord had to be clamped and cut quickly to avoid an over-transfusion of blood from the placenta into the baby.  However, an OB recently told a client of mine that even if she had a Synto injection, the cord could be left until it stopped pulsing.  I’ve checked Myles textbook for midwives but it’s not clear on this.    I appreciate your support.   Best wishes, Karen Shlegeris in Townsville No virus found in this incoming message. Checked by AVG Anti-Virus. Version: 7.0.344 / Virus Database: 267.11.9/116 - Release Date: 30/09/2005