A bright lovely good morning to you all, In all of my groups, after fully explaining informed choice, I explain that there are three options for the women when choosing the way she would like to birth her placenta:
1. medically managed with an injection given into the thigh which will induce an artificially strong contraction to hasten the expulsion of the placenta and reduce excessive blood loss and this would be very appropriate for someone who is high risk for example; a smoker, a woman who drank alcohol very regularly throughout the later part of pregnancy, an anemic woman, those who have already had medical intervention such as an epidural, induction, etc. 2. to decline the injection 3. to take the wait and see approach... explaining to the midwife at the time (and write in the birth plan so partner understands... "I would prefer to avoid the injection as a routine injection, preferring instead to hold my baby at my breast, to naturally stimulate oxytocin to expel my placenta, but am prepared to receive the injection if it is medically necessary for a big bleed" I also explain the normal blood loss is 300 to 500 mls of blood and an excessive blood loss would be 600mls+ which would require an injection. There are three injections which are available for a pph or big bleed and they are Syntocinon, syntometrine and ergometrine, each one increasing in intensity and side effects such as nausea. I then simply explain that most women describe a normal physiological third stage as mild period pain, however usually this pain will increase with each subsequent baby and/or with medical intervention. As for after pains over the next 24-48 hours I am always careful to point out that this is "normal" and women are less likely to be overly concerned about it when they are very familiar with the very positive fact that it is the uterus returning back down to it's normal size... and that this is a very good thing and it is what a woman wants. It seems to me that with good strong positive reinforcement women recognise the benefits of normality - and keeping birth as normal as possible. I feel completely comfortable in emphasizing "normality as the best, safest, and worth striving towards" compared to routine or encouraged by friends (epidural), medical intervention. Warm hug to all, Julie Julie Clarke Independent Childbirth and Parenting Educator HypnoBirthing (R) Practitioner ACE Grad Dip Supervisor NACE Advanced Educator and Trainer NACE National Journal Editor Transition into Parenthood Sessions 9 Withybrook Place Sylvania NSW 2224 Telephone 9544 6441 Mobile: 0401 2655 30 email: [EMAIL PROTECTED] visit Julie's website: www.transitionintoparenthood.com.au -----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Mike & Lindsay Kennedy Sent: Monday, 3 April 2006 6:15 PM To: ozmidwifery@acegraphics.com.au Subject: Re: [ozmidwifery] managed versus physiological 3rd stage, was: after birth pains Just a couple of thoughts. 1 Despite a 30min limit they cannot give you treatment without your consent. So as long as you arn't bleeding out you can take longer to deliver your placenta. Logic dictates you arn't going to refuse treatment if this becomes essential and you can always change to active managment if this really become necessary. 2 Early breastfeeding is good for you and for your baby and will probably help deliver your placenta sooner. On 4/3/06, Mary Murphy <[EMAIL PROTECTED]> wrote: > > > > Physiological 3rd stage is usual in homebirths and I observe that pain is > often when the placenta is separated and sitting in the cervix. The uterus > is signaling, "get it out". It is a sign for the woman to make efforts to > expel it. This may be squat over a bucket, sit on the toilet or simply bear > down. The pain goes when the placenta is expelled. Afterbirth pains then > take over and this has already been discussed. Cheers, MM > > > > ________________________________ > -- My photos online @ http://community.webshots.com/user/mike1962nz My Group online @ http://groups.yahoo.com/group/PSP_for_Photographers New Photo site@ Mike - http://mikelinz.dotphoto.com Lindsay - Http://likeminz.dotphoto.com "Life is a sexually transmitted condition with 100% mortality and birth is as safe as it gets." Unknown -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
