
Evidence Based Birth® EBB 131 - Evidence on: Pitocin During the Third Stage of Labor
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Jun 24, 2020 This podcast dives into the use of Pitocin during the third stage of labor, examining its role in managing postpartum hemorrhage. It presents various management approaches, including active and expectant care, while reviewing the latest research. The importance of informed consent is emphasized, highlighting how to communicate effectively with healthcare providers. Listeners will gain insights into the historical context of these practices and how collaborative efforts can enhance support for birthing individuals.
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Pitocin Alone Helps Reduce Bleeding
- Trials specifically comparing routine Pitocin versus no uterotonic found Pitocin reduced >500 mL and >1000 mL bleeding.
- Pitocin also reduced need for additional uterotonics but didn't change transfusion or retained placenta rates.
Observational Data Favor Skilled Expectant Care
- Observational studies in settings favoring physiologic care show no increase in PPH with expectant management and sometimes less severe PPH.
- These findings question RCT generalizability from settings accustomed to active management.
Support Natural Oxytocin Release
- Support physiologic third-stage with environment and behaviors that boost natural oxytocin.
- Encourage skin-to-skin, breastfeeding, warmth, privacy, and delay cord clamping to aid placental separation.
