# why do I have to have medical intervention to deliver the placenta?



## monkeypooh

I am having my first baby and everything is a learning experience for me. I was disturbed to read that new moms are REQUIRED to have pitocin after the delivery to help deliver the placenta. Is this true? why is this necassary? and can I refuse it and deliver the placenta naturally?


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## Tacey

It's not like that in the UK. Surely they can't force you to have intervention if you don't want it? It can't be necessary for everyone. I and lots of people I know had no injection after the birth (neither did all those millions of women in the past!) and had no issues.


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## monkeypooh

So if they try to give me an injection to deliver the placenta I can just say no thanks and they won't make me have it?


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## Rmar

Of course you can refuse, it is your own body. It might be something you would want to discuss beforehand as you might not even realise they are prepping to do it until it has already happened as you will be preoccupied with your newborn.


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## booflebump

You will need to make your wishes clear beforehand. In the UK, if you consent to having the injection for the placenta, you are given it as the anterior shoulder is born - so you won't have time to say no then if you haven't already. Discuss it with your OB - you don't have to have anything you don't want to x


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## madasa

No, they can't MAKE you have it. Discuss policy with your OB or midwives. If there are consent forms they want you to sign, request them now, so you can read them thru, amend, initial, think about, discuss, research, whatever.... Now is far bette rthan in labour. :)


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## silver_penny

I would love to tell you that they can't make you do anything. However, my DS1 was born in hospital, and they literally forced the pitocin on me. I was sitting there holding my newborn son and a make nurse comes around with the pitocin. I asked him what it was, and when he told me, I said "No. I don't want it." "It's hospital policy" "I don't need it, don't give it to me" "But I have to..." He then put it in my IV drip.

I have since learned that hospitals are not subject to phrases such as: "No" and "Don't" 

If you want someone to listen to you in the hospital, you have to memorize the phrase "I Do not give my consent to _______ ." This phrase is legally binding and if they do whatever you told them not to, they are legally liable.


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## veganmama

okay, WHOA WHOA WHOA. i see you're from ottawa, and i am too and my midwife said NOTHING about this. 


are you sure you're correct?


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## PepsiChic

They do this int he US too, after my OBGYN was 100% knowledgeable about my needles phobia and i had a hospital natural birth, no IV etc she then pulled out a needle and said "i have to give you this it'll help get the placenta out and stop bleeding"

I screaming bloody murder and lept out of the bed (and instantly fell down as i had just given birth to baby and was a little weak on my legs!)

they all freaked out that i got out of bed and put me back in bed and decided i didnt need the shot after all..


needless to say i deilvered both baby and placenta completely natural without an issues. just say NO and be firm.


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## NaturalMomma

I would ask your Doctor or nurse on a print out of the hospital policy where it says this. If there is no written policy of this practice then it is likely a scare tactic to get you to do what they want. Where I live you have the right to refuse anything, even a c-section, and pictocin for the placenta is not standard practice in many of the hospitals here.


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## xSin

silver_penny said:


> If you want someone to listen to you in the hospital, you have to memorize the phrase "I Do not give my consent to _______ ." This phrase is legally binding and if they do whatever you told them not to, they are legally liable.

This is really really important to remember, especially as the way the medical system here in Canada is set up it is nearly impossible to pursue with any level of success, the idea of a medical malpractice suit. 

Any medical intervention / procedure that is given WITHOUT consent however falls under the legal definition of assault and that can carry huge consequences.


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## Kess

You certainly don't NEED the pitocin as standard, but I would straighten it out beforehand definitely as they won't ask at the time. You will need to be really firm, the phrase upthread sounds useful, and maybe something in writing to remind them - a note stuck on something? It shouldn't be necessary but I've heard so many stories of medical professionals especially in America doing things against consent, and even my Mom in this country was not asked if she wanted the injection they just gave it. Canada seems to have features of both the US and UK systems, so I'd be careful.


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## monkeypooh

veganmama said:


> okay, WHOA WHOA WHOA. i see you're from ottawa, and i am too and my midwife said NOTHING about this.
> 
> 
> are you sure you're correct?

Am I correct about the injection to deliver the placenta? From what I understand it is common to get one. I am not 100% positive and that is why I am asking. I will have a doctor not a midwife ( couldn't get one, ended up on a waiting list)


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## ZoeZo

I'm sure you have a bill of rights in the US, hang on...

https://en.wikipedia.org/wiki/Pregnant_patients'_rights_in_the_United_States

Does this mean you can refuse no matter what the hospital policy? I cannot believe they forced it onto you!


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## ChrissiK

I had two birth in the US and refused the injection. Nursing will stimulate in the same way as the drug! 
The injection is just so that the doc can leave faster, it's within normal range to take an hour for the placenta to be delivered, but the time is rarely given...:-(


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## rwhite

Whaaa? I've never heard of that here, that's screwed up. I HAD to have hormones to deliver my placenta, but only because it wouldn't come out after 1.5hrs - I was going to have a physiological (natural) 3rd stage. And it's your right to.

Wonder what they think women did back in the days when there was no pitocin, how did they deliver their placentas then? :wacko: :dohh:

It's worth enquiring about, and putting in to your birth plan if you're allowed it. I'd also mention it again just after you've had your LO in case they try and pull a fast one.


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## Blah11

Seems a bit of an odd thing for them to make compulsory as like a PP said, loads of people deliver the placenta without it. Mine took a good hour to come out but it did so don't let them clock watch with you!


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## Jingles23

Hi, just wanted to jump in here for a sec. I'm also in Ontario, my dd is almost one and, while we aren't pregnant yet, I'm starting to plan how I want my next birth to go. I did have the pitocin shot to help my placenta out but I have no idea why. It was probably out within ten minutes. I was so shocked because I never thought this would be standard practice. I was totally expecting to deliver it naturally and everything I had read said it could take a while. Definitely going to be talking to my OB about this for next time. Actually, I'm hoping for a midwife. One thing I've really learned is that you can say no and that talking to your care practitioner ahead of time will really help.

Sorry for the long post. Just something that's really been bothering me lately. I don't see much need for messing with things that work out just fine on their own.


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## Heather M

I'm with a MW in Alberta and it should be a choice that you have whether you want it or you don't. Here in alberta it is standard of care to give the shot. I had this with my first as my dh wanted everything standard as we were at home and I was ok to go with him on that for our own peace of mind (I actually didn't mind it at all). This time however we are opting to not have it. My MWs WILL have the shot ready however...and it is one of the only things they make sure to have ready to go...as they will give it if there is hemorraging, etc. They would also give it if I havn't delivered the placenta after a certain amount of time. If you want more information I could forward you our informed consent document about this specifically (from a Canadian perspective)...just PM me...Always good to do your reading...you DO have a choice.
:) Good Luck!


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## amjon

I was never asked. The nurse just put in the in the IV. I don't think I really needed it. My new OB wants to give it for my next pregnancy, but I think I will refuse it unless I have major bleeding. (He wants to give it to control bleeding more than placenta delivery.)


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## libbylou

I'm in BC and just talking about this with my midwife
It is standard practice BUT I can decline to have it (which I have)
They will have the shot ready anyway and it the placenta is taking too long to come out or if there is a concerning amount of bleeding then they will give it to me (which I have consented to)


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## jasminejo24

if i were you id tell your midwife/doctor you dont want it and laminate a sign that says "i do not concent to pitocin to deliver my placenta" and stick it on the wall behind your bed that way its plain for all to see and it should scare them into not doing it. check your hospital policy


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## Lizzie K

Just like everyone else said, you don't have to consent. Make sure they know you don't consent to pitocin for delivery of the placenta and if your OH is going to be there, make sure he knows too and will advocate for you. Also anyone else who might be in the delivery room with you. I have already told my husband that his whole purpose of being in the delivery room with me is to keep me calm and to keep the Drs from doing something I don't consent to.


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## JenluvsDot

I work at a midwifery center, and our midwives NEVER make a patient take meds to deliver the placenta. EVER! That is a load of bs. It is your body, and you can refuse. I will say that after the placenta is out, you should think about having in encapsulated. It drastically decreases postpartum depression, and has a lot of other benefits to mom. I was like ewwww when I first heard about it, but then I did some research and spoke to our midwives, and it seems like something worth doing. Good luck!!!


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## Vicyi

I had the injection with my DD although i do not remember either HAVING the injection OR consenting to it. I only know i had it as my Mum told me. With my DS i had it in my birth notes that i wanted it but MW said as everything went so smoothly with the labour i didn't need it. Sure enough it came on its own and everything was fine x


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## TheyCallMeMom

With my first two children I had hospital births and it was given in my IV without them even mentioning it. I think that's how it is with most doctors. It was never even discussed with me at any point with either pregnancy or birth.
With this baby we are planning a home birth with midwives. I have been given the option of waiting for the placenta to deliver naturally or getting the shot to help it along. At this point because I experienced a little more bleeding than normal with my second child I am leaning towards getting the shot just to make sure that everything stays going smoothly and to prevent a hospital transfer after the birth.


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## monkeypooh

Great info ladies, thank you so much. Answers a lot of my questions.


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## Kess

libbylou said:


> I'm in BC and just talking about this with my midwife
> It is standard practice BUT I can decline to have it (which I have)
> They will have the shot ready anyway and it the placenta is taking too long to come out or if there is a concerning amount of bleeding then they will give it to me (which I have consented to)

Just something to consider - make them get your consent _at the time _before they give the injection, or have a specific amount of time or bleeding that triggers your pre-given consent. The problem with "too long" or "too much bleeding" is they are so totally subjective, a HCP could give the injection after five minutes and say that was "too long" in their opinion, for example. They could give the injection for whatever reason they want, and then if challenged they could say retrospectively that they felt there was too much bleeding. If you're opting to do something different to normal practice, you can't safely leave the decision up to the judgement of the HCP who normally do something different to what you want.


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## flipflopfan

They might try to scare you into taking the shot, but most of the time the placenta will come out quickly and easily if you let gravity do its job. Get in a seated or standing position soon after giving birth and it'll probably come right out. If it still hasn't come out after allowing gravity to do its thing for an hour then I would consent to the shot, but that's just my opinion. I would make sure I put whatever I'm comfortable with in writing to my midwife prior to birth so she understands what I've consented to--that way she's much more likely to accept what I've chosen instead of using different tactics to get me to do it differently in the moment.


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## Lozdi

I've never had that shot, and I have given birth twice. I like in the UK and was pleasantly surprised at the birth of my first when the midwife looking after me gave me a warm jasmine compress to help the placenta come away! It worked too!

Second birth was very fast and the placenta came out the same way as baby did- swiftly and with no need for anything!

I'm looking to have a home water birth with this one, and leaning towards a lotus birth and if anything, I would use a Jasmine compress again for the placenta.

I am open to the idea of the shot if I am bleeding too badly, as I am on low dose asprin and although I will stop that a few weeks before EDD, I would rather have a shot ready just incase I bleed too much!


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## mandwrx

Here we are asked what we prefer and it is added to the birth plan and notes that you would like to deliver placenta naturally.

To be honest I think it is a time saver for them, give you the jab, placenta comes quickly, they can finish up and move you on, clean up the room for the next lady!


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## Pixxie

I would tell them clearly and laminate a sign for the bed! If you don't want it then you don't have to have it, if they give it you anyway that's assault!


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## mrs.amillian

silver_penny said:


> I would love to tell you that they can't make you do anything. However, my DS1 was born in hospital, and they literally forced the pitocin on me. I was sitting there holding my newborn son and a make nurse comes around with the pitocin. I asked him what it was, and when he told me, *I said "No. I don't want it." "It's hospital policy" "I don't need it, don't give it to me" "But I have to..." He then put it in my IV drip.*
> 
> I have since learned that hospitals are not subject to phrases such as: "No" and "Don't"
> 
> If you want someone to listen to you in the hospital, you have to memorize the phrase "I Do not give my consent to _______ ." This phrase is legally binding and if they do whatever you told them not to, they are legally liable.

That is abuse, you can and should report that nuse, that is disgusting behaviour, you shouldn't need a specific phrase, you made your wishes incrediably clear.
Report him and I'm really sorry that happened to you :hugs:


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## alette

I didn't get Pitocin until after the placenta was delivered. It came out just a few minutes after the baby did, and once it was out my doctor nodded to the nurse and she started the pitocin. They just told me it would help my uterus contract back down and slow the bleeding faster. I didn't notice any bad side effects or anything from it.. But then I did have an epidural so if it was giving me painful contractions or something I wouldn't have noticed anyhow.

They also weren't in a rush to get us out.. You get a 3 day hospital stay following a normal delivery of a healthy infant, and the room you deliver in is the room you get to recover in and stay in until you leave. We were pretty eager to leave the hospital though so we asked the doctor to discharge us a day early and he did.


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## JessPape

No doctor can FORCE you to have a drug you do not want, so they can not require it. Unless its medically needed you can say no. :)


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## MikaylasMummy

In aus you don't have to have ANYTHING you don't want.If they don't have informed consent before giving you any treatment(informed consent can just be a "I'm going to give u this needle now ok?" and you nod) and u complain they will be in big trouble.if you say no and really don't want it stick to your guns they can't make you.in saying that before you decide I suggest thoroughly researching the benefits and negatives of the injection as it may be something you really want to consider.retained placenta can be VERY dangerous and the pitocin is to help the placenta come out easily and therefor in one piece.it may be necessary for them to pull the placenta out if your body doesn't deliver itself and if the placenta is in pieces it's hard to ensure it's all out.I had retained placenta due to other reasons and I was extremely sick for weeks.sicker than iv ever been with temps and pain and had to go back and have a d&c to get it out.the infections could have caused scarring which can prevent or complicate future pregnancies.anyway back to the original qu.I'm studying it at uni ATM(nursing degree) and the Drs literally can't touch you if you have expresse you don't want to be touched.even if it's a matter of life an death.but I agree with the pps you will need to make them aware and have them write it down and even have a witness when u tell them before you birth because I doubt u will notice much during/straight after the birth


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## ZoeZo

Kess said:


> Just something to consider - make them get your consent _at the time _before they give the injection, or have a specific amount of time or bleeding that triggers your pre-given consent. The problem with "too long" or "too much bleeding" is they are so totally subjective, a HCP could give the injection after five minutes and say that was "too long" in their opinion, for example. They could give the injection for whatever reason they want, and then if challenged they could say retrospectively that they felt there was too much bleeding. If you're opting to do something different to normal practice, you can't safely leave the decision up to the judgement of the HCP who normally do something different to what you want.

This is helpful, thanks. My MW has already hinted that I may need an injection due to a fibroid (and even canulated/have a drip - not at home they can't ;) ). In my mind I've decided I will have drugs for PPH IF needed, there is no way of telling until after the birth if the fibroid will cause excess bleeding, I dunno how much I should worry about either.

Silly question with regards to bleeding, I've assumed you start to bleed immediately after the birth of the placenta? This is my first so I'm a bit clueless! :shrug:


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## MikaylasMummy

Yes if you are going to hamerage it usually happens right after the birth of the placenta.usually it's due to the blood vessels feeding the placenta not being closed down as the uterus has tired too much to contract enough to do so.Hense the pitocin to give it a little help.but you can hamerage hours after birth.I'm not sure why it would be delayed


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## ZoeZo

Ah thank you, so when does the 'normal' post birth period/bleeding start? I'm really clueless!


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## MikaylasMummy

No worries hun that's why this site is so fab.the normal bleeding starts straight away as well it's kind of just ongoing from birth.the difference obviously is the amount of loss and it woud be evident if you were losing too much and if you have an instant heamerage the doctors will be there and know straight away.


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## ZoeZo

Thank you! You really don't get told the finer details! Like how your nipples will hurt like hell on and off during pregnancy, that in third tri your foo foo gets tender and swollen, it'll hurt to blow your nose etc! lol x


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## MikaylasMummy

Hahaha yep it's all a nice little surprise


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