Updated: Apr 3
When I first started attending births as a doula, I spent a lot of time preparing my clients for the mental and physical aspects of labor. We talked about comfort measures, preparing their mindsets, and when to go to the hospital.
Then they would birth their baby, and 5 minutes later their OB or midwife would say something like, "ready for a shot of Pitocin?"
My clients were wide-eyed and overwhelmed. Here they are, trying to enjoy their Golden Hour with baby, and it's being interrupted by decision making. They weren't in the right headspace to be learning about the pros and cons of 3rd-stage Pitocin while trying to latch a baby for the first time.
Now, when I meet with clients I always make sure they know about these 3 post-birth interventions. I encourage them to decide if they want them BEFORE they go into labor.
All 3 of these interventions are standard in hospital births, and available at birth centers and home births, but might not be right for you.
1. 3rd-stage Pitocin
The 3rd stage of labor is the birth of the placenta (after baby is born). When the placenta detaches from the uterine wall, it leaves an internal wound. This is why you bleed vaginally postpartum, even if you have a c-section.
During this time, it's standard to give a single dose of Pitocin, to encourage uterine contractions. Pitocin is a synthetic (man-made) form of the natural hormone Oxytocin. It has pros and cons when compared to Oxytocin, but is generally effective at helping the uterus contract. The goal is to help the uterus contract quickly, to minimize postpartum bleeding and risk of postpartum hemorrhage.
3rd-stage Pitocin can be administered through an IV, or through a shot. If you're already using Pitocin during your labor, your team will continue running it through the 3rd stage, so this won't be a decision you'll have to make.
The alternative to 3rd-stage Pitocin is to let your body contract on it's own. Some people also decide to "wait and see", meaning they initially decline 3rd-stage Pitocin, but are open to it if their care provider feels they're bleeding excessively.
Learn more about the pros and cons here: Evidence on Pitocin During the Third Stage of Labor.
2. Eye Ointment for Baby
AKA Erythromycin. This eye ointment is an antibiotic that is standardly rubbed over baby's eyes in the first 24 hours post birth (usually much sooner than that).
It's used to proactively prevent possible infection from bacteria and viruses in the birth canal (most commonly: chlamydia and gonorrhea). It is possible for babies to be infected during a c-section, but the actual risk is unknown because it's so rare. This infection can lead to blindness in infants.
Many US states have laws requiring eye ointment for babies, but Minnesota's law allows for parental objection.
Learn more about the pros and cons here: Evidence on Erythromycin Eye Ointment for Newborns.
3. Vitamin K for Baby
Babies are born deficient in Vitamin K, which is needed for blood clotting. This puts them at higher risk of (rare) internal bleeding.
To combat this, babies are standardly given a single shot of Vitamin K soon after birth. Alternatively, they may be given oral Vitamin K, which is available in a 3-dose series. The oral Vitamin K has been shown to be slightly less effective, but is more common in Europe. It can be hard to get the oral dose in a hospital, but here in the Twin Cities, many of the birth centers sell it.
Note: Vitamin K has recently been swept up with the anti-vaxx movement on mommy blogs, but it is not a vaccine. Learn more about the pros and cons here: Evidence on The Vitamin K Shot in Newborns.
Learn more about ALL of the decisions you need to make during birth: