The First 15 continues, closing out the triad of active management of the third stage of labor. To accompany cord clamping (now delayed 60 sec), cord traction and uterine massage.

Doing our part to lower maternal death, the leading cause being hemorrhaging by including not only as a treatment, but as prevention. In the hospital, most providers choose active management as their practice but fail to discuss the experience, the benefits, the risks or any other alternate options.

It seems to be so routine that they do not feel it is a decision that the mother or parents need to even make. Though active management and pitocin can be a great choice for many women looking to lower her chance of hemorrhage and has had multiple interventions already, the power comes with knowledge.

I'm researching, discussing and sharing that knowledge with clients and you, so let's get into the history, date and current recommendations for pitocin and uterotonics in postpartum.

Resources:

Pitocin During the third Stage of Labor by Rebecca Dekker, RN and Anna Bertone MPH, Evidence Based Birth

Management of the Third Stage of Labor, Updated:

Jun 03, 2024, Author: John R Smith, MD, FACOG, FRCSC; Chief Editor: Christine Isaacs, MD, Medscape

Postpartum Hemorrhage: Prevention and Treatment, 2017, AAFP, Ann Evensen, MD, Janice M Anderson, MD, and Patricia Fontaine, MD, MS

00:40 Breaking Water and Pitocin Orders

02:18 Concerns About Early Pitocin Use

04:41 Importance of Informed Consent

09:45 Postpartum Pitocin and Hemorrhaging

14:30 Historical Approaches to Hemorrhaging

18:14 Development of Oxytocin Drugs

24:35 Discovery of Oxytocin

26:44 Pitocin: Synthetic Oxytocin

27:23 Active Management in Labor

29:50 Historical Trials and Errors

32:25 Prostaglandins and Alternatives

36:01 Modern Practices and Recommendations

41:13 Preventing and Managing Hemorrhage

45:20 Final Thoughts and Advice

50:35 Upcoming Episode Preview

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