Sorry here i go again about synthetic oxytocin injection... I'm just trying to understand it and make an informed choice that will be the right one for my baby and my birthing experience.

I am lucky enough to have a personal friend who is a midwife who is looking out for me and sharing her knowledge with me. She is who i am hoping is going to support me through labour. I love her to bits (known her for years) and respect her very very highly. She also has a lot of experience working in maternity wards in hospitals. After raising some of my concerns regarding active management of the third stage of labour, she emailed me back some links to studies that supported active managment for me to compare to see balanced arguments.

Let me get this right though... please please can someone with more knowledge tell me if i'm right? My body will (assuming all goes to plan) naturally produce it's own oxytocin directly after birth that will
  • make me fall head over heels with my baby
  • stimulate more contractions to expel placenta, and
  • reduce blood loss and therefore reduce possibility of PPH


Naturally, oxytocin is produced in the middle of my brian, and when it is released, it is released in little pulses pushing it through my body (?). If it is injected in a synthetic form, it stimulates one big rush of oxytocin throughout me, pushing a large amount of blood through the placenta/cord (?), helping the placenta to come away from the uterus wall sooner, and then in active managment, generally, traction is used to expel the placenta quicker, and PPH is reduced.

So, am i correct then in thinking that IF active managment is facilitated, it's better to go all the way and clamp the cord early to reduce the risks of that large flow of blood causing dramas (jaundice etc) to the baby?

Alternatively, if i stick to my guns about delayed cord clamping, it would be safter to go all the way with expectant managment of the third stage, and allow my baby and body to release the oxytocin at it's natural rate, so there isn't that rush of blood through the cord?

Or is it possible to delay cord clamping, and have the injection administered AFTER the cord is cut? Would that be a compromise?

Right now (after a fair amount of reading), I don't really think that accepting the injection is going to do too much harm to my baby (unless the timing of the cord clamping is a factor?), but I also don't see a really compelling reason to have it either, given that my birth preferences are such that everything i need to stimulate natural production of oxytocin should occur. I am asking that baby be placed directly on my naked chest and for us to be allowed to have skin to skin contact for as long as we need for baby to self-establish breastfeeding.

The research articles i read in support of the injection didn't mention anything about how the control group naturally encourraged the production of oxytocin, and lets face it, the current hospital system doesn't provide the ideal enivronment for stimulation of oxytocin unless we are vocal about our preferences. Am i right?

I am at the point right now where i am starting to feel that the risk of causing stress and tension between my caregivers and myself at this stage could be more detrimental to the birth than accepting a managed third stage of labour. I have to be realistic about that, as my tendancy could be towards sticking to my guns to a point where i have the opposite effects.
A satisfying birth experience is too important to me to get too stubborn about, iykwim?

i need to know that I am understanding what i am reading... so if anyone could clarify or confirm any of that, i would be really really grateful!