Uterus massage is it necessary? & PPH?

**dust** · February 18th, 2009, 08:43 AM

one interesting thread now

I delivered the placenta without any synto, pulling or massaging with no#2 it came 15mins after which i was thrilled about. Much less bleeding that time around too. But i did have the synto after delivering the placenta coz the midwife said just in case... they did offer to help get the placenta out but i wasnt going to have a bar of it.

Im really going to have to try and figure out the bleeding for myself with the one on its way in august... and put my foot down if i dont believe i need it. I really did bleed less this time around and im happy with that.

**Snacks** · February 18th, 2009, 09:18 AM

Great to hear, dust! Gives me confidence to ask them to refrain from touching me with either needle or massaging hands during 3rd stage

**Alan** · February 18th, 2009, 09:06 PM

I don’t use synto routinely for homebirths. When working at a hospital I always give the woman the option not to have the synto.
I believe that giving synto as the baby is being born is like taking some panadol at bedtime just in case you are going to have a headache in the morning.
Synto acts by causing the uterus to contract and thus helping to stop excessive bleeding and expelling the placenta.
The down side is that it will also cause the cervix to close and there is a chance of trapping the placenta inside the uterus.
Also the majority of women do not bleed excessively after birth. Synto, once injected works very quickly so why not give it if a woman starts to bleed excessively and not because there is a chance that she might.

**Inertia** · February 18th, 2009, 10:03 PM

I don?t use synto routinely for homebirths. When working at a hospital I always give the woman the option not to have the synto.
I believe that giving synto as the baby is being born is like taking some panadol at bedtime just in case you are going to have a headache in the morning.
Synto acts by causing the uterus to contract and thus helping to stop excessive bleeding and expelling the placenta.
The down side is that it will also cause the cervix to close and there is a chance of trapping the placenta inside the uterus.
Also the majority of women do not bleed excessively after birth. Synto, once injected works very quickly so why not give it if a woman starts to bleed excessively and not because there is a chance that she might.

Alan,

I am put on drip fed oxytocin after the baby is born due to a PPH I had with my 3rd baby. I've never really thought about the whole thing at all and they have *never* asked if I wanted the synto because I am Vaso-Vagal Trypanophobic. Basically, don't let me know there is a needle involved and and I suffer neither serious blood pressure spikes and falls and I am less likely to react unreasonably. Since the PPH I worked very carefully with the pathologist at my then local hospital to get me to a point where I can accept a canula from her only. The hospital was amazing in so much as they would get her in just to be able to do it for me.

However, I am now 3 hours away from that hospital and my anxiety about getting the canula has completely returned. Would it be possible for me to go back to the syntocin and uterine massage after cord traction removal? I could try and ask if they would let me see the pathologist for the canula here and see if that works, but it took a long time to train one hospital how to deal with a trypanophobic. I don't think I have the time to do it again.

**Alan** · February 19th, 2009, 08:02 AM

Hi Inertia
This condition must be very frustrating for you. I can only imagine some of the derogative comments you must have received from people who do not understand your condition.
As to whether the hospital would let you go the synto and uterine massage would be up to the hospital. It would depend greatly upon your past obstetric history, for example how bad was your PPH, did you have a PPH with all your births etc.
The problem with a PPH is that, if it is a bad one, you can lose a large amount of blood very quickly. By putting a canula in prior to the birth makes it possible to give you not only drugs but also fluid and even blood if it is needed.
It sounds like your phobia is quite extreme, I would suggest that you really need to talk to the hospital about your condition and see what provisions they can put into place to try to ease your fears.

**Alan** · February 19th, 2009, 08:05 AM

Forgot to add that you are at an increased chance of having a PPH because of the number of children you have had. Most hospitals would prefer you to have a cannula inserted well before the birth of your baby.

**Inertia** · February 19th, 2009, 12:07 PM

Alan, you could probably believe some of the comments I have heard. The worst and most common is when people call me a 'baby'. No one seems to understand that there is a very real, and very dangerous phobia against medical needles. My XHs mother was feral about it for months until she saw my legs give way under the blood pressure low after I was jabbed by a needle for a barium meal. I have had it since my first barium meal when the assistant that did the injection collapsed a vein in my left arm. They cant use that arm now because the vein is so very small now.

The PPH was severe. It went undetected for over an hour because my sister was there with the two older children to see the new baby. It was her (an AIN) that worked out there was something very wrong and ushered the kids out after she hit the panic button. I lost 3l of blood and was transfused overnight. I remember they tried the Syntocin first and then when I woke up I had the canula. I remember the last canula vividly, it was like a straw. The two before that were small, but I arrived at the hospital only a few minutes before baby was born so they just got someone to put one in.

I will discuss it with them, but from the sounds of things I am going to have to work with them with the phobia. Its really not helping that my support network went from dozens of people to 1 person in the last 2 years, but my mum and another sister are planning on coming down from QLD around then to give Phil a hand with the kids. Just wish it was my older sister (the AIN) as she has been the one that was always with me when I had to have a blood test.

Thanks for your advice, I will certainly talk to them about all my options. Guess I am just lucky I have never had a tear!