Do midwives carry medications that would prevent me from bleeding too much?
The definition of a hemorrhage during a normal vaginal birth, is blood loss of more than 2 cups in the first few hours after birth, or more than 4 cups within the first 24 hours afterwards.
This is a good question to ask a midwife you want to hire because the answer is, it depends.
The definition of a hemorrhage during a normal vaginal birth, is blood loss of more than 2 cups in the first few hours after birth, or more than 4 cups within the first 24 hours afterwards.
There are the 3 types of medications typically used for postpartum hemorrhage in out-of-hospital settings. These are:
Synthetic oxytocin AKA pitocin.
Pitocin can be administrated in IV form or intramuscularly, as a shot in the thigh. In out-of-hospital settings pitocin is more often given via a shot. Pitocin works quickly to control bleeding but does not last longer than 10 minutes, so it may have to be repeated, if the bleeding is not controlled by then. It doesn’t have significant negative side effects, although there have been some studies that show it slightly delays milk production, and is correlated with slightly increased rates of postpartum mood disorders.
Misoprostol AKA cytotec
Cytotec works really well to cause contractions of the uterus to slow a hemorrhage. It also has the negative side effect of causing a potential fever and loose stools. It comes in pill form and is either given to the mom orally to chew up and put in her cheek or under her tongue, or it is administered rectally.
Methylergonovine Maleate AKA Methergine
Methergine cannot be given to women who have high blood pressure. It is administered orally in pill form, or intramuscularly via a shot in the leg. It works well to contract the lower segment of the uterus. Methergine has several negative side effects, including loose stools, lowered breastmilk production, changes in blood pressure, and nausea.
Choosing the right medication:
For most midwives I know who carry medications, they choose to use pitocin first as a medication during a postpartum hemorrhage. If the pitocin doesn’t work, they will usually repeat with a second dose of pitocin, or administer cytotec, or both, depending upon the severity. Midwives usually use methergine for too much bleeding that occurs several hours after birth or if the mother doesn’t respond well to other therapies.
So ask your midwife, does she carry medications to prevent too much bleeding? If so, which ones? What is her usual guideline for controlling and preventing too much bleeding? The answer depends upon the individual midwife and the locality she practices in.
5 Things You Didn’t Know You Need for Home Birth
“Dehydration and electrolyte imbalance can cause uncoordinated uterine contractions and lead to a longer, more painful labor. “
Utility bill
A copy of your ID and proof of address
1. Copy of your ID and proof of address.
When midwives go to file the birth certificate, the health department needs to see a proof of residence. If you move late in pregnancy, it may be a good idea to visit the Bureau of Motor Vehicles to update your license before you have the baby.
2. Depends.
Did you know they now make them in a variety of fun colors? They used to only be available in peach or lavender. Depends are great for the first 24 to 48 hours when your lochia (that’s the word for the normal postpartum bleeding that occurs as the endometrium sheds and the placental site heals) is like a heavy period. The great thing about Depends is you don’t have to worry about extra laundry. Plus, depends have better back protection than heavy duty pads so you don’t have to worry about soiling your sheets when you are snuggling in bed with your baby.
Toilet paper…
3. Extra toilet paper.
If you’re having a home birth, chances are good you’ve hired a midwife and her team, who will be with you in your house from when you go into active labor, until a few hours after the baby is born. Your body will also be making room for a baby to come out, so trips to the bathroom are frequent. It’s important to have extra toilet paper on hand!
Epsom salts or liquid calcium magnesium.
Dehydration and electrolyte imbalance can cause uncoordinated uterine contractions and lead to a longer, more painful labor.
4. Epsom Salts or Liquid Calcium Magnesium.
Magnesium deficiency can cause leg cramps and lots of Braxton Hicks contractions. It’s helpful to have epsom salts on hand for a soak in the tub if you aren’t sure whether you’re really in labor. You can find epsom salts in the pharmacy section of the grocery store or in any pharmacy. It’s also helpful to have liquid calcium-magnesium around at the end of pregnancy, in case you have leg cramps or are having a lot of uncomfortable contractions which are making it difficult to sleep. My favorite brand of liquid calcium-magnesium is Integrative Therapeutics, which you can find on Amazon
5. A Sense of humor
Whether it’s because you are trying to prevent your four-year-old from drinking the birth pool water, or need to laugh as you put on the “one-size-fits-none-victoria’s-secret-special” stretchy panties, this part is crucial. Humor is also a great way to encourage labor and can help you cope when you’re past your due date and not sure if you are EVER going to have the baby.
Need an idea for some laughs? Check out Jim Gaffigan’s Mr Universe here
What items did you find unexpectedly helpful for your home birth?
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