# blood loss of 400 cc yet still given pit after placenta delivery



## agnieszkaj (Oct 14, 2007)

Does this make sense? I see that my blood loss is listed at 400 cc. Five minutes after natural delivery of placenta, I was given IV pitocin. I already had the IV port due to my gbs antibiotics in labor. Isn't 400 cc low enough to not warrant pitocin? Rrr


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## sapphire_chan (May 2, 2005)

My first thought was maybe your uterus wasn't clamping down fast enough and they were looking to minimize the amount of blood loss, but I think 5 minutes might be too soon to make that decision, but I don't actually know for sure.

It could also be that they were looking at the rate of blood loss when they made the decision to use pit. Maybe after 10 minutes you would've bled 800ccs, 1200ccs at 15 minutes, etc. Maybe at 5 minutes you started bleeding more?

One way to find out would be to call up the L&D department and ask them when they use pitocin after a placenta comes out. If they want a reason for your question, tell them you just saw in the news about "active management of the third stage". They'll tell you if pit is routine or if they decide case by case.


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## Mama2Xander (Jul 3, 2004)

In my experience (I used to be a L&D RN) it was pretty common to give IV pitocin if the mom had an IV in place already, regardless of blood loss or other factors. It wasn't hospital policy but it seemed that most docs figured if there was an IV already in place they may as well use it for pit. (Not saying I agree with this, in fact I think it causes problems, but it was commonly done).


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## Jane (May 15, 2002)

Pitocin is often a standard order for postpartum.

It could also be a "rate" issue - there are people that don't loose much blood, but they are loosing it fast - so the pit comes on board. The differernce in recovery between someone who has 400 cc loss and 800 can be really big, so many practioners just on stuff.

Did you have a long labor or long pushing phase? those are risk factors for bleeding, so it lowers the threshold for doing stuff to stop it.


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## elanorh (Feb 1, 2006)

Standard procedure at the hospital I birth in, is to administer pit in the third stage of labor.

I didn't realize this (didn't realize I'd even had it) until looking over my bill two years later. It's so routine that they were all surprised I was even questioning it (it had been added to my IV).

My OB was fine with me refusing it with #2, but the nurses still opened pit (despite the delayed cord clamping we had going on!) and OB had to become quite brusque about telling them NO, it's not in her birth plan, she doesn't want it, get it out of here and if it shows up on her bill she's not paying for it. He made the nurse throw it away in a different room even.









Check with the hospital, see how they manage the third stage of labor. And if they 'don't know,' ask your OB or the CNP or whoever at your OB practice. I ended up talking to both my OB and the hospital while figuring out what happened.


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## NZmumof2 (Jun 22, 2006)

When someone does have a PPH they can lose 2000cc a minute so if you lost that 400cc fast I'd give pit - you only have 6000cc of blood so waiting 5mins in a true PPH can be fatal.

It's hard because in retrospect you don't always know if the pit was needed but if as a practitioner you see brisk bleeding it is prudent to act fast. I'd explainthat to the woman I was attending though


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## Collinsky (Jul 7, 2004)

After my (unnecessary) transfer following my uncomplicated UC birth, spontaneous delivery of placenta en route to the hospital, and minimal blood loss, I was offered Pit by the dr. There was absolutely zero medical indication for anything of the sort. In many hospitals, it is just protocol for postpartum care, regardless of the situation.

Granted, when the dr offered it, he said something like, "We usually give Pitocin, but... you don't want it, I'm guessing?" And he was right. Good dr.


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## agnieszkaj (Oct 14, 2007)

Okay, I'm going to talk to my mw about this. My mw does not routinely give pitocin after birth. My doula (who does lots of births with my mw) has never seen my mw give anyone pitocin after birth. It looks like I was lucky for some reason. Additionally, my birth plan specifically said NO pitocin at any time.


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