Beyond the Shot: Preventing Postpartum Haemorrhage ~ Wisdom from a Traditional Birth Companion
Postpartum haemorrhage is a complication that can happen in any birth setting, although it’s more likely in a hospital. Despite the universal application of “active management” as a prevention, the rate of haemorrhage due to uterine atony has been steadily climbing in developed nations.
“Active management of the 3rd stage”, is an intervention for the birth of the placenta, the time when women are most likely to lose a significant amount of blood. It involves injecting the mother with a uterotonic (something to make the uterus contract), usually synthetic oxytocin, as soon as the baby is born, and it may include some other steps like early cord clamping or pulling on the umbilical cord depending on the protocol used. This intervention is applied to all birthing women in all hospitals, birth centres, and homes with few exceptions.
You’d think if every mother everywhere gets this injection, then it must be a good thing. Well, that’s the thing about obstetrics. It tends to take an intervention that might be suitable for some clients in certain situations and applies it to everyone. And the results are increasingly worrisome.
The Art of Palpation ~ Wisdom from a Traditional Birth Companion
Palpation is the act of using one’s hands to figure out something on or in a body. In maternity services, the practitioner routinely palpates the pregnant belly to assess the position and size of the foetus.
After the male midwife, which later became the obstetrician, infiltrated birth services and paternalized it into a male-centric, provider-centric practice, they’ve been “discovering” all kinds of things that were just normally known and carried out by midwives for centuries. Among them is the standard way to palpate a pregnant belly.
I tend to see palpation through a different lens. I feel it’s more about building a relationship with the baby than anything else.
When not to induce – reason #408 – a placenta with calcium deposits
I received yet another phone call from someone who was trying to sort out the risks of staying pregnant versus the risks of being induced. From what the client could share, it was hard to know if the practitioner wasn’t fully informed on placental calcification at term, or wasn’t fully forthcoming about the non-clinical indications of that particular development in a healthy pregnancy.
To be sure, there are times when the benefits of an induction to rescue a compromised baby far outweigh the short and long-term risks of an induction.
Unfortunately, when trying to make an informed decision, clients often need to learn what their practitioners don’t know or won’t tell them.