Do midwives carry medications that would prevent me from bleeding too much?
/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.
