The First 15 continues, closing out the triad of active management of the third stage of labor. To accompany cord clamping (now delayed 60 sec), cord traction and uterine massage.

Doing our part to lower maternal death, the leading cause being hemorrhaging by including not only as a treatment, but as prevention. In the hospital, most providers choose active management as their practice but fail to discuss the experience, the benefits, the risks or any other alternate options.

It seems to be so routine that they do not feel it is a decision that the mother or parents need to even make. Though active management and pitocin can be a great choice for many women looking to lower her chance of hemorrhage and has had multiple interventions already, the power comes with knowledge.

I'm researching, discussing and sharing that knowledge with clients and you, so let's get into the history, date and current recommendations for pitocin and uterotonics in postpartum.

Resources:

Pitocin During the third Stage of Labor by Rebecca Dekker, RN and Anna Bertone MPH, Evidence Based Birth

Management of the Third Stage of Labor, Updated:

Jun 03, 2024, Author: John R Smith, MD, FACOG, FRCSC; Chief Editor: Christine Isaacs, MD, Medscape

Postpartum Hemorrhage: Prevention and Treatment, 2017, AAFP, Ann Evensen, MD, Janice M Anderson, MD, and Patricia Fontaine, MD, MS

00:40 Breaking Water and Pitocin Orders

02:18 Concerns About Early Pitocin Use

04:41 Importance of Informed Consent

09:45 Postpartum Pitocin and Hemorrhaging

14:30 Historical Approaches to Hemorrhaging

18:14 Development of Oxytocin Drugs

24:35 Discovery of Oxytocin

26:44 Pitocin: Synthetic Oxytocin

27:23 Active Management in Labor

29:50 Historical Trials and Errors

32:25 Prostaglandins and Alternatives

36:01 Modern Practices and Recommendations

41:13 Preventing and Managing Hemorrhage

45:20 Final Thoughts and Advice

50:35 Upcoming Episode Preview

More from My Friend's a Nurse:

Join us for the Next Childbirth Crash Course This September 18th-20th!

Join us for the next Birth Plan Workshop!

Join the newsletter for behind the scenes and episode insights you don't want to miss!

Visit MyFriendsaNurse.com

Grab this FREE Hospital Bag Checklist

Email Colette directly for coaching availability and membership colette@myfriendsanurse.com

If you are interested in partnering or being a guest on The Birth Link Podcast please email info@myfriendsanurse.com

Stay Connected:

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Today we have the opportunity to sit down for an in depth look at postpartum care and how to prepare for this delicate time. Specifically how new parents can navigate and set expectations for your family’s and newborn’s sleep and feeding routine. How sleep affects your milk supply and your newborn’s sleep at night. Listen in on this expert interview, where I learned a few things myself and reviewed tricks to produce sufficient milk supply and newborn healthy feeding habits. You may want to take notes!

Melanie is a certified lactation educator at UCLA and owner of Melanie Wachsman Doula in Los Angeles, CA. She is a Gentle Sleep Educator and consultant and Sleep Savvy certified. You can find more information on her as a maternity expert at doulamellie.com IG @doula_mellie

00:00 Welcome to Episode Nine!

00:45 Introducing Melanie Wachsman Bingham

01:16 The Importance of Newborn Sleep

03:31 Melanie's Journey to Becoming a Doula

04:57 Balancing Sleep and Feeding for Newborns

10:33 Practical Tips for Newborn Sleep Routines

19:31 Managing Parental Sleep Deprivation

24:55 Navigating Cluster Feeding

26:12 The Benefits of Bedside Co-Sleepers

26:38 Understanding Baby's Primal Instincts

28:14 Finding the Right Sleep Setup

29:43 The Role of Partners and Support Systems

30:41 Personal Experiences with Sleep Training

36:25 Different Types of Nighttime Caregivers

45:55 Preparing for Baby's Arrival

50:08 Final Thoughts and Resources

More from Melanie:

Visit her website DoulaMellie.com

Connect with her on Instagram: @doula_mellie

More from My Friend's a Nurse:

Join us for the Next Childbirth Crash Course This September 18th-20th!

Join us for the next Birth Plan Workshop!

Join the newsletter for behind the scenes and episode insights you don't want to miss!

Visit MyFriendsaNurse.com

Grab this FREE Hospital Bag Checklist

Email Colette directly for coaching availability and membership colette@myfriendsanurse.com

If you are interested in partnering or being a guest on The Birth Link Podcast please email info@myfriendsanurse.com

Stay Connected:

Instagram

TikTok

FaceBook

For the last 60-80 years an incision in the vaginal opening to help the baby come up has been used routinely, with some experts stating, there is no reason not to, so don’t even worry about it!

Yeah.. that was Dr Diethelm specifically, in 1938. Speeding up the pushing stage, helping mom out after pushing for a long time, worrying about the baby being held inside by the tight perineum, trying to avoid major tears by giving a smaller incision, all in the hopes to help out.

Medical and surgical interventions became popular in the 1920s as deliveries moved to the hospital, of course! Most with the best intentions in mind. They thought of a great idea, to use this procedure on everyone and with the help of forceps, totally eliminating the mom from having to push at all! Thanks!

But has the actual evidence held up this theory? Well get into it today! Take what you’ve learned and start the conversation with your provider, remember knowledge is power! Stay informed and stay healthy!

In this episode of the Birth Link Podcast, Colette discusses the topic of episiotomies in detail to help you navigate episiotomies for an empowered birth experience.

00:00 Introduction and Personal Update

00:13 Exciting New Ventures in Maternal and Newborn Care

01:42 The Importance of Birth Plans and Privacy

02:02 Hospital Experiences and Challenges

04:30 Protecting Your Space During Labor

05:37 Introduction to Episiotomies

07:07 History and Evolution of Episiotomies

14:20 Medical Perspectives and Practices

21:29 Conflicting Evidence and Modern Views

23:02 Episiotomy Risks and Recovery

23:16 Hospital Guidelines and Doctor Preferences

23:56 Infection and Pain During Sex

24:30 Severe Perineal Trauma and Fourth Degree Tears

26:15 Shortening the Second Stage of Labor

29:45 Shoulder Dystocia and Episiotomy

31:10 Restrictive Episiotomy Policies

38:18 Factors Increasing Episiotomy Risk

40:02 Factors Lowering Episiotomy Risk

41:22 Importance of Discussing Episiotomy with Your Provider

44:46 Conclusion and Next Episode Preview

Resources:

• [Fetal expulsion: Which interventions for perineal prevention? CNGOF Perineal Prevention and Protection in Obstetrics Guidelines].
• Riethmuller D, Ramanah R, Mottet N.
• Gynecol Obstet Fertil Senol. 2018 Dec;46(12):937-947. doi: 10.1016/j.gofs.2018.10.029. Epub 2018 Oct 28.
• PMID: 30377094 French.

Mayo Clinic, Labor and delivery, postpartum care; Episiotomy: when it’s needed, when it’s not

Selective versus routine uses of episiotomy for vaginal birth

Hong Jiang 1, Xu Qian 1, Guillermo Carroli 2,...