Oxytocic drugs can be used in various ways and for different reasons in the 3rd and 4th stages of labour by your caregiver.
These can be used:
Routinely
Only when bleeding heavily
In cases of delayed placental separation
Routinely
Oxytocic injections are routinely given into the woman's thigh during the birth of the baby's shoulders and body as a precautionary measure ('prophylactically' or just in case) to actively manage the 3rd stage in all delivery suites and if requested in birth centres or homebirth. Their use is aimed at reducing the time it takes for the placenta to be born (and thus the blood loss) and control the bleeding from the uterus soon after the birth in the hope of preventing possible problems such as excessive bleeding, known as
postpartum haemorrhage or PPH.
The drugs used in this case are usually 10 Units of Syntocinon or less commonly one dose of pre-mixed Syntometrine. Even if the woman has been having a drip with Syntocinon to induce or augment her labour, she will still require an injection of Syntocinon as the baby is being born.
In birth centres or homebirth, oxytocic drugs are usually only used whenever a problem presents itself. This may be to manage excessive bleeding or to help deliver a retained placenta if all other natural interventions fail to work. Some birth centres recommend the use of oxytocic drugs if the labour has been long (more than 24 hours) or the 2nd stage or pushing phase has been long (more than 2 hours) as these factors can increase the woman's chances of bleeding.
If the woman has had a previous birth in which she encountered problems with excessive blood loss, it is likely that an oxytocic drug will be used routinely in these birthplaces for the second or subsequent birth, in a similar way to the delivery suite. This is just in case the woman bleeds again.
Only when bleeding heavily