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Henci GoerFind out what other moms-to-be are asking.  Join in the discussion with Henci Goer, an expert in obstetric research. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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Reply To Topic Topic: ncb info etc...and a few questions?
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Posted By Henci Goer, BA on 12 May 2009 07:34 PM

Sounds like you have found yourself a doctor whose practice style is in line with what you want.  If she is part of a group, though, you might want to find out how likely she is to be at your birth. One of the problems I've seen is that not infrequently, doctors in the same group have wildly differing approaches. If there is a good chance you might get someone other than her, you'll have to ask your questions of them too. (I know; a pregnant woman's work is never done.  )  

As for Pitocin after the birth, my take on the research is that the benefits of routine administration are overrated, and it can always be given if a woman is bleeding too heavily. On the other hand, it doesn't seem to have much in the way of ill effects other than, maybe, more cramping than you would otherwise experience. Unless you have strong objections, this isn't where I would draw a line in the sand.

Much more important is that you do not want the umbilical cord cut before it stops pulsing. Doing so deprives the baby of a substantial proportion of its blood supply. The placenta is also more likely to come away easily and in a shorter time when the blood in it has been allowed to drain back into the baby's circulation. You also do not want umbilical cord traction, that is, the birth attendant pulls on the umbilical cord to deliver the placenta. (Not to be confused with giving the cord a gentle tug to see if the placenta has detached.) The medical literature is clear on the lack of benefits for these and the potential harms.

About vitamin K, I haven't kept up with that controversy. The issue here is that vitamin K helps with clotting. It is made by helpful bacteria in the gut, but a newborn doesn't yet have its gut colonized. The problem with giving it to the mother is that her milk won't come in for a couple of days. What can be done is to give it orally to the baby, although I don't know how much research there is on this. One concern with oral vitamin K is What if the baby spits it back? Then you don't know how much the baby got. With my last one, now age 23, I did feel strongly about not giving the baby an injection shortly after birth. After talking it over with my doctor, we decided to give her double the dose that would be normally be injected. We put it into a medicine syringe, and once she was nursing, I inserted the tip of the syringe into the corner of her mouth, delivered the dose, and she sucked it down along with the colostrum without even noticing.  

As for pain meds, they all have side effects and they all--epidural medications too--get to the baby. Childbirth Connection has an excellent section on coping with labor pain.

-- Henci

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