I personally made an informed decision when I had my kids to have syntometrine.
My mentor on my last placement though, at parent ed class basically made out that without it they (the women) would haemorrage everywhere. She told them they had the choice, but made sure they were too scared to choose not to have it. Some of her labour coaching examples needed updating too .. she was all chin on the chest and 'push, push, push, push, ....'' I really wanted to say something but am only a lowly 1st year, just don't feel it is my place to yet.

yes, but why don't midwives give more informed choice regarding synto? Because of that old chesnut, TIME!!
If a phys 3rd stage could take up to an hour or more, and an active only 5-15 mins, which do you think is given better promotion?
It has been known in our trust for sister to knock on the door, and say 'i know what you're doing in there!' and hurrying up the process and pressure to give synto. I have delivered only 2 phys 3rd stages, and both of these were homebirths where the reigns were much looser shall we say. They were both fantastic experiences.
Do we have a glossary def on synto? My understanding is that it reduces the volume of blood lost after delivery - it does not prevent haemorrage (but i guess we all knew that!). ergo - prolonged Lochia loss after active management, maybe 10-15 days. Heavy Lochia loss after phys 3rd stage, but shorter time of bleeding. Rapid delivery of placenta v slower delivery.
might come back to this in a bit, but need to put kids to bed............

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Is Lochia loss the bleeding in the next few weeks?

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yes, Lochia is blood loss postpartum.

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Its the glossary Noo, R is linking all the new terms up today but for now its ..

http://www.studentmidwife.net/studen...14-lochia.html

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Oh this makes me so cross reading these posts, this is exactly what my dissertation topic is on and my 3rd chapter in particular is all about, government guidelines, womens rights, and the role of the midwife.
TBH, they only introduced active management, to stop PPH not try and prevent it!!
No womans body is trusted these days to be able to naturally expel the placenta!!
And as a bit of random info cord clamping and cutting was only introduced for no better reason than to spare bed linen-as medical men became involved in maternal care, women were encouraged to birth on the bed-thus soiling the linen, so they aptly introduced cord clamping!! Great eh??? Nothing like a stooopid reason for doing something, let alone that the babies blood is in that cord, and leaving it pulsating will help expel the placenta anyway.
Sorry rant over, but I hope you've all learnt something!!! lol

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If I ever had another, I would not allow cord clamping until the cord stopped pulsating. DS2 has problems, and I can't help but think it was because his cord was cut early (cord wrapped twice round neck, bradychardic, so cord cut and clamped before he was completely out). Obviously nothing can be proved and his situation couldn't be helped, but seems to be a coincidence that niggles at me and makes me think that the cord should always be left alone unless cutting it is absolutely necessary.

Yes it should be (well I believe so anyway!!) if you read the work of Mercer and Mercer and Skovgaard there is lots on it!!

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tracyb, am a bit confused.
are you annoyed at what i have written?
Are you saying that active management stops PPH?
if so, then i am SO confused and didnt mean to make you annoyed!!
my understanding is that it reduces the volume of blood lost, but it only prevents the incidence of pph occuring, it does not stop it.

would be happy to be told otherwise!!

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I wasnt given a choice either ...i was just told that they were going to give me an injection to help with the expulsion of the placenta....there was no asking if it was what i wanted or not .I wasnt told anything about an injection up untill this time so i wasnt informed about it at all and thought it was necessary .

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