Rachel writes:
"Routine injection of oxytocics to expedite delivery of the placenta is a
widespread, evidence based practice, and it has been shown to reduce both
blood loss postpartum and the incidence of serious postpartum hemorrhage.
Most studies are carried out in hospitals where many women are medicated
during labor so their own endogenous hormone secretion may not be at its
best, and staff are used to seeing plenty of blood. "

This reflects the medical model of care, which shows little if any faith in birthing women and our bodies. One intervention leads to the "need" for another.

" Personally I prefer a policy of 'expectant management', involving careful observation of mother until the placenta is delivered, and judicious use of oxytocics at the first
sign of hemorrhage, whether that be before or after the placenta is out. This is based on my own 'if it ain't broke, don't fix it' attitude in
general."

This reflects the midwifery model of care which honors, values and respects the normalcy of birth. The problem in the US is that most midwives practice what has come to be known as "med-wifery"--in other words parents aren't getting what they think they are getting, b/c these people are by no means practicing in a midwifery model. The midwifery model values breastfeeding and attachment as much as any LC or LLLL does.
Jennifer Tow, IBCLC, CT, USA

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