Re: my previous comment:


I want to be very clear. Once the mother has discussedn her birth plan to her satisfaction and that of the obstetrician, and agreed to accept the obstetrician's proposed care, the liability and the prescribing of medications and the amount, kind and rate of intravenous fluids is entirely the responsibility of the obstetricians and anesthesiologists. 


How rapidly fluids are administered may sometime be partially under the control of the L&D or recovery room or postpartum nurses. At least one of the references for my JHL RPS article stated that nurses were sometimes observed allowing fluids to flow faster than the physician had ordered. And looking back, I myself confess that (having been raised on the "clean your plate/waste not want not" theory), in my own L&D, recovery room/postpartum duty years long ago, I was sometimes guilty of letting every last drop of remaining IV fluid run in to a mom before removing the needle, when there was no need nor direct order to do so. 


But if formal research were to be done, 


1) the results might provide guidance about what could accurately be said or not in a prenatal class, or 
2) after birth, while giving anticipatory guidance to a mom with ways to cope with the expected breast edema soon to arrive after she goes home 
3) the appropriate information could be supplied for pediatric or home health follow-up when the mother might be expected to need intervention for swelling and the baby, help in latching. 
4) Most of all, for any mother and/or baby who experiences a genuine intrapartum health emergency requiring a "crash" onset of acute management, with possible multiple IV and blood products and emergency medications, any swelling and/or delay of lactogenesis 2 could be better anticipated and the nursing care for breasts and baby could be managed expectantly.


I'm sure that mine is not the only curious mind that wants to know, scientifically, not just empirically.


K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC     Dayton OH

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