Postpartum Pitocin: Why It’s Given After the Baby is Born and What Your Options Are
After you’ve brought your baby into the world, you might think the hard part is over. But in reality, your body still has one more job to do: deliver the placenta and control any bleeding that happens afterward. This is where postpartum Pitocin often comes into play.
You might be wondering, why is Pitocin given after the baby is born? Or, what are your other options for managing this part of labor? Let’s dive into it so you can make an informed decision when it’s your time.
What is Pitocin?
Pitocin is a synthetic form of oxytocin—the hormone responsible for making your uterus contract. It’s a powerhouse hormone, not only during labor but also during postpartum recovery. After birth, your uterus still needs to contract to help deliver the placenta and stop any major bleeding from where the placenta was attached to the uterine wall.
That’s where postpartum Pitocin can help. Administered as a shot or through an IV, Pitocin helps your uterus clamp down, reducing the risk of excessive bleeding, also known as postpartum hemorrhage (PPH). And even though Pitocin is often used, you have options for how this stage is managed. Let’s break it down.
What is Postpartum Hemorrhage (PPH)?
Before we dive too deep, let’s talk about postpartum hemorrhage (PPH)—because this is the main reason Pitocin is administered after your baby is born. PPH is defined as losing more than 1,000 mL of blood within the first 24 hours after delivery, or any blood loss that causes dizziness, rapid heart rate, or low blood pressure. While some bleeding is expected after birth, too much blood loss can lead to complications.
The good news? Pitocin, and a few other techniques, can help reduce this risk.
What Are Your Options for Managing the Third Stage of Labor?
When it comes to delivering the placenta (aka the third stage of labor), there are generally three management approaches to consider: expectant management, active management, and mixed management. Each has its own pros and cons, so it’s important to know your options before you decide what’s right for you.
Expectant (Physiological) Management In expectant management, your body is allowed to do its thing naturally. No Pitocin is given right away, and the focus is on letting your body’s natural oxytocin levels rise and help your uterus contract. The placenta is delivered on its own, with minimal intervention. Cord clamping is usually delayed until the cord stops pulsating, and you may be encouraged to gently push or use gravity to help the placenta detach.
If you choose this route, Pitocin is only administered if it's really needed later—like if your body isn’t able to fully contract and reduce the bleeding on its own.
Active Management Active management is a more hands-on approach, often involving Pitocin as soon as your baby is born. The goal here is to prevent excessive blood loss by encouraging strong contractions from the start. Along with Pitocin, the provider might clamp the umbilical cord earlier (though delayed clamping can still happen!) and use gentle cord traction to help the placenta out.
The benefits of active management? Research shows it can lower the risk of blood loss over 500 mL (from 15% to 5%) and reduce the need for blood transfusions (from 3% to 1%). However, the downside is that it may also lead to stronger afterpains and more cramping as your uterus contracts.
Mixed Management Can’t decide? You don’t have to pick one extreme or the other. A lot of birthing people go for mixed management—delaying cord clamping to give their baby all those extra nutrients from the placenta, but still opting for Pitocin afterward to help prevent heavy bleeding.
Why is Pitocin Given After the Baby is Born?
Pitocin is given after birth because your uterus needs to keep contracting to close off the blood vessels where the placenta was attached. Without these contractions, you could be at risk for hemorrhage. So, Pitocin basically gives your body an extra nudge to contract efficiently and prevent too much blood loss.
Remember, while Pitocin is often used, it's not your only option. You can choose expectant management, use a mixed approach, or go with active management from the start. The important thing is that you’re aware of your choices and can talk through them with your care provider.
Can I Have Delayed Cord Clamping with Pitocin?
Absolutely! You don’t have to pick between the benefits of delayed cord clamping and the protection Pitocin offers. Most experts recommend delaying cord clamping for at least a minute (or until the cord stops pulsating), because it can boost your baby’s iron levels and help prevent anemia. After delayed cord clamping, Pitocin can still be given to help reduce postpartum bleeding.
So, if you’re worried that you can’t have both, rest assured—you can delay cord clamping and use Pitocin for postpartum hemorrhage prevention. Just make sure to chat with your provider so they know your preferences.
Pros and Cons of Postpartum Pitocin
It’s natural to want to weigh the pros and cons of any intervention, especially when it comes to birth. So, let’s look at both sides of using postpartum Pitocin.
Pros:
Reduces the risk of excessive bleeding or postpartum hemorrhage.
Lowers the likelihood of needing a blood transfusion.
Helps ensure strong uterine contractions during the third stage of labor.
Cons:
May cause stronger afterpains, especially if it’s not your first baby.
Can lead to more cramping as your uterus shrinks back down to size.
May not always be necessary if your body’s natural oxytocin levels are doing the job.
Postpartum Pitocin in Homebirth or Birth Center Settings
If you’re planning a homebirth or birth center birth, you may be thinking that Pitocin isn’t an option, but that’s not necessarily true. While expectant management is often the default approach in these settings, midwives are fully equipped with Pitocin and other medications to handle postpartum hemorrhage if it occurs.
If you prefer to allow your body to deliver the placenta on its own, that’s absolutely an option. But it’s also comforting to know that if any excessive bleeding starts, they can administer Pitocin to help your uterus contract and prevent further complications.
Always discuss your birth plan with your midwife or birth center team so you know what’s available to you in terms of postpartum care and can feel confident about your options no matter what setting you choose.
Making the Decision: How to Feel Supported
Making these decisions might feel overwhelming, but they don’t have to be. Having the right support system in place can make all the difference. As a doula in Denver, I’m here to help guide you through the process, advocate for your preferences, and make sure you feel fully informed along the way. If you’re feeling unsure about postpartum Pitocin, or any part of your birth plan, we’ll work together to find the best approach for you.
And don’t forget, understanding the benefits and options of Pitocin is just one part of a much bigger picture. My childbirth classes in Denver dive deep into all aspects of labor, birth, and postpartum care, so you can walk into your birth space feeling empowered, informed, and ready for whatever your journey holds.
Need more support? Want to talk about your options for birth or learn more about how a doula can support you? Let’s connect. Click here to submit an inquiry, and I’ll be happy to answer any questions or help you plan the birth experience you deserve.
