Dear Joy... Thanks for your information. How you describe your management of third stage is very similar to what we do in Seattle; basically we are hands off until after the placenta has delivered, and the cord is never cut routinely before it has stopped pulsing. So, that is why when faced with active management of third stage is was pretty much do it as it is described in the protocol. And there seemed to be such an urgency about getting that cord cut as soon as the oxytocic was given. I have a passion for physiology so I want to know what this urgency is all about. At this point I am thinking it is habit.
I have read Michel Odent's "The Scientification of Love" and found it a quick and informative read. I think it is a very interesting question that has been raised regarding the incidence of PPD and administration of oxytocics at any stage during labour. One thing I came across when doing some research on postpartum haemorrhage (and I can't remember the citation, unfortunately) was a small study done (I think in UK) with only about 100 women, where the researchers measured the levels of naturally occurring oxytocin in women postpartum following a spontaneous birth. There was quite a range. They were looking for at least an association with oxytocin concentration and incidence of PPH. They did find one: low levels greater chance of PPH but, if I remember correctly, it wasn't significant. I will try to find it again on Pubmed. I was then reading an article in Scientific American by Roger Smith, where he was looking at the hormonal orchestration of labour. I was struck by the work done on oxytocin receptors in uterine muscle, not only the number of receptors but when they become receptive to oxytocin and what turns them off. As usual it seems the more we find out the more questions arise. Just thinking about it, I am wondering if there could also be a link/association between either lower natural oxytocin production, lower number of oxytocin receptors, induction and/or augmentation of labour, and post partum depression. Of course finding oxytocin receptors on a woman's cells would be an invasive procedure: much of the research for Smith's article had been done on sheep. I am just prattling on. I just find it all incredibly interesting. love, marilyn -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
