Today in our Lamaze class, we were discussing about the various interventions that are now a common part of most hospital procedures when a mother is admitted in labor. So, we talked about induction and augmentation, we talked about the pros and cons of amniotomy, episiotomy and other pain relief medications in labor.
One of the common themes that emerges whenever we do an “Intervention” class, is that despite the fact that we are able to start labor, we do not have that much control in stopping the “cascade of interventions” that then follow. This is especially true for induction and augmetation. As we discussed this topic further, we talked about the many cons to using vaginal Misoprostol and other Prostaglandins to induce labor, one of its main disadvantages being hyperstimulation of the uterus, causing ill-effects on mother and baby.
Now, research published in the British Journal of Obstetrics and Gynaecology (BJOG) shows that when vaginal Prostaglandins are administered to induce labor, the metabolites remain in circulation for several hours and are transferred to the fetus, and land up reducing breastfeeding rates, by interfering with the natural hormonal balance, that enables the mother to release Prolactin after birth.
Similarly, it has been found that, when synthetic Oxytocin (Pitocin/Syntocinon) and Ergometrine (Methergine) are routinely admistered in the 3rd stage of labor (delivery of the placenta) to prevent blood loss, without waiting and watching to see if the uterus can clamp down on its own, it reduces breastfeeding rates by 7%. The article says that this amounts to upto 50,000 infants in the UK and upto 300,000 infants in the US who are affected by lack of breastfeeding in the immediate days following birth. This in turn, is estimated to account for a 1000 cases of obesity, and 2000-3000 cases of asthma in the first 9 years of life, as a result of top-feeding, along with increase in other respiratory tract infections and diarrhoea.
In India, we barely have any data in this regard. However, I routinely see the detrimental effects of medicines and other interventions in labor on breastfeeding, in the many mothers who come to me for lactation support after having given birth at other hospitals. In our practice at Healthy Mother, we follow expectant management of the 3rd stage of labor – which means we do not routinely administer either Pitocin or Methergine, unless we see the need to do so. And, we help mothers and infants bond in the first minutes post-birth, which in turn promotes better start to their breastfeeding relationship.
Here is the pdf document of the full research article published in BJOG.