What is an ecbolic? Do I need one?
"My midwife has asked if I want a natural delivery of the placenta (whenua), or would I prefer an injection to deliver it?"
What is the third stage of labour?
The third stage of labour is defined as the period from the birth of your baby until the complete birth of the placenta/whenua and membranes (NZCOM, 2006).
An ecbolic is an injection of a synthetic hormone that is given into your thigh with the birth of the baby’s shoulders. The injection can be either syntocinon or syntometrine, although the drug of preference tends to be syntocinon. Birthing the placenta and membranes by this method is called ‘active management of the third stage of labour’ and used to produce uterine contractions to help control the bleeding from the placental site.
When is the injection necessary?
If you have your labour induced, your labour is augmented (given an intravenous hormone to make your contractions more frequent, you have an instrumental delivery (forceps or ventouse), Caesarean section, postpartum haemorrhage or you have a medical reason. The recommendations are that you have an active management of the third stage. Your consent is required for the injection to be given, although if there is an emergency situation, there may not be time to discuss it fully with you but your midwife will advise you.
Do I have to have the injection?
The New Zealand College of midwives recognises that women can expect a physiological third stage (where the mother births her placenta without the aid of an ecbolic) when there has been a straight forward labour and birth.
During your pregnancy your midwife will discuss your birth plan and explain the options available to you.