Originally Posted by fergus51
I don't think it's completely irrelevant, but it seldom changes our management of the patient either. We always err on the side of caution.
The only thing which really concerns me is the possibility of a drug reaction if ergometrine is used for third stage management. Reactions to other drugs are fairly consistent among the females in my family.
In all likelihood (grandbaby is being delivered in a hospital based birth centre), there'll be no need for active third stage management, but in the event that there is such a need it would be nice to avoid the potential problem of her diastolic BP going through the roof as mine did (it was not mismanagement in my case - ergometrine was routinely used at that time and there was no particular reason to believe that I was at increased risk from it; to this day, my medical files are flagged to ensure that I'm never given it again ).
I think that I'll probably mention it at the next antenatal appointment. That's the one where my daughter will be drawing up her birth plan and so third stage management will be under discussion anyway. For a while, most hospitals were using syntocinon routinely and only administering ergometrine for PPH, but from what I've read ergometrine is coming back into favour so it at least makes sense to find out about the standing orders at this particular facility.