What happens when a medication designed to stop hemorrhage quietly starts creeping into routine birth care?

This week, Dr. Stu and Midwife Blyss take on TXA (tranexamic acid), what it is, when it actually makes sense, and why they’re increasingly concerned about how it’s being used in modern maternity care.

From postpartum hemorrhage protocols to the growing push for prophylactic use during cesareans and even BEFORE birth, this conversation digs into the science, the politics, and the unintended consequences nobody seems willing to talk about.

Along the way, they tackle the bigger issue underneath it all: Who gets to define “safe” birth care? Hospital systems? Bureaucrats? International organizations? Or the people actually attending births?

References:

Evidence Based Birth Podcast Episode 396 - Inequities in VBAC Access with Dr. Nicholas Rubashkin, MD, PhD

https://podcasts.apple.com/us/podcast/ebb-396-inequities-in-vbac-access-with-dr-nicholas/id1334808138?i=1000764260687

Mom who sued the State of Nebraska in home birth case delivers baby

https://nebraskapublicmedia.org/en/news/news-articles/mom-who-sued-the-state-of-nebraska-in-home-birth-case-delivers-baby/

Home births to resume after safety concerns

https://www.yahoo.com/news/articles/home-births-resumed-safety-concerns-183648374.html

Practice Bulletin No. 183: Postpartum Hemorrhage: https://journals.lww.com/greenjournal/abstract/2017/10000/practice_bulletin_no__183__postpartum_hemorrhage.56.aspx

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum hemorrhage (WOMAN): an international, randomized, double-blind, placebo-controlled trial:

https://pubmed.ncbi.nlm.nih.gov/28456509/

Efficacy of prophylactic tranexamic acid among parturient at increased risk for postpartum hemorrhage undergoing cesarean delivery: A systematic review and meta-analyses of randomized controlled trials

https://pubmed.ncbi.nlm.nih.gov/41066405/

Discussed in This Episode

The Momnibus Act & the Future of Midwifery

TXA Enters the Midwifery World

What TXA Actually Does in the Body

The Evidence Behind TXA for Hemorrhage

Why Routine Prophylactic TXA Raises Concerns

Does TXA Cross the Placenta?

Four Ts of Postpartum Hemorrhage

Why Timing Matters in Hemorrhage Care

Defining “High Risk” in Birth

Use of Oral and Intermuscular TXA

Podcast Produced by: Raquel Hernandez, Pride and Joy Doula Care 

This show is supported by

• LMNT | Got to lmnt.com/birthinginstincts to get a free sample pack with any order
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• Restorative Roots | Go to restorativeroots.com and use code BIRTHINGINSTINCTS to get $20 off
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