The goal of this project is to examine the cardiac symptoms and physiologic changes after administration of a reduced dose of carbetocin in participants undergoing elective cesarian section.

• Does reduced dose carbetocin (50mcg) have fewer cardiac side effects than usual dose carbetocin (100mcg) when comparing patient reported symptoms, ECG changes and troponin increases?
• Is there a relationship between patient reported cardiac symptoms after carbetocin administration and subjective measures of cardiac ischemia (ECG changes and troponin increases? Researchers will compare 50mcg of carbetocin to the control group of 100mcg of carbetocin in patients undergoing elective cesarian section.

Participants will:

• Be given 50mcg or 100mcg of carbetocin during cesarian section
• Asked to report cardiac symptoms
• Be assessed for ECG changes and blood loss using standard of practice monitoring
• Have a troponin I blood test completed after delivery

Inclusion Criteria:

• Undergoing elective cesarian section
• Primary and repeat cesarian section

Exclusion Criteria:

• Prior and current cardiovascular co-morbidities including pre-eclampsia
• BMI greater than 50
• Pre-existing bleeding disorders
• Allergy to carbetocin
• Age under 18