How Does Pitocin Affect Labor and Delivery?

  Photo by  Bonnie Kittle  on  Unsplash
Photo by Bonnie Kittle  on Unsplash

A commonly used labor-induction drug, Pitocin has become less popular in recent years. The drug has been blamed for everything from the extremely high c-section rate in the U.S. to premature deliveries to issues with breastfeeding. The primary purpose of Pitocin is to start labor when waiting for nature is too risky.

However, that is not how most hospitals use the drug today. Pitocin is used in about 30% of hospital deliveries in the United States. It’s a very common treatment to start labor or augment an unproductive natural labor. It’s frequently used when the second (pushing) stage of delivery has stalled, or when the mother is 41 or more weeks gestation and has not spontaneously gone into labor on her own.

Fortunately, the fear around Pitocin doesn’t live up to the factual data. The vast majority of women who are given Pitocin have healthy, happy babies and safe, effective labors.

BENEFITS

Pitocin is a synthetic version of oxytocin. It will help speed up and strengthen your contractions if you’ve started laboring on your own or your cervix is ready to begin labor. This is what’s commonly called a “favorable cervix”. If your body is not ready to give birth, the cervix will be closed, thick, and high. In cases like this Pitocin is unlikely to work. If you have gone 7 days or more beyond your due date, or have a health condition that requires immediate delivery, your doctor may give you a cervical ripening agent prior to starting Pitocin. In some cases, your doctors may skip the Pit and plan a C-Section instead.

  • Faster Labor–Generally, the primary benefit of Pitocin is to help the mother deliver the child more quickly than she would naturally. It can also jump start labor if the mother has been in the first or second stage of labor too long. It’s also used if the mother has not gone into labor on her own a week past her due date or longer and has a favorable cervix.
  • Baby’s Arrival–Another benefit to using Pitocin is that the baby will usually arrive that day or the next. If you’ve had a difficult, complicated, or just plain uncomfortable pregnancy, you will enjoy being done.
  • Lowered Risk of C-Sections–Contrary to popular belief, a recent study from the Canadian Medical Association found that women with Pitocin-augmented labors were at lower risk for cesareans than those who labored without the drug. This was true for full-term and post-term mothers. The risk of C-Section was reduced 12% for these women.
  • Lowered Risk of NICU Stays–The same study found that there was a decrease in NICU treatment needed for infants delivered with Pitocin. There was also a reduced risk of infant death. The study also determined that there was no increased risk of maternal death.

RISKS

While those benefits are great, it’s important to note the inherent risks with a medication like Pitocin. These risks are often more pronounced in first-time mothers, women attempting a VBAC (vaginal birth after cesarean), or women with underlying medical issues like IUGR intrauterine growth restriction) or Gestational Diabetes.

  • Overstimulation of the Uterus–This occurs when contractions last 2 minutes or longer or 5 or more contractions in a ten minute period. It can result in fetal heart issues, placental abruption, or uterine rupture.
  • Drop in Fetal Heartbeat and Fetal Distress–This occurs when the baby is not tolerating labor well. It leads to oxygen deprivation which can be dangerous for the baby.
  • Infection–Fever, chills, fainting, and paleness of the face are signs of a serious, potentially life-threatening infection in the mother.
  • Rupture of the Uterus–This extremely rare complication requires emergency surgery.
  • More Severe Pain During Contractions–There is anecdotal evidence that Pitocin contractions are stronger, faster, and thus, more painful.

Fortunately, once you are on Pitocin, you will be closely monitored by a team of doctors who will be able to assess these risks. If your doctors suspect the Pitocin is not performing adequately, they may shut it off, decrease the dosage, or call for a c-section. Remember that no matter how you deliver your child, the most important thing is that Mom and Baby are healthy.

If you are induced or given Pitocin at some point during labor, you will not be allowed to eat. Your contractions may be painful, even with an epidural. The labor may take longer than you anticipate. Some labors can take days. These factors can also combine to cause you physical, mental and emotional exhaustion. Of course, that is true of every labor and delivery–whether or not Pitocin is used.  Similarly, many people report that Pitocin contractions are worse than natural ones. Speaking from personal experience, they both hurt. A lot. I’m not convinced one is worse than the other.

POTENTIALLY DANGEROUS SIDE EFFECTS

Speak to your doctor immediately if you experience any of the following side effects after delivery:

  • Headaches
  • Fast, Slow, or Uneven Heartbeat
  • Slurred Speech
  • Hallucinations
  • Severe Bleeding Beyond 6 Weeks Postpartum
  • Severe Vomiting
  • Seizures
  • Fainting

These symptoms could signify a serious medical problem, including dangerously high blood pressure. If you’re experiencing these symptoms, you need to seek medical help immediately.

 

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