Common Interventions - Pitocin

At some point during labor and birth, you’ll likely be faced with the choice of whether to accept a medical intervention. So, it helps a lot to learn ahead of time what the common interventions are, their risks and benefits, and, if you don’t want them, how to avoid them.

Your doula will know all about these interventions, and will be available before and during labor if you want to ask questions or discuss. But we want to give you an overview of one of the most common interventions used to start and speed up labor – Pitocin.

What is Pitocin?

Pitocin is a synthetic version of oxytocin, a hormone your body naturally produces during labor. Both Pitocin and oxytocin cause your uterus to contract during labor. Pitocin-induced contractions quickly become much more powerful and frequent than naturally-occurring contractions.

When is it administered?

Pitocin may be used to induce labor if you’re past your due date. Or, it may be used to augment, or speed up, a labor that is thought to be moving too slowly.

There’s a problem with the idea of slow-progressing labor, though – a lack of standardized, evidence-based guidelines for how long it should take labors to progress. Many hospitals used to use a graph called the Friedman Curve, developed in the 1950’s, but it’s been debunked by organizations like the American Congress of Obstetricians and Gynecologists (ACOG) as outdated. So, different care providers and hospitals have very different ideas of what constitutes a slow labor.

How is Pitocin administered?

It’s administered by IV, usually starting with a very small dose that is then increased incrementally. As your contractions are monitored, your care provider might increase, decrease, or even stop Pitocin doses.

What are the risks and benefits?

Based on a review of eight randomized, controlled studies of over 1,000 low-risk, spontaneous labors, Pitocin reduces delivery time by an average of two hours. That’s probably the main benefit of this intervention – it speeds up labor.

But, the same review found that Pitocin does not reduce Cesarean sections. It also doesn’t reduce instrumental deliveries, where the doctor or midwife uses an instrument like forceps or a vacuum to assist with the birth. Other studies have shown that the drug comes with risks and adverse effects like:

·         Increasing the discomfort or pain brought on by contractions,

·         Increasing the risk of uterine atony, condition that results from the uterus failing to contract to deliver the placenta,

·         And decreasing the baby’s supply of oxygen from the placenta during labor.

How can you avoid Pitocin?

If you’re trying to avoid using Pitocin to induce labor, consider:

·         Discussing with your care provider alternative ways to induce labor, like acupuncture, nipple stimulation, sex, castor oil, or gentle exercise.

·         Discussing with your care provider how long you can safely wait past your due date if you prefer not to induce.

If you want to avoid using Pitocin to augment labor, try:

·         Using comfort and relaxation techniques during labor like soft lighting, music, deep breathing, moving, and changing positions. Labor progresses more quickly when you’re relaxed.

·         Laboring at home for as long as you’re comfortable before moving to the hospital, or discussing the option of a home birth with your care provider.

·         Starting a conversation with your care provider ahead of time about Pitocin and how you can avoid it.

Sources:

https://www.scienceandsensibility.org/blog/take-the-hint-pitocin-does-not-reduce-the-risk-of-caesarean-or-instrumental-birth

https://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/

http://www.lamaze.org/blog/induction-with-pitocin

https://www.scienceandsensibility.org/p/bl/et/blogid=2&blogaid=82