Your doctor may use pitocin to induce labor, if your labor has slowed, or if your contractions aren't strong enough. Because of its prevalence in the United States birthing community, it's important for expectant parents to know about the pros and cons of pitocin.
What Is Pitocin?
Pitocin is synthetic oxytocin. Oxytocin stimulates contractions during labor, helps stimulate contractions after the baby is born to stop bleeding, and helps control the milk ejection reflex during breastfeeding.
Inductions are becoming increasingly common in the United States. Inductions are done for a number of reasons including:
- If your membranes have ruptured (water is broken) and contractions have not begun
- If you go past your due date and your care provider becomes concerned about delivering a large baby or placental malfunctions
- Gestational diabetes
- High-blood pressure
- Fetal distress
- Low amniotic fluid
- Other medical conditions including cancer, heart problems, lung problems, etc.
- Other pregnancy complications
Synthetic oxytocin is most commonly used during inductions to begin contractions. It works well if the cervix is already dilated or effaced. If your cervix has not begun dilating, your care provider may opt to use a cervical ripening agent so pitocin works better.
Pitocin is often given during labor if your care provider feels your labor has stalled (your cervix stops progressing), your contractions aren't strong enough or they aren't close enough together. Many care providers recommended synthetic oxytocin if an epidural is given, because epidurals often slow down labor.
How Is Pitocin Given?
Synthetic oxytocin is given via an IV. Care providers start the dosage of medication low, and increase the amount being given every half an hour. Increases will continue until your contractions are only a minute or two apart and very strong.
Pitocin may also be given via an injection after you deliver to prevent bleeding.
- Uterine Rupture. There is a small risk of uterine rupture with the use of pitocin, especially if you are trying for a VBAC (vaginal birth after cesarean).
- Fetal distress. Some babies do not like the stronger contractions synthetic oxytocin offers. They may go into fetal distress. If this happens, the medicine will be turned off and your care provider will evaluate the situation. Because of the risk of fetal distress, you will be on a fetal monitor if synthetic oxytocin is used during labor.
- Long term consequences for your baby. Pitocin is a relatively new medication and long-term risks have not been evaluated. Some experts link the use of synthetic oxytocin with autism and Asperger's syndrome.
- Pitocin does tend to make labor shorter. This is a huge bonus for many women exhausted by labor
- Using synthetic oxytocin to stimulate labor if the membranes have been ruptured has cut down on infection rates.
Does Synthetic Oxytocin Make Labor Harder?
Yes and no. Synthetic oxytocin makes contractions similar to transition-like contractions. Transition contractions are extremely strong, long, have multiple peaks, and only have about a minute in-between them. This may sound impossible, but during transition (cervix dilated 8-10 centimeters), transition contractions are doable. Transition typically lasts less than two hours and your body has had a chance to adjust to the strong contractions with strong endorphin levels.
However, if you're experiencing transition-like contractions while you're only a few centimeters dilated, it changes everything. Your body hasn't had a chance to build up endorphin levels, you probably haven't figured out a good coping technique for labor, and you will likely have transition-like contractions for longer than two hours.
But, many women go without pain medicine even though they are on pitocin. If you are committed to a natural childbirth, but need synthetic oxytocin, you can still labor without pain medicine.