If your labour is not progressing as fast as your provider thinks it should (and this can be subjective), they may induce labor using Pitocin, which is a synthetic (man-made) form of the hormone oxytocin, given to you via IV. Chemically, Pitocin and oxytocin are identical, however, how they actually perform in the body differs. Pitocin is given to induce labour, to increase the strength of contractions, and to treat symptoms of post-partum hemorrhage.
High levels of Pitocin during labor can cause de-sensitivity of the receptors, which may cause irregular and non-productive contractions. This is less likely to happen in spontaneous labor (meaning you haven't been chemically induced and you’re not given Pitocin). In spontaneous labour, natural oxytocin is released in pulses and then rapidly broken down by an enzyme so that there’s very little oxytocin left in between each pulse. Some people claim that high-dose Pitocin reduces your likelihood of needing a C-section, and this is not true, as there is no evidence for this. High-dose Pitocin has no effect on C-section rates and has many side effects such as hyperstimulation of the uterus and abnormal fetal heart rate. There is no clear consensus in the medical community about when labor should be augmented with Pitocin, what dosing to use, or the timing of the dose increases. Some studies actually show no medical rationale for using Pitocin, and rather, it seems to play a more important role in the efficiency of hospital rooms. Though it probably doesn't need to be used as often as it is, Pitocin can play a beneficial role when used appropriately. Pitocin can help cause stronger contractions when needed, which can be beneficial during stalled labour or if you had an epidural that caused contractions to reduce in strength.
The 4 big risks of Pitocin:
Uterine tachysystole: Having more than five contractions in 10 minutes averaged over 30 minutes. This is an abnormal contraction pattern that can lead to fetal distress.
Increased risk of uterine rupture if you’ve had a prior cesarian.
IV line and continuous fetal monitoring are needed (often internal monitoring), which has its own risks.
Pitocin is considered a “high alert drug” - if a mistake is made or a drug error, this could lead to a bad outcome.
Alternatives to high-dose Pitocin augmentation
Use a birth ball to address fetal position by opening the hips and pelvis to help the baby come down.
Walking or standing in an upright position to help the baby come down.
Stay hydrated - aim for 125 ml per hour and be mindful if you are vomiting you need to replace those fluids lost, too
Maintain your energy through food - your uterus cannot contract if it has no energy. Having complex carbohydrates throughout labour can give you the energy you need to keep going. - Keep in mind that high-sugar packaged snacks can cause issues for the baby’s blood sugar, so try to focus on whole foods that include protein (apples with peanut butter, protein balls, fruit, and nuts), and other light meals. - **If your provider suggests you should not eat or drink during labour in case of an emergency c-section, please know this is not evidence-based and there is no literature to support this*
Nipple stimulation or cuddling your partner can boost natural oxytocin, which can help promote uterine contractions.
If you have exhausted all of these options, an epidural can give you relief in order to rest or sleep before you're ready to continue with labour.
Ask your provider to start with low-dose Pitocin instead of high-dose, as it has fewer side effects.
Remember that birth is a natural process, and you know your body best, momma!
Using Pitocin for induction is neither good nor bad, but it is important to know your options and know the risks vs benefits. If your doctor/midwife says there is an imminent risk to you or your baby if you don't use Pitocin, it might be time to utilize it as an intervention. If it seems like it's simply to speed up labour for their benefit, and you're feeling okay, then make sure you or your birth partner is able to advocate for what you need and want. There is no judgment in the interventions you use to birth your baby. *This is not intended to be used as medical advice. this is for informational purposes only*
Author: Adrienne DeLuca, BHK Naturopathic Graduate