Did you know that Pitocin is the most commonly used drug for inductions in the US? Did you also know that it is classified as a “high-alert” drug, and half of all paid legal claims involve pitocin? So why is it used, and what side effects of pitocin should you be aware of? I’ve complied a list of the risks, benefits, and side effects of pitocin to help you make your own decisions regarding the use of pitocin.
Uses of pitocin
Pitocin is used to either start a labor or speed it up if it is not progressing as fast as is expected by your care providers. According to Gabbe’s Obstectrics, these are the medical reasons your labor may need to be started or sped up:
- Preeclampsia
- Diabetes
- Kidney diseases
- Lung disease
- The water sac breaking(this is controversial)
- Infection of the uterus
- The unborn baby is not doing well
- The baby is no longer alive
- A pregnancy that lasts longer that 42 weeks
Some reasons a doctor might consider induction include:
- High blood pressure that is preexsisting
- Systemic lupus erythematosus
- Gestational diabetes
- Some blood clotting problems
- Cholestasis of pregnancy
- Too much amniotic fluid
- The unborn baby has some malformations
- Logistic factors(distance from hospital, fast labors, etc-this is also controversial)
According to ACOG and Gabbe’s Obstetrics (in addition to other obstetric books and other professional organizations), elective induction is not recommended nor encouraged.
Risk Factors of Pitocin Use
- Increased risk of c-sections (especially in first time moms and those with unfavorable cervix)
- Longer stay in the labor and delivery units
- Increased costs for labor, pharmacy, and postpartum care.
Common Side Effects of Pitocin
- Increased contractions that may get too strong (thus leading to uterine rupture or oxygen deprivation for the baby)
- More painful contractions.
Medical Care Needed
A nurse should always be monitoring your baby’s heart rate when using piticin. If she notices that your contractions are too close together, she may turn the pitocin down. She may also do this if your baby’s heart rate starts dropping too much. Often times, this stops the problems. Other interventions they may need to use at this time include oxygen for mom, rolling mom to the left side, or encouraging a different position.
Effect of Labor
Some women say that labor with pitocin is more painful than labor without. This may be due to the fact that pitocin is forcing your uterus to contract, rather than your body doing it on its own. For those who are wanting to work through contractions without an epidural, having pitocin on board might make this more difficult (though many women labor successfully without an epidural, so it doesn’t mean you can’t).
It is important that we understand what we are doing when we are making decisions surrounding our birth, including the use of pitocin, and that we discuss these with our physicians. As with anything in birth, weighing the risks and benefits should be something all expectant mothers are encouraged to do.
The American College of Nurse Midwives feel that the use of pitocin disrupts the process of normal birth (though they also feel that medical interventions are needed at times). For more information on what a normal birth means and how pitocin may interfere with it, you can check out my post about this topic: Defining Physiologic Birth.
Resources:
Obstetrics: Normal and Problem Pregnancies, 5th ed. Gabbe et al.
Davis’s Drug Guide for Nurses: Sixth edition, Judith Hopfer Deglin and April Vallerand
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