Birth Blog

How Pitocin “Works”

by Julia West on June 20, 2013

Most of the time I hear about inductions, Pitocin is the drug used to start labor. A friend recently told me that when her OB suggested Pitocin, she was not told anything about the drug, how it worked, what to expect or possible complications from it. It was just presented as a way to “get her baby out.” She was not told that inducing labor would double her chance of having a c-section. (Here is an article about the study that shows this.)

In order to understand how Pitocin works, it’s helpful to understand how natural contractions work. When labor begins, the baby signals for the body to stimulate production of estrogen. The same hormonal signals also help the baby’s vital organs to mature.(1) The uterus begins to contract at a typically slow and steady pace. Often contractions start out 10-15 minutes apart, then the intensity grows and the amount of time between contractions decreases. As the uterus “squeezes” during contractions, the baby’s oxygen is naturally limited, but then the contraction ends and both mom and baby can catch their “breath.” The progression of labor is gradual so both mother and baby work up to hardest, fastest contractions at the end of labor. The contraction pushes the baby’s presenting part on the cervix to help it stretch, thin out and pull upward to open. This triggers the release of oxytocin, which crosses the blood-brain barrier to produce those lovely “mothering” hormones. Have I mentioned the uterus is AMAZING?

Pitocin is the synthetic form of oxytocin. It brings on contractions that are harder and faster than natural contractions, so it is harder for both mamas and babies to keep up. (For this reason, it is a helpful tool in clotting the blood vessels in the case of a hemorrhage.) But it does not cross the blood-brain barrier, and so mothers do not have the benefit of receiving the “love” hormones. It also does not ripen the cervix, so if the cervix does not ripen, the process may be considered a “failed induction,” which leads to a c-section. Risks include uterine hyperstimulation, fetal distress, longer labor and greater pain and excessive fluid retention.(2) Because of the risks to mama and baby, all mothers on Pitocin are required to be constantly monitored. Did I mention inductions double a mother’s chance of having a c-section? Some may say that is no big deal as long as mother and baby are safe. Ask any mom who has taken care of a newborn in the first few days after recovering from a c-section- I doubt the phrase “no big deal” will come up.

Pitocin should be used with caution and the risks should be fully presented. The Coalition for Improving Maternity Services says: “Elective induction of labor, that is, induction for non-medical reasons, such as convenience, exposes babies and mothers to the hazards of induction with no counterbalancing benefit.”

Sources:
(1) The Complete Book of Pregnancy and Childbirth by Kitzinger
(2) Pregnancy, Childbirth and the Newborn by Simkin, Whalley and Keppler

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