Using Pitocin for induction- what you need to know.

Maybe you have just found out from your care provider that you have to have an induction when it comes time to birth your baby.  Maybe you don't really understand what to expect and what questions to ask your care provider about being induced.  

We just want you to know what the  benefits, risks and side effects of using Pitocin are.  We firmly believe that knowledge is power.  Knowing all of the information will help you to ask better questions and understand your options.  

About 40% of births are induced by Pitocin, mostly for medical reasons and sometimes for connivence for the mom or the care provider.  

When induction is medically necessary

To determine if labor induction is necessary, your health care provider will evaluate several factors, including your health, your baby's health, your baby's gestational age, weight and size, your baby's position in the uterus, and the status of your cervix. Reasons for labor induction include:

• Approaching 2 weeks overdue. 
• Your water has broken, but labor hasn't begun.
•  Infection in your uterus.
• Fetal growth restriction.
• Not enough amniotic fluid surrounding the baby.
• Gestational diabetes. 
• High blood pressure disorders in pregnancy- preeclampsia, chronic high blood pressure, gestational hypertension
• Placental abruption. Your placenta peels away from the inner wall of the uterus before delivery — either partially or completely.

When induction Isn’t necessary

In a perfect world, Pitocin would only be used when medically necessary to improve outcomes for both mom and baby. In reality, Pitocin is often used without a medical reason. Some of the non-medically necessary reasons are:

• Convenience
• Baby is getting big-ultrasound predictions of baby’s size are historically inaccurate (by several pounds in some cases!).
• Mama goes past 40 weeks- The American College of Obstetrics and Gynecology (ACOG) recommends that induction should take place between 42 weeks 0 days and 42 weeks 6 days.
• Mama is ready

But first!

ANY form of induction will NOT work if the cervix is not ready for birth! If you have to be induced for medical reasons you will likely have to do a cervix softener before induction.  Cervidil and Cytotec are the most common cervical softeners.  If you want to learn more about your cervix and what it is telling you, check out this video all about the Bishop's Score.

What is it?

Pitocin is synthetic Oxytocin.  Oxytocin is a hormone in your body that does so many incredible things.  But in labor, it is the Oxytocin that signals the uterus to contract thus getting the baby out of the uterus and into your arms.  

Benefits

Pitocin has been a game changer for those with medical conditions or issues that develop while laboring and still have a vaginal delivery.  Just 60 years ago if you had a vaginal delivery or you had to have surgery.  There was no in between.  Pitocin has bridged the gap and made it possible from women to still have vaginal deliveries with some minor complications.

Pitocin has given hope to a lot of women that developed health issues during their pregnancies and given them peace of mind.  

One of the biggest benefits of Pitocin is its ability to reduce postpartum hemorrhage  by helping the uterus contract back to its normal size after delivery of the placenta. 

Risks

Because Pitocin is a drug there are risks and side effects that come with it.  

• Overstimulation of the uterus. Because Pitocin is a synthetic form of oxytocin, it is hard for the body to ideally utilize it.  The contractions stimulated by Pitocin are often a lot stronger, harder and closer together than natural contractions.  This can lead to overstimulation of the the uterus which can cause a cascade of other issues.  
• Drop in fetal heart rate and fetal distress. Pitocin might cause abnormal or excessive contractions, which can diminish your baby's oxygen supply and lower your baby's heart rate.
• Uterine rupture. This is a rare but serious complication in which your uterus tears open along the scar line from a prior C-section or major uterine surgery. Very rarely, uterine rupture can also occur in women who had never had previous uterine surgery. An emergency C-section is needed to prevent life-threatening complications. 
• Excessive bleeding after delivery. Labor induction increases the risk that your uterine muscles won't properly contract after you give birth (uterine atony), which can lead to serious bleeding after delivery.
• Infection. Some methods of labor induction, such as rupturing your membranes, might increase the risk of infection for both mother and baby. Prolonged membrane rupture increases the risk of an infection.
• Failed induction.   About 25 percent of women, who often start with an unripened cervix, might need a C-section. 

Side Effects

It’s important that each mom together with her healthcare provider, has the information—both the benefits and the risks—she needs to make an informed decision about whether or not Pitocin is the right intervention for her. 

• Pitocin can lead to other interventions-Those who had induction and epidural were 6 times more likely  to have a c-section than those who had neither.
• You’re on the hospitals  “time clock-When you’re on Pitocin,  the hospital or doctor usually expects a certain amount of progress per hour. Many hospitals use 1 cm per hour, after reaching 4 cm, as their guide. If you aren't progressing at their rate, you might have to have additional interventions.  
• Longer labor- This is because inducing labor when the cervix isn't ready doesn't work very well.  Contractions won't get your baby out unless your cervix is soft, open and in position.  Most women that go into spontaneous labor, get to labor in the comfort of their home and have freedom of movement.  When you're induced, you will be at the hospital during the early labor phase and this can make your labor feel a lot longer.  
• Stronger contractions- Pitocin labor is different than natural labor. Experts agree that contractions are much longer, stronger and closer together.  than natural contractions. Also, the uterus doesn’t get to completely relax in between contractions. 
• Can effect your baby- Pitocin can also cause some issues for the baby. The U.S. packet insert for the use of Pitocin suggests there are risks to baby as well. 

• fetal heart abnormalities (slow heart beat, PVCs, and arrhythmias)
• low APGAR scores
• neonatal jaundice
• neonatal retinal hemorrhage
• permanent central nervous system or brain damage
• fetal death

 

if I have to be induced, how to make it work best

One word...

RELAX

Seriously.

If you can condition yourself to relax your mind and your body for your induction and your labor, you will be fine!  We know so many women that have been induced and not had epidurals or any of the side effects of Pitocin.  The key is that you now understand all of the risks, side effects and benefits of having Pitocin.  Now there is not as much unknown.  Even if you don't want to be induced, if it is medically necessary, you are still in control of how you react.  This feeling of control over your situation is key. Now you can approach your induction with confidence instead of fear. 

If you can relax into the contractions by deep breathing and having physical support from your birth partner, your own body might take over and the Pitocin drip can be turned down or turned off. 

As Judith A. Lothian RN, writes in an article published in the Journal of Perinatal Education:  

"Having a deep understanding and confidence in the normal physiologic process of labor and birth and confidence in her own ability to give birth makes it easier for a woman to let go of the belief that technology and routine interventions make birth safer for mothers and babies.”

YOU CAN DO THIS!!!!

Birth is a beautiful process that unfolds for each women differently.  When you own your own birthing experience you approach it with more confidence and confident mothers will change the world.  

TELL ME....

If you had to be induced, where you given the risks and benefits of Pitocin? What was your experience?

 

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