Pitocin Induction During Labor

Pitocin is a synthetic version of a hormone called oxytocin. During the end of pregnancy, the release of oxytocin stimulates the muscles of the uterus. This causes contractions to begin and gets the process of labor going.  The hormone is often misspelled, even in medical records, as pitosin and petosin. 

Pitocin can be useful in situations where a mother in labor is experiencing weak contractions or if the labor isn't progressing normally. However, the use of Pitocin should be treated as a delicate process that needs to be monitored properly, or else there could be dangerous complications. If the Pitocin is misused during labor, it puts both the baby and the mother at risk due to hyperstimulation.

Hyperstimulation is when contractions become extremely intense and come in much shorter timeframes. This can cause intense pain for the mother and puts her at risk of uterine rupture, postpartum hemorrhage, and lacerations on the cervix or vagina.

Because of how severe the contractions are, they may put the baby at risk of brain damage. The contractions put too much pressure on the baby and restrict blood flow to the brain. This can result in hypoxic-ischemic encephalopathy or even fetal death.

Labor induction with a synthetic hormone is appropriate in many cases.  But some doctors believe too many women are induced with Pitocin for reasons like the doctor's schedule and hospital staffing and this puts newborns and their mothers at unnecessary risk.

When Pitocin is first administered intravenously, it begins a chemical process in the mother's body after about 30 minutes with the first contractions occurring soon after. But how long it takes Pitocin to induce labor varies.  It's hard to tell when exactly a mother will go into labor after being induced by Pitocin. There is no set timeframe, just like how it is for spontaneous labor. If you're induced in the hospital, doctors usually keep the mother inpatient the entire day to see if labor begins.

If the hormone does not work and labor still does not begin, the mother may be sent home to try another day. This is wildly frustrating for any woman. If you know your labor is going to be induced, it's a good idea to bring things that will keep your mind occupied. Waiting around for labor to begin can make you feel anxious and nervous, so try to have something to keep you entertained.

Pitocin stimulates the uterine muscles to contract and the force of the contractions will gradually help to dilate the cervix. However, the cervix needs to be at a certain stage of readiness before Pitocin induced contractions can help accelerate dilation. Cervical ripening or preparedness for labor is evaluated based on something called a "Bishop score." Typically the Bishop score must be 6 or higher before this synthetic hormone is used. If the Bishop score is under 6 doctors will usually administer a cervical ripening agent such as Cervidil or Cytotec to help soften and ripen the cervix.

Once the cervix is sufficiently ripe (a Bishop score of 6 or higher) regular contractions of the uterus will gradually help push the cervix open to full dilation. Pitocin will help stimulate uterine contractions which can speed up dilation. The rate at which Pitocin helps accelerate dilation depends on the dose. Higher doses of Pitocin will generally stimulate the uterine muscles more, causing more frequent and intense contractions.

The goal is to achieve a pattern of 3 contractions every 10 minutes that last around 40-60 seconds. The cervix should be dilating at a rate of 1 cm per hour, and the dose should be reduced once the cervix has dilated to 5-7cm. Pitocin is usually stopped once dilation reaches 7-8cm.

There are a few differences between Pitocin and Cervidil, including the primary use for each one. Pitocin induction is mainly used to stimulate contractions for mothers who are experiencing weak contractions or prolonged labor. Pitocin is used once the cervix is already ripened, meaning the cervix is softened and ready to start dilating. On the other hand, Cervidil is used when the cervix has NOT ripened. Cervidil helps soften the cervix and prepares it for labor, but it is not used to stimulate contractions.

Pitocin and Cervidil also carry different side effects. The more common side-effects of Pitocin include nausea, vomiting, stomach pain, and irritation at the injection site. Misuse of Pitocin can cause fluid retention, uterine rupture, painful contractions, and hyperstimulation. Cervidil is associated with much fewer common side-effects, with less than 1% of patients experiencing fever, nausea, and diarrhea.

The two medications are also administered differently. Pitocin is given via intravenous insertion (IV) and is slowly increased to start contractions. Doctors can adjust how much Pitocin is being given depending on how labor is progressing. Cervidil comes in the form of a thin, gel-like package and is inserted vaginally. The drug is then gradually released over a 12-hour period, usually the night before doctors plan to give Pitocin.

Pitocin and Cervidil work most of the time. The keyword here is "most". Statistics show that 75% of first-time mothers who are induced will have a successful vaginal delivery. Still, that means around 25% of these women might need to wait longer or get a C-section because the cervix is not dilating after induction.

No medication is perfect, and labor can sometimes be unpredictable and difficult to manage. It's important to know that while having a C-section may not be the most desired outcome, it may be the best way to keep your baby safe in some cases. If you're planning to get induced, make sure you establish a connection of trust with your doctor to help you feel less anxiety about your labor.

Additionally, labor induction is not a viable option for everyone. Certain conditions prevent the use Pitocin, including:

• You've had a prior C-section with a classical incision or major uterine surgery
• The placenta is blocking your cervix (placenta previa)
• Your baby is in a breech or transverse position
• You have an active genital herpes infection
• You have an umbilical cord prolapse

According to a lot of mothers, the use of Pitocin can make labor feel much more painful and intense. This shouldn't be a surprise after reading what Pitocin does to your body during labor. It pushes the body to have more frequent, stronger contractions than usual, which can end up hurting a lot worse than natural labor. The upside to this is that Pitocin can be great at making labor progress faster, so the initial pain may be worth it in the end.