P is for Pitocin

Pitocin is a synthetic form of the hormone oxytocin. It used to induce or augment the labor process when medically necessary. It is also sometimes administered after childbirth to help the uterus contract and prevent postpartum hemorrhage.

How is Pitocin used?

Pitocin is administered through an IV and is started at a low dose. This dose increased about every 30 minutes until there is a consistent contraction pattern. Once the contractions are occurring every 3-5 minutes, the dose continues until the cervix dilates and the baby is born. Pitocin is used for inductions and for labor augmentation.

If a pregnant person is being induced, they often stay at the hospital overnight, a cervical ripener is placed to soften the cervix, and the next morning Pitocin is started. The laboring person will continue to receive Pitocin through their IV until their baby is born.

When a laboring person has been in labor for a long time or if  the contractions start to slow down, Pitocin may be suggested. The goal is to get the contraction stronger and closer together, and therefore more efficient so baby can be born. Sometimes is is just the thing that is needed for labor to pick up.

What comes with Pitocin?

While receiving Pitocin, the laboring person will also be getting IV fluids and continuous monitoring. In most cases the person can be out of bed and is able to move around or sit on an exercise ball. The nurses will also be checking vital signs and increasing the Pitocin every 30 minutes until the contraction pattern reaches 3-5 minutes apart.

Having Pitocin does not necessarily come with a lot of other interventions. It also does not mean that a cesarean will happen. Sometimes, other interventions or a cesarean is needed to help a pregnant person deliver their baby safely but receiving Pitocin does not guarantee those outcomes.

What are the risks?

One risk of Pitocin is that it can cause contractions that come too quickly. This can be overwhelming for the laboring person, and can stress the baby out. Continuous monitoring is used so the nurses can see how baby is responding to the medication.

When contractions come too quickly the uterus does not have time to relax, the placenta does not adequately fill with blood, and these things can cause the baby stress.  If the baby gets stressed out, the nurses may decrease the dose of Pitocin or completely turn it off. They may also help the laboring person into different positions until they find one that baby responds well too. The IV fluids are often increased and an oxygen mask may be placed on the laboring person’s face until baby recovers.

Another rarer risk is uterine rupture. This is where the uterine muscle gets a small tear in it. This is considered a medical emergency and the laboring person would have a cesarean to deliver their baby.

Is an epidural necessary if Pitocin is used in labor?

An epidural is not mandatory if a laboring person has Pitocin. The contractions tend to be stronger than natural contractions thus leading to the request for pain control. Some laboring persons choose to labor and get as far as they can before requesting an epidural. Others choose to start the Pitocin and get the epidural at the same time.

There are many laboring persons that choose not to have an epidural if they have Pitocin.  If good support and coping techniques are in place, a person can labor and have their baby without an epidural.

What are some good coping techniques to use?

Coping techniques are as individual as each laboring person. Calming techniques that are used when a person is stressed or in pain can be used for coping in labor.
Using upright positions, moving with contractions, asking for time to adjust to the contractions before the pitocin is increased, or (if possible) get in the shower for a while. Others find massage, visualizations, or birth affirmations help them to cope.

These techniques are still helpful if an epidural is chosen. They can help the birthing person stay connected to the laboring process while waiting for baby to be born.

How can a doula help?

A doula can provide reassurance, calming techniques, massage, and cues to focus on for relaxation. The doula will also provide support for partners. If labor is long and the partner needs to catch a nap, the doula will stay awake to provide the support.

Whether the laboring person is planning to get as far as they can, or go the whole way without an epidural, a doula will be there to provide motivation for getting through the contractions. If an epidural is chosen, the doula will still be there to provide support and reassurance.

 

It is important to remember, Pitocin is a tool that is sometimes needed in labor. It does not always lead to interventions or cesarean. And an epidural can be used for comfort or declined based on the birthing person’s preference. 

DC Doulas supports every type of birth and would be happy to stand by your side.

 

Written by Lois Perks


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