How Is Pitocin Used to Induce Labor?

Woman on the electronic fetal monitor in labor
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If you have ever talked to anyone who has had their labor induced, started with medication, you may wonder how that works. One of the most common methods is to use a medication called Pitocin. How is Pitocin used to induce labor?

Pitocin is a liquid medication that is a synthetic form of the naturally occurring hormone, oxytocin. Pitocin is diluted with a standard saline solution and introduced into your body by intravenous or IV drip.

The medication is regulated on a medication pump to ensure that you get a very specific amount. This is an attempt to minimize complications from the medication and to help your doctor or midwife mimic normal labor as much as possible.

This IV drip will be set to deliver a certain amount of Pitocin per hour. Depending on the orders written by your practitioner, the Pitocin drip will normally be turned up every hour until you have reached the contraction pattern that they are looking for you to have. This may be different for each woman. Some practitioners turn the Pitocin up really quickly and others go more slowly. Some of this will depend on how you respond to the Pitocin and how well your baby responds to Pitocin. When used with an amniotomy, breaking the bag of waters, there is a slight reduction in the cesarean rate.

According to a national survey of US mothers, about half of the women giving birth will receive this synthetic form of oxytocin to either induce or speed up their labors.

This means that you have a very good chance of experiencing Pitocin in your next labor and birth experience.

What Does a Pitocin Induction Look Like

Since Pitocin is a medication that causes your uterus to contract, there are some additional safety precautions that are often taken to ensure the safety of you and your baby.

This means that you will likely have some added safety interventions. 

When you have Pitocin you will also normally have:

  • continuous IV drip to deliver both the medication and fluids
  • continuous electronic fetal monitoring to monitor your uterine contractions and baby
  • regular blood pressure checks

The Risks Associated with Pitocin

As with any medication or intervention, there are increased risks with using Pitocin including:

  • fetal distress
  • more likely to request pain medication, like an epidural
  • cesarean section (from the induction itself, may be reduced with amniotomy)
  • contractions that come too close together
  • uterine rupture

Is Labor More Painful With Pitocin?

Women have different views on Pitocin. Some find it wasn't a problem at all, while others intensely dislike the way they experienced their labor. Much of this has to do with your expectations of the medication, as well as how your practitioner uses the medication. Discussions about how labor will be managed ahead of time will help you adjust to the use of Pitocin.

If you are planning to have an unmedicated labor and Pitocin becomes the right option for you or your labor, you may want to ensure that you have adequate support for your labor, including a doula. This can help you stay more comfortable as labor progresses.

Pitocin to Speed Up Labor

Pitocin can also be used to speed up your labor, this is known as the augmentation of labor. While there were no differences in the cesarean rates for women who had their labor augmented with Pitocin, there was only a small decrease in the amount of time in labor, about two hours. This did not alter the outcomes but may matter to you one way or another. There are also other alternatives to speeding up a slower labor. Be sure to discuss this option with your doctor or midwife if labor is slowing down.

Sources:

Bugg GJ, Siddiqui F, Thornton JG. Oxytocin versus no treatment or delayed treatment for slow progress in the first stage of spontaneous labour. Cochrane Database of Systematic Reviews 2013, Issue 6. Art. No.: CD007123. DOI: 10.1002/14651858.CD007123.pub3

Costley PL, East CE. Oxytocin augmentation of labour in women with epidural analgesia for reducing operative deliveries. Cochrane Database of Systematic Reviews 2013, Issue 7. Art. No.: CD009241. DOI: 10.1002/14651858.CD009241.pub3

Declercq ER, Sakala C, Corry MP, Applebaum S, Herrlich A. Major Survey Findings of Listening to Mothers(SM) III: Pregnancy and Birth: Report of the Third National U.S. Survey of Women's Childbearing Experiences. J Perinat Educ. 2014 Winter;23(1):9-16. doi: 10.1891/1058-1243.23.1.9.

Wei S, Wo B, Qi H, Xu H, Luo Z, Roy C, Fraser WD. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD006794. DOI: 10.1002/14651858.CD006794.pub4

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