Posted by: Morgan | November 14, 2009

Pitocin: What it is, how it’s used, and its relationship to further birthing interventions

This is approximately the manuscript for my informative speech on Pitocin. Please watch clip before reading post.

Birth will effect most people at some point in their life, either by birthing their children themselves or by being with a partner who is birthing their children. Many parents are not fully informed on the procedures surrounding labor and delivery, sometimes with very unforeseen consequences, as we saw in the clip.

According to Tina Cassidy, author and New York Times reporter, counts from 2003 show that 1 in 5 American births are synthetically induced. Pitocin is the most common way this is done. The use of Pitocin is a regular routine in American hospitals, so I want to inform you about what it is, how it is used, and its relationship to further birthing interventions. I am extremely passionate about pregnancy, birth, and postpartum care and have done a lot of research on this subject.  I also surveyed 16 women, with a total of 24 births, who had Pitocin or epidurals used during their birthing experiences.

 

Many people have heard of Pitocin, but very few know what it actually is. Pitocin is a synthetic version of the naturally occuring hormone, oxytocin, which is found in both males and females. Pitocin is actually a brand name for synthetic oxytocin, but for the purposes of this speech I will be using the term Pitocin to refer to all brands of synthetic oxytocin.

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Oxytocin is released from the pituitary gland and, aside from causing contractions and progressing labor, it is also credited with facilitating bonding and trust between humans.

There are several similarities and differences between Pitocin and natural oxytocin. The primary way they are similar is that their chemical make-up is almost identical. Both also induce contractions of the uterus and progress labor and delivery. The main way they are different from one another, besides the synthetic vs natural aspect, is that oxytocin is released from the  brain in spurts while Pitocin is typically a continuous stream submitted to the body. Another way they are different is that Pitocin does not create feelings of bonding or trust between humans.

You may be wondering, if oxytocin is a hormone our bodies naturally produce, what is Pitocin used for? To better understand what Pitocin is used for, it is good to know how it is administered. Pitocin can be administered one of two ways: through an intramuscular shot or intravenously.

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The intramuscular shot is typically used afterbirth to prevent hemorrhaging and to help the uterus retract to its original size. The intravenous method is the more common administration and is used to induce labor, augment labor, and in most cases of abortion after the first trimester.

On the Drug Fact Sheet by the FDA for Pitocin is this notice:

“IMPORTANT NOTICE: Elective induction of labor is defined as the initiation of labor in a pregnant individual who has no medical indications for induction. Since the available data are inadequate to evaluate the benefits-to-risks considerations, Pitocin is not indicated for elective induction of labor.”

Medical inductions are indicted when there are Rh blood problems, maternal diabetes, preeclampsia, water breaking and delivery being indicated but not begun, and in rare cases of uterine inertia.

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With the widespread use of Pitocin in American hospitals, there is no question that it has a link, whether that be good or bad, to further birthing interventions. Some of these are more intense contraction patterns, something we call the Pitocin-Epidural spiral, and problems related to potential due date error.

Because Pitocin is administered continuously, the contractions caused by Pitocin are more intense than natural contractions, in over 90% of cases. In the survey I conducted, there were many women that commented on this. Two of the quotes, in response to the question “Did the Pitocin change your labor?”, were:

“It was infinitely more intense and painful without much difference to the labor process it was said to help. Pure torture! My contractions went from a 4 or 5 to an 8 or 9 out of 10 very quickly.”

“Contractions were closer together, more regular, and more intense.”

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Because we do not yet understand how the brain regulates natural oxytocin, we can not distribute Pitocin into the body as each body truly needs. Though extremely rare, some women do not experience the intense contractions related to Pitocin. A quote from my survey, in answer to the same question above, shows this:

“Yes. Irregular contractions started. Some hard, some not so hard. Stayed irregular.”

This can often lead to the next intervention, as the more intense contractions often lead to requests or offers of pain medication for the birthing woman. The most common of these is the epidural, a regional anesthesia. Pain relievers, including the epidural, relax the body and can stop labor progression. Because of this the amount of Pitocin must be increased, leading to what is known as the Pitocin-Epidural spiral. More Pitocin is used, increasing the pain, so the epidural/pain medication is increased to combat this for the mother. The two are used back and forth to combat the effects of the other.

During a contraction, blood flow to the uterus is greatly reduced. When Pitocin is used continuously, contractions last longer and have little break between them, sometimes resulting in one contraction beginning before the previous one has ended. With long-term Pitocin use, the baby can very easily go into distress from lack of oxygen. This can lead to an emergency cesarean to help prevent brain damage to the baby.

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Another complication that is related to elective induction is that of potential due date error. The process of determining a due date can be slightly off, leading to a 1-3 week discrepancy. This may not sound like a large amount of time, but as it concerns a baby in-utero, it is. A friend of mine was induced in what her doctors thought was her 38th week, but found after the baby was delivered that they had been off by 3-4 weeks, and the baby was 34-35 weeks. He was in the NICU for one month, and was not able to breathe or eat on his own for a majority of that time. Overly intense labors due to Pitocin can also lead to intensive care for the mother, as was the case for one of the women I personally surveyed.

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In the end, the goal is a healthy baby and a happy mom. Now that you know what Pitocin is, how it’s used, and its relationship to further birthing interventions, I hope that you are encouraged to investigate all of the procedures surrounding your own childbirth experience, so that you can make educated decisions as a parent. Thank you.

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