Pitocin: Should You Use It During Labor?

Can we talk about how astonishing the human body is? Not only can it make and support life, but the way it does it is positively brain-bending! Like, the heroic, but shy, hormone called oxytocin (which in synthetic form is called Pitocin). Also called the love hormone, oxytocin does not seek the spotlight, but this indispensable ingredient plays a starring role in romance, sex, pregnancy, birth, bonding, and breastfeeding. Which is all quite a bit more interesting its high-profile hormonal siblings that tend to grab all the headlines—the stress queen, cortisol, and the sugar princess, insulin.

Oxytocin vs Pitocin

Oxytocin definitely should get a best supporting actress Oscar for her role in your birth and postpartum rom-com. In fact, besides helping you fall in love and have sex to make your baby, this versatile actor also helps you squeeze your baby out…when the time is right. Synthetic oxytocin—also called Pitocin—is sometimes given during labour to contract the uterine muscles to advance the birth process swiftly and efficiently.

It is amazing! But as amazing as modern medicine can be, it does not always mean that it is always needed. So, let us look at Pitocin…and what does it do and—more importantly—should you use it during childbirth?

What is Pitocin?

Pitocin is the man-made version of the 'love hormone' oxytocin. In addition to helping boost your mum-baby bond after your bundle has arrived, oxytocin kickstarts labour by getting the thick walls of the uterus contracting to help push your baby down and out.

Using Pitocin to induce labour:

For centuries, midwives have tried to jump-start a tardy labour with nipple stimulation. Interestingly, that works by stimulating a the release of natural oxytocin. Now medical specialists use IV Pitocin as a more controlled and predictable way to encourage labour. When a mum has been trying for many hours but does not seem to be progressing—or if the bag of waters broke many hours before and doctors are worried that bacteria might sneak in and infect the baby—doctors may suggest Pitocin to pick up the pace. Once given, Pitocin usually brings on strong contractions that will move the birthing process much more quickly.

When to use Pitocin to induce labour:

Using Pitocin is all about timing. If the cervix is not ripe (softening and thinning out—called effacement—and staring to dilate), then Pitocin will not help. It would be like squeezing hard on a tube of toothpaste…with the cap still on! Pitocin makes the uterus tighten and push—but it cannot make the cervix to open up. Doctors measure the dilation of a cervix and anything less than 6 means that the cervix is not ready for labour (doctors call that the Bishop’s Score).

Once the cervix is ready, if the decision has been made to use Pitocin induction, a nurse will administer it through an IV. Since it is such a powerful drug, doctors tend to start with a small dose, rather than pushing the pedal to the metal. (Pitocin can bring on very powerful contractions, so it is usually used in tandem with an epidural to keep the pain manageable.

How fast does Pitocin work?

Exactly how fast Pitocin starts to work will vary, but most birthing people feel the increased intensity and frequency of contractions within 30 to 60 minutes. As the cervix is getting more and more dilated, the nurses may continue the Pitocin or stop it, depending on how well the contractions are going.

What are the pros of using Pitocin?

When labour just is not progressing, Pitocin can save the day. It moves labour into a faster, more efficient pace. And in the case of specific risk situations, it is literally just what the doctor ordered.

Pitocin may be recommended for mums in labour who are dealing with:

stalled labour (failure to dilate, which may lead to a c-section if not remedied)
gestational diabetes
post-term pregnancy (when a baby is two or more weeks past the due date)
premature rupture of membranes (once your water breaks, infection can enter the womb and cause an infection to the mum and baby…so, time is of the essence)
chorioamnionitis (a situation where infection has already entered the uterus)
pligohydramnios (when amniotic fluid is very low, the baby is no longer floating and may start leaning on key blood vessels, causing signs of distress)
high blood pressure

What are the cons of using Pitocin?

Although Pitocin may be an example of how modern science can make something as ancient as childbirth a safer experience, there are still downsides.

Potential risks of Pitocin include:

discomfort (nausea, vomiting, increased pain)
excessive contractions (occurring too frequently, causing fetal distress)
fetal distress (reduced heart rate from compression of key blood vessels)
tear or rupture of the uterus (fortunately, this is a very rare complication)

Remember, the midwife or healthcare provider will start Pitocin on a low dose and only increase it based on how labour is going.

Be sure to talk to your provider if you are curious about how Pitocin factors into your birth plan. Whether or not doctors recommend Pitocin on your big day, having all of the information will help you be more in control and confident as you approach the incredible experience…that is birth!