Written by

Roxanne Albert, BSN, RNC-OB

October 3, 2022

Pitocin vs Oxytocin: What’s the Difference in Labor?

Birth, Birth Options, Induction

What is the difference between oxytocin versus pitocin during labor?

When it comes to pitocin vs oxytocin, both work in a similar way in that they cause uterine contractions to both help labor progress and stop bleeding in the postpartum…but that is where their similarities really end.

Oxytocin

Oxytocin is our “Love” hormone. We release it when we feel, safe, supported, and loved. Actions like hugging, kissing, dancing, or having sex with someone we love and care for can stimulate the release of oxytocin.

1. Labor Feedback Loop

Oxytocin also plays a huge part in labor! It is part of our labor positive feedback loop along with prostaglandins, that stimulates and sustains labor. Oxytocin tells the uterus to contract, the uterine contractions increases the amount of pressure on the cervix, the pressure on the cervix stimulates the release of prostaglandins, the release of prostaglandins stimulates oxytocin. Then the loop goes on and on until a baby is born.

2. Labor concentration

Since for labor the stimulation and release is in a cyclical manner, the concentration of oxytocin is constantly changing throughout the entire phase of labor. It is all based on feedback from the body on how much oxytocin is released at any given time. This is why in normal physiologic birth there are natural pauses throughout labor based on our bodies needs. It is also why labor can be stalled during stressful periods where we may feel unsafe or unsupported!

3. Affect on the Brain

Oxytocin as an effect on our brain when it is releases because it crosses over our blood brain barrier. It gives us this happy and loved feeling.

Therefore, during labor we have this happy, loved, and safe feeling from the effects of the oxytocin while also having the contractions.

Pitocin

Pitocin is the synthetic form of oxytocin. It is delivered by an IV (Intravenous) catheter at a certain concentration. For induction of labor, It starts at a lower number and then is increased at an interval determined by your doctor. (Most commonly increase by 1-2 units every 30mins). The amount given does not change often, throughout the entire labor it is usually at the same amount for long periods of time.

Pitocin is used to stimulate uterine contractions. For labor, the contractions are to cause cervical change. Postpartum it is to help the uterus contract to stop bleeding from the wound where the placenta was attached.

As with ay intervention in life, there are risks and benefits of Pitocin use. Some include:

Birth Worker Course

Approach supporting pregnancy and birth with anatomy, physiology, and evidence-based information. Support your patients and clients by understanding what is happening during labor; the anatomy of the pelvis and baby’s movements; and more!

Benefits

Induction of labor when unsafe for pregnancy to continue
Treat/Prevent Postpartum Hemorrhage – #1 cause of maternal death
When given IV – can be turned off and effect wear off within 15-30 mins

Risks

Prolonged use could increase risk of postpartum hemorrhage
Contractions too often and/or too close together causing distress in baby
Contractions are perceived to be more painful/stronger

Pitocin vs Oxytocin: Major Differences During Labor

Oxytocin and Pitocin work similarly in that they are causing uterine contractions, but they are also VERY different. This is why a lot are almost fearful of induction, because the contractions from Pitocin are different. The whole labor is perceived and felt differently. But Why?

1. Concentration/Administration

Oxytocin and Pitocin differ in the amount that is in the body at any given moment. This can affect the way that labor is felt by each!

Oxytocin is constantly changing in concentration throughout all of labor based on what the body’s feedback is. It changes to either increase and ramp up labor, or slow it down based on our body. There are natural pauses in our labors when our body senses it need something. Whether it senses we are in an unsafe environment, need for nourishment, or a need for rest.

Pitocin does not change easily, and usually remains at a certain dosage at all times. There are no natural pauses in labor when pitocin is used. If your body is in need of rest or nourishment, the contractions will continue regardless. This can greatly affect our ability to cope.

2. Contraction Strength

This is a difference that anyone who has had both a normal physiologic birth and Pitocin labor will tell you is real!

A common statement made by those is that Pitocin was WAY WORSE.

3 Reasons this is the case

Pitocin does not cross the blood brain barrier so contractions do not give you the happy and euphoric feeling that oxytocin does. So our perception of the contraction is different.
With inductions, labor are usually different and harder than spontaneous labor. When we are forcing our body to do something it was not yet ready to do can cause it to be harder. Inductions also take a LONG time sometimes, so you may be more fatigued once they start Pitocin, unlike with spontaneous labor sometimes.
The difference in the amount of the drug/hormone in our body, If our body needs a break during labor, we get that break with oxytocin. Contractions slow down to make it more manageable to do what we need to do. With Pitocin, we don’t get that break. This can make it harder to manage labor mentally and physically.

3. Readiness of Body

When Pitocin is being during labor it induce labor, so the body was not yet ready for labor to start. This can make it a longer and harder to achieve. The cervix may not be ripe, which makes it harder for oxytocin to do its job.

When oxytocin is kick starting labor, it is usually because the body was ready to baby to come OR baby needs to be born because something is going on in the body. Either way the cervix is usually ripened and baby is ready to come. This can make the process “easier”

Pitocin is a great tool that we have in our toolbox for when it is needed. Some need to be induced for medical reasons, I love that we have an option to get labor started for them. Understanding the difference between oxytocin and pitocin on labor can help us either make decisions for our labor process, or help support our patients/clients make decisions about their labor.

Learn more about Labor and Birth Options in our Childbirth Education offerings if you are currently expecting!

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Frequently Asked Questions

Is oxytocin or Pitocin better?

Neither one is "better" — they are different tools for different situations. Oxytocin is the hormone your body makes naturally to drive labor and help you feel safe and loved, while Pitocin is its synthetic form, used when labor needs to be started or supported for a medical reason, or to help prevent bleeding after birth. Both cause uterine contractions, but the right choice depends entirely on your individual circumstances, so it is a conversation to have with your provider.

Is Pitocin another name for oxytocin?

Not quite — Pitocin is the synthetic form of oxytocin, the hormone your body releases on its own during labor. They work in a similar way by causing uterine contractions, but Pitocin is delivered through an IV at a steady dose, while your body's natural oxytocin rises and falls based on what your labor needs moment to moment. So they are closely related, but they are not the same thing.

Why do doctors push Pitocin?

Pitocin is used to stimulate uterine contractions when there is a reason to start or support labor. The most common reasons are inducing labor when it is no longer safe for the pregnancy to continue, and treating or preventing postpartum hemorrhage — the number one cause of maternal death — by helping the uterus contract firmly after birth. It is a tool with both risks and benefits, and your provider should walk you through why it is being recommended in your specific situation.

Why are moms against Pitocin?

Some are wary of Pitocin because the contractions can feel different from those in a spontaneous labor. Because Pitocin usually stays at a steady dose, you do not get the natural pauses your body would normally give you to rest, and the contractions do not bring the happy, euphoric feeling that natural oxytocin does — Pitocin does not cross the blood-brain barrier the way your own oxytocin does. This can make labor feel more intense and harder to cope with, but it does not mean Pitocin is bad; it is a tool with real benefits when it is needed.

Why is Pitocin not recommended?

Pitocin is not "not recommended" — it is a great tool to have in the toolbox when it is genuinely needed, like a medically indicated induction or stopping bleeding after birth. Like any intervention, it does carry risks: prolonged use can increase the risk of postpartum hemorrhage, and contractions that come too often or too close together can cause distress for baby. The goal is not to avoid Pitocin entirely but to understand its risks and benefits so you and your provider can decide when it is the right choice for you. ---