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What is Pitocin??
What is Pitocin? Pitocin is synthetic oxytocin.
Oxytocin is our love hormone. This is what we release naturally in our bodies when we feel safe, supported, loved, when we orgasm, when we hug someone we love, and when we kiss someone we love. In the postpartum oxytocin supports breastfeeding with the milk letdown reflex.
During labor, oxytocin causes uterine contractions and it’s a very helpful hormone within our bodies for starting and sustaining labor.
Synthetic oxytocin is Pitocin, which can be referred to by other names in different countries. It is made in a lab and it’s administered through an IV or sometimes given as a shot.
Pitocin is administered usually through an IV. Pitocin is slowly increased at a set amount at a set interval (15 to 30 minutes) over time until your contractions are 2-3 minutes apart, lasting for one minute. It can be helpful to ask your medical team to explain how they commonly administer Pitocin at your birth location if you are feeling anxious about Pitocin.
What are the risks of Pitocin?
The general risks of Pitocin include:
- Contractions can become too close together or too strong, and baby starts to have difficulty with labor. This can cause their heart rate to drop, and may lead to an emergency c-section if their heart rate continues to decline.
- The way this is mitigated is that your medical team should slowly increase Pitocin and monitor how you and your baby are tolerating the amount of Pitocin.
- You can also have an internal monitor placed to assess the actual strength of your contractions to ensure they are not too strong for your baby.
- Pitocin could increase your risk of postpartum hemorrhage if used for a prolonged time. There are only so many oxytocin receptors in the uterus, and if you have received Pitocin for a prolonged period, those receptors can be flooded. If the receptors are flooded after birth, the uterus may have more difficulty clamping down to stop bleeding. It may not be the Pitocin alone leading to this increased risk because you are usually having other interventions if you have been on Pitocin for some time, but it is still worth noting.
If you need Pitocin during your labor, it can be helpful to discuss with your provider the risks and how they mitigate those risks in their facility.
Are Pitocin Contractions More Painful???
The goal of Pitocin is to cause uterine contractions. That is the only similarity that it has with oxytocin (our naturally occurring labor hormone). Because Pitocin is similar but not the same as oxytocin, our labor hormone, how you perceive your contractions may be different.
Many of us may be afraid of Pitocin, especially if we want an unmedicated birth because we are told that these contractions will be more painful and unbearable.
Since Pitocin is a synthetic oxytocin, it does not impact how we feel about our contractions. Oxytocin causes us to also release endorphins that act as natural painkillers, which can help make contractions feel less intense. In addition, oxytocin will ebb and flow throughout your labor based on what you and your baby need–if you need to rest, or your baby needs more time to recover, your oxytocin levels will decrease to allow your contractions to space out. Pitocin does not ebb and flow, as it is a continuous administration over time. So, if your body or your baby needed a break, the Pitocin would not slow down in response to this. The combination of these two factors can increase the pain you feel with contractions with Pitocin.
Another factor that may impact how your contractions feel is your mental state! Your mental state is so important for your birth, especially coping with labor contractions.
If you are receiving Pitocin, your birth plan may be changing from what you were planning. For example, if you were planning a low-intervention, unmedicated birth, and suddenly you need a medical induction, you might be feeling a little more anxious.
In my first birth, I had my labor augmented with Pitocin. Comparing my contractions between my first birth with Pitocin and the next two without Pitocin, I can say that the non-Pitocin contractions were much more tolerable. However, I am not sure if it was because of the Pitocin or because I was feeling incredibly stressed and anxious during my labor that made it harder for me to cope. It is a valid fear to be concerned that Pitocin can make your contractions more painful!
How to Cope with Pitocin Contractions
Pitocin contractions are reported to be notoriously more painful than oxytocin contractions. It may be that Pitocin doesn’t cause your body to also release endorphins for pain relief like oxytocin does; maybe it relates to the fact that oxytocin will ebb and flow during your labor based on your needs, while Pitocin is a continuous flow. Or maybe it relates to your mental space, where you might be feeling more anxious or stressed because you need Pitocin.
Regardless, Pitocin contractions are reported to be more painful–how much more painful is not measured, but let’s discuss some ways to help you cope with Pitocin contractions!
- You can set the environment to help increase the release of your naturally occurring oxytocin! This could include dimming the lights, playing soft music, speaking with quiet voices, and having your partner provide physical support during your labor. This can help with your mental space, as well!
- Nipple stimulation to release more oxytocin! You can use your hands or a breast pump to stimulate the release of more oxytocin to decrease the amount of Pitocin you may need. Your hospital will likely have a breast pump that you can use, or you can bring your own.
- Labor comfort measures, such as counter pressure, TENS, and shower/tub, are all things you can have your partner do during contractions to decrease the intensity of your labor contractions. Partner support can also help with your mental state!
Why even bother with Pitocin?
Pitocin is primarily used in labor induction to start uterine contractions. Pitocin is not always the first step in induction, and you may not ever need it during your labor either! Sometimes an earlier induction step gets you into active labor.
As much as we would like everyone to go into spontaneous labor and not need any interventions, including Pitocin, this is not the reality that we live in. There are reasons that someone may need to or want to be induced near the end of their pregnancy.
Some reasons you may need Pitocin:
- You need a medical induction due to a pre-existing or new prenatal complication, such as pre-eclampsia, gestational hypertension, cholestasis, or gestational diabetes.
- There are general guidelines on when you may be recommended to have an induction, such as at 39 weeks if you have gestational diabetes–but you are an individual and the decision to have a medical induction should also consider how your current health is!
- With a medical induction, the risk of continuing your pregnancy may outweigh the risks associated with Pitocin and induction. It is worth discussing with your provider your options if you do not want an induction yet, such as additional monitoring of baby.
- You are opting for an induction when you are past your due date and nearing 42 weeks. Some clinics recommend inductions right at 40 weeks, other 41+3, and some closer to 42 weeks. Communicating with your provider your preferences is important.
- You are choosing an elective induction for personal reasons. This could include your partner being in the military and about to deploy, so you want to schedule an induction when they are still home. Or you may have limited time that family can come support you, so you want to schedule an induction. The reason that YOU choose an elective induction is personal and your decision.
- You are experiencing a labor stall that is impacting your labor progress. This could be related to your energy levels, nourishment, health, and even how you are mentally feeling.
Watch this YouTube video for our 10 tips for labor induction! We share our top tips from our experience as a birth doula and labor nurse–the most important being that you feel informed and comfortable that choosing induction is the best option for you.
What options do you have with Pitocin??
If you do need Pitocin, did you know you had options with it?? First, you can try nipple stimulation with your hands or breast pump to see if that starts contractions for you before progressing to Pitocin!
Next, if you find that your contractions are too strong and you’re having trouble coping, you can ask for the Pitocin to be turned down or even off.
You may receive some pushback with this, as the fear that if your Pitocin is turned down or off you could lose the progress you’ve made. But I have found that if someone is “fighting” their contractions and struggling to cope, it can affect how you feel about your birth AND it can impact your labor progress because you’re struggling to relax. If your request to turn down or turn off the Pitocin is denied or ignored, ask the nurse to put in your chart that you requested the Pitocin to be turned down or off and the staff refused. You maintain your autonomy during your birth at all times!!
And then if your labor is not progressing or you are still not really feeling contractions, ask for a break! This will give you the chance to eat, shower, and reset before trying the induction again. If you are at the hospital for an ELECTIVE induction and your water is NOT broken, you can also just leave and go home.
Is Pitocin Evil?? No!
You may also find that once you’re in an active labor pattern with Pitocin, turning it down will allow your body to take over on its own! It is evidence-based to turn down or off the Pitocin once you’re in active labor to allow your body to take over.
Pitocin is a TOOL available for you IF you need or want it for your birth. Not everyone will need it, and not everyone wants it–and this is okay. It is important that you feel informed on WHY Pitocin is being recommended and confident that its the best decision for you and your birth.
Pitocin is reported to be more painful than oxytocin contractions, so you can do things to help with your oxytocin release to decrease the pain. This could include setting up a birth cave type environment with dim lights, quiet voices, and physical support from your partner.
And you have OPTIONS with Pitocin!! Be sure to communicate your preferences and know that you maintain autonomy during your birth at all times!
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