Refusing pitocin?

csalagi

So I'm aiming for a natural birth at my local hospital and I know hospitals are well known for having "time limits" on how much you should be progressing throughout your labor.  I'm wondering what to do if my labor ends up not progressing as fast as they want it to.  Can I just refuse pitocin if they say I'm not progressing?  What is a safe time limit to wait until I should be concerned about not progressing?  Realistically is there any danger in a stalled labor if my water hasn't broken yet or are there still reasons to be concerned?  Sorry if this is a stupid question

Texas77again

honestly these are good questions for your health care provider.  they will know best what the limits are.  when i worked in TX the women were required to progress at least one centimeter every 4 hours once they were in active labor.  in OK that law does not apply. 

there are usually reasons why a labor has stalled if that occurs.  it can be that the baby is in a bad position, mom could be exhausted, problems with her cervix due to previous surgery...etc.  sometimes there is a reason to move the labor along to prevent stress on the baby. 

if mom and baby are tolerating labor well then there really is no medical reason to speed it up.  i would strongly recommend discussing this with your provider.

sschwege

These are good concerns, I was worried about this as well and so I labored at home as long as possible.  The longer you are in the hospital the more likely they are to want to start, "moving things along."  Trust your own instincts and as long as you are getting good fetal movement between contractions there is probably no reason to rush off to the hospital.  

csalagi

I'm definitely planning on laboring at home as much as possible!  I told DH I'm not leaving the house to head to the hospital until I'm in transition and he's so freaked out that I'll end up having the baby at home or in the car   I'm just asking in case my plans change and I end up having to be in the hospital sooner.

I guess I should bring this up to my OB, but even if I don't like what she says I have no other options for the rest of my pregnancy care.  She is the only OB my insurance will cover and I'm really afraid to bring my birth plan up to her because I don't know if I want to know what she has to say about it, lol

HappyMommy28

sschwege:

These are good concerns, I was worried about this as well and so I labored at home as long as possible.  The longer you are in the hospital the more likely they are to want to start, "moving things along."  Trust your own instincts and as long as you are getting good fetal movement between contractions there is probably no reason to rush off to the hospital.  

This exactly!  My MW even told me to stay at home as long as possible.  Otherwise they would try to "speed things up" However, in general I believe you have a right to say no to pitocin or any other meds going into your body.

spark&echo

csalagi:

I'm definitely planning on laboring at home as much as possible!  I told DH I'm not leaving the house to head to the hospital until I'm in transition and he's so freaked out that I'll end up having the baby at home or in the car   I'm just asking in case my plans change and I end up having to be in the hospital sooner.

I guess I should bring this up to my OB, but even if I don't like what she says I have no other options for the rest of my pregnancy care.  She is the only OB my insurance will cover and I'm really afraid to bring my birth plan up to her because I don't know if I want to know what she has to say about it, lol

You can always refuse an intervention.  It may be a fight, but if you go in with a good advocate and knowledge on your side, then that will help.  They can't really make you do anything, but they can pull out all the stops and scare the crap out of you.  Is it possible for you to hire a doula?  

As far as not discussing your birth plan with your OB, I think it's best that you do.  (I can't tell if you were kidding about that or not.)  That way you both will know what the other feels.  This isn't something you want to do while you're in labor.  Have the conversation beforehand - trust me, knowledge is power, and if you know where she stands, you'll be able to get a good game plan in place for how to deal when/if you guys end up butting heads.

madhatter2003

You can always refuse it. And if the baby is doing well there isn't a need to speed up labor unless it's completely wearing you out.  I had prodromal labor with DD and did end up going with pitocin after 4 days of contractions. I just couldn't get into a regular pattern even with walking, using the birth ball, acupressure, etc.

 

julyjennifer

I labored at home for much of my labor, and when I got to the hospital I was at 10 cm. So I don't have any experience about declining interventions in the earlier stages, but we did decline a few interventions during the pushing stage.

The MW on duty was not the one I'd had for prenatals, so I didn't know her at all but I hardly noticed that she was even there whenever she came because I was so far into labor that I was only aware of things that were within about 6-12 inches from me.  My pushing stage was going over 3 hours and DD's heart rate was dropping some with the ctxns and apparently the MW wanted to use pitocin, but my DH just shook his head at her knowing we didn't want interventions and he said she gave him a look like "maybe you should just let me do my job" but she didn't push it.  I don't remember hearing about the pitocin idea myself (but I was very inward-focused at that point).

She told me that she may want to do an episiotomy, and I told her "I'd really rather not.  Is there anything else we can try?" (I am proud that I had so much presence of mind at that point in labor).  I think the nurse suggested I change positions somewhat and that seemed to help.

I do remember the MW telling me that she needed me to push this baby out asap.  Probably 10 minutes later I managed to push her out, and she got 9s on her Apgars.  DD was left occiput posterior (sunny side up) so it was more work to get her out.  I knew she was fine and I knew I could do it.  I was in my zone doing my birthing thing and I didn't really let the MW get in the way of that.  My DH was a good advocate for me. 

Pamela05

Texas77again:

honestly these are good questions for your health care provider.  they will know best what the limits are.  when i worked in TX the women were required to progress at least one centimeter every 4 hours once they were in active labor.  in OK that law does not apply. 

I would like to know what Tx law that is.  I can find nothing in the Tx Administrative Code that gives a timeline, just that a midwife must monitor (and maintain records of ) failure to progress.  I cannot find the same specifications for an ob.  And nowhere does it give timeframes.

kspies

Definitely make your wishes clear to your provider before you go into labor. My doctor knew how badly I wanted to avoid pitocin so she was able to provide me with some alternatives when I had to be induced, namely nipple stim (instead of hooking me up to pit I did 10 min on/30 min off the breast pump for a couple hours). I got my records from the hospital and they said "declined/refused pitocin" (not sure what the difference is!) even though they never directly told me "we need to start pitocin." It seemed like most of the nurses/doctors I dealt with didn't know how to deal with a laboring woman who didn't have a pit drip (but your doc is the one that matters!). Now if you have to be induced and your cervix is high and tight, it might be a different story. But it absolutely can be done, and remember that it is always your choice. 

mzclaire

yes, it is always your choice!

If the hospital staff is asking you to use an intervention that you don't want, you can always ask for alternatives. A simple "We'd like to try a few alternatives first" goes a long way (or so I've been told.) Alternatives being changing position, walking, etc.

We're going to labor at home as long as possible, too. That's why I'm hiring a doula, to help me labor at home, and to let me know when we need to get going!