Augmenting w/ pitocin?

atc282

When I discussed my hopes to VBAC a long while back, I remember her saying that she wouldn't ever induce a patient but would "augment" with Pitocin-- if need be--once labor started on its own.

I feel like I've read this increases the chance of UR? She has never had a patient with UR but now I'm concerned that her augmenting could increase the chances.

Anyone have a small dose of pitocin and still successfully VBAC? Should I request that she not use Pitocin under any circumstances?

Thanks for any feedback!!

bugabean

It does increase the chances, but not by very much. My VBAC labor was rather heavily augmented with pitocin (I was surprised how much, tbh) and everything was fine. It seems I just have long labors, and I'd do it again in a heartbeat.

MrsJordanalmond

my ob will augment with pit, but not induce from 'nothing'.

while there are certain risks with pit, if your labor is stalled for too long it will increase your chances of a rcs.  it's all a delicate balancing act. 

chicsub

MrsJordanalmond:

my ob will augment with pit, but not induce from 'nothing'.

This.  I never needed it, but this was what my midwife said as well.

preg_amy

My labor was augmented with pitocin.  I was at pushing stage, but my contractions were kind of far apart, so it was hard to get my momentum going.

My MW suggested pit to get the contractions a little closer together to help things along.  She said that she thought the risks of UR wouldn't be enough to worry about, and if I ended up pushing forever because of the ctx being so far apart, that could possibly put additional stress on my uterus.

I wanted to try nipple stimulation first, but she said that she preferred pit because they could control it. If I pumped and my ctx were too strong or close together, they couldn't do anything about it, but they could always lower or turn off the pit.

They kept it at between 1-3, I think.  It worked and I only pushed for almost 4 hours, haha.  I think it definitely would have been longer without the pit.  My MWs were very low intervention and careful about anything that would cause UR or would stress the baby.  So I felt comfortable with trusting her.

 

So yeah, I don't think it's a bad idea to go in there with the idea that you don't want pit.  But I don't think it's necessary to completely rule it out.

Geekchick921

I'm pretty sure the studies vary, but I think augmentation with pit has an even lower UR rate than straight-up inducing with pit, but even that doesn't raise the rupture rate very much.  The practice guidelines from the ACOG don't rule out using pit to induce a VBAC patient.

BlinkingLight1

I wanted to avoid pit like a heart attack, but at 42.5 weeks I still hadn't gone into labor. I was induced with a foley cath (no active labor) then AROM (no active labor) then pitocin. I successfully VBAC'ed. I feel like my pitocin usage was more of an augmentation than induction. We started it at a 2 and got up to 8 (they said the highest was 36).

babyike

I was given a "whiff" of Pitocin, meaning the smallest dose possible (I think it was a 2 on the machine).  I went from 3cm to almost 5cm in about 20 minutes, and then to 10cm and complete within 2 hours.  Pushed for 13 mins and had a hospital waterbirth VBAC with midwives, a doula, and DH.  I was hesitant of the Pitocin because of my negative experience with DD, but it turns out my body just needed a little pick me up to help get things back on track after a long early labor with DS.  I think it's so important to stick with your plan if possible, but even more important to remain flexible and open to trying different options when your plan is is need of assistance... Just my two cents...

HTH!  Feel free to PM me with any questions you might have!  Good luck!

cwifekmom

I was induced with pitocin, and able to have a successful VBAC with no pain meds.  My pit ended up going up to 30, they increased it by 3 every half hour.  My doctor feels that the risk of pitocin is very small, so he will induce or augment with it when needed.  But my doctor tends to treat VBAC patients the same as non vbac patients with the exception of keeping a close eye on them for uterine rupture, and he will not use cervical ripening methods.