so does pitocin increase risk of uterine rupture or not?

delg23

I'm getting conflicting info on the internet. My doctor's said they may give me some pitocin if my labor slows down. Anyone find any good information on this?

TIA!

P.S I'm probably going to become a PW soon because I have to decide VBAC or not at my next appointment. Sorry in advance!!   

MAprincess

Generally, it does increase the risk a fraction of a percent.  But when properly monitored and giving a lower dose, the risk is minimal.  I had pit throuh my entire labor and they really pushed it up to ensure I could delivery vaginlaly (I had until 7 am to deliver before the hospital policies would have forced a c/s- I delivered finally at 2 am).

But I am glad that I had the pit.  I trusted my providers and knew they were watching me closely. FWIW, pit has increased risk in a non-VBACer.  But you also have to think about the fact that the actual risk of a VBAC is so minimal that I personally couldn't reconcile the risk of death to me in surgery over the fraction of risk in a VBAC (that I felt was practically erased when properly taken care of).  Ihad many difficulties in surgery (many in my family do) that made VBAC actually safer for me, overall.

I know there is a lot of info out there- good luck with your choice!  Also, you an alays decline the pit if that is not something you are comfortable with.  Your doctor will not force it on you, but that is a really positive sign that he will do that to give you the best chance of a VBAC.

cchill01

Everything MA said.  And technically, you don't have to decide until you're in labor or on the table.  You can always schedule, then change your mind.  The OR and delivery rooms are on flexible schedules.

BlinkingLight1

Yes, it does.

However the increase risk is a small one, especially if used in low doses. 

I had Pitocin with my VBAC and didn't have a rupture. 

babyike

MAprincess:

Generally, it does increase the risk a fraction of a percent.  But when properly monitored and giving a lower dose, the risk is minimal.  

But I am glad that I had the pit.  I trusted my providers and knew they were watching me closely. FWIW, pit has increased risk in a non-VBACer.  But you also have to think about the fact that the actual risk of a VBAC is so minimal that I personally couldn't reconcile the risk of death to me in surgery over the fraction of risk in a VBAC (that I felt was practically erased when properly taken care of).  Ihad many difficulties in surgery (many in my family do) that made VBAC actually safer for me, overall.

I agree with MA.  I also was given pit augmentation after a LONG early labor, and I only needed the minimum dose of "2" mius and it was only upped to a "3" after 30 mins.  I delivered 2 hours 15 mins after starting pit (went from 3cm / +1 station to 10cm / complete).  I am so thankful for my birth team and grateful I was able to feel completely safe and trusted their advice!  So very different from my labor and c/s with DD....  GL to you OP!!!

delg23

Thank you! I'm just a little concerned because I didn't react too well to the pitocin last pregnancy and that sent me into a c-section because of my son's distressed heart rate, but I went in w/ him having a distressed heart rate.

blf722

Pp have given you some good stats.  I had pit with my VBAC at 6 cm and my cervix was swelling, it kicked things up a notch and I had a successful 9 lb. VBAC baby.  With my first (induction) I did not respond to pit very well either, but luckily it worked well for my VBAC.  I agree with someone else above, you should be able to decide if you are VBAC whenever you choose.  I would be quite hesitant about a provider that made me decide that soon before the EDD.

Geekchick921

Ditto all the information MA gave you.  I also think there's less of an increase in the risk of rupture (or fewer studies that found an increase in risk) if it's used to augment spontaneous labor rather than straight-up induce.

Good luck at your next appointment! 

llamakins

My OB was comfortable starting at the lowest dose and creeping up. At that point my labor had stalled and I think the pit allowed me to have a vbac. just posted my birth story.

delg23

It makes sense that it would increase odds more to induce labor rather than help it along. They didn't say I have to decide or anything. They just said they "like to". I'm going to ask more details about under what circumstances would they want to do that. Its just that I know they do strongly suggest getting an epidural in case of emergency and I'm not comfortable not taking their advice on that one, but on the same token getting an epidural could lead to needing pitocin.

Basically, I'm just trying to weigh the experience, and odds of needing an emergency c against just having a planned C. The fact that there is less than the recommended time frame between my pregnancies makes more risk adverse. 

cwifekmom

I had pitocin to induce my labor and had a successful VBAC.  My doctor is highly successful and known for VBAC and I trusted him to monitor me.  He increased it slowly but it was not turned off until it was at a 30.  To me, the slightly increased risk was still less than the risk of rcs. 

 He will not induce with any cervical ripeners though.