Pitocin use...need help

molli_q · August 2010

Hello ladies,

I am just at my due date and am planning on a natural delivery. This is our first child so I am not sure what to expect. But I do know that although the baby is low and the head can be felt on my cervix, I am not dilated as of Friday. We talked to the dr. about our options if I go over my due date and he said he will let me go 41-42 weeks depending on baby, but I also asked him if I do go over and induction is necessary what he will use. He said he uses pitocin almost exclusively. I have been trying to research and all I am finding has not many good things to say about it. I am really not interested in this if I don't have to. I feel like it will damper our attempts to have a natural birth. Do you ladies have any thoughts. Thanks for your help. I just want the best for me and baby!

pepomntpat · August 2010

I would make sure to ask for the lowest dose possible and make sure you have the option to turn it off at times to see if your body has taken over the contractions.

Also, what is he using to ripen your cervix. That is imortant.

molli_q · August 2010

I need to ask him about that. I have been reading about cervadil...is this a safe option?

Cheekers2010 · August 2010

Good Morning!

Please continue to do research (especially on cervidil). There are also lots of natural methods that you can try before you get to the point of a medical induction. Try googling "natural induction methods." Many articles come up that include time-honored ideas (as well as the warning that you should always check with your doctor). If your doctor is not a big supporter of natural birth he will probably tell you to go ahead and try but won't have a lot of information. Just let him know what you're going to do.

Also remember that full-term is considered 38-42 weeks and some women and some babies just take a little longer to cook. I think the statistic is that only 3-5% of women deliver on their EDD. I am due the 12th of Dec but for my own peace of mind, I'm considering the following two weeks (up to Dec 26th) my "due weeks."

Hope this helps!

christina627 · August 2010

My induction was pretty easy, but I was ripe and 3 cm dialated. She stripped my membranes and then gave me the losest dose of PIT possible and only went up once and back down and finally off completely. No pain meds.

AutumnBride929 · August 2010

I would be pissed. Pitocin is not necessary for an induction and causes undue stress on the baby and mom. I would ask him to break my water before anything and use nipple stimulation on myself to keep the contractions coming nice and strong. Pitocin only goes into my body as a last resort and when medically necessary. Otherwise, it's not allowed. I am not a Pitocin-friendly entity. I speak from experience, lol.

d.cubed · August 2010

Pitocin works on a RIPE cervix. Ask about your effacement. If you are not effaced, it probably will NOT work and you will end up with a c/s.

Remember, you don't have to be induced just because your doctor wants you to be. Make sure that you REALLY need it (i.e. there is low amniotic fluid). A certain date is not the best reason to induce.

If you need to be induced, however, I would do every possible thing to start labor prior to using pitocin. Sex, nipple stimulation, acupuncture, primrose oil, etc. Personally, I'd even go to castor oil, IF my cervix was ripe. Otherwise, I wouldn't touch the stuff.

I would not have my bag of waters broken, however, because then you've just put yourself on the clock and breaking the bag does not always lead to contractions. By breaking the bag, you may have just set yourself up for a c/s. Also, it seems that contractions are MUCH harder once the bag is broken.

If it comes down to a medical induction, I would definitely request the cervidil before the pitocin, just to get your cervix ripe enough so that the pitocin actually does work.

GL!

carpozi · August 2010

Besides the other natural induction methods PP mentioned, you can also try a chiropractic adjustment (I suggested this to a friend in my Bradley class who was going to be induced in a few days if she didn't go and 6 hours after the adjustment she went into labor. Her hip joint was turned in a big and blocking some of her pelvis!) and you can also try castor oil, but make sure to tell your dr. cause there are risks with it. You still have time... good luck to you!

AutumnBride929 · August 2010

d.squaredII:

I would not have my bag of waters broken, however, because then you've just put yourself on the clock and breaking the bag does not always lead to contractions. By breaking the bag, you may have just set yourself up for a c/s. Also, it seems that contractions are MUCH harder once the bag is broken.

I don't think AROM means you may have set yourself up for a c-section (and, obviously, that wasn't the case for me but I know you didn't say it guarantees one). If you're going to get Pitocin anyway (whether it be because you had your water broken first and then didn't progress or straight away before the water breaks), I would opt for having it later rather than sooner. But, obviously, it's a personal decision... you will just have to weigh the pros and cons as you see them.

But if you are far enough along (like 42 weeks), your chances of an AROM alone working are quite good than if you were to get an AROM at 40 weeks, ykwim? So it all depends on your favorability no matter the induction method that you choose. I have heard of starting on Pitocin and then being taken off of it because your contrax are coming along nice and strong so there are lots of different circumstances. It's hard to decide what you want to do though, especially when you have a Pit happy doctor! The stuff just freaks me out with all of the risks that come along with it.

MamiMoore · August 2010

As a fellow natural bumpie, my advice is to stay away from pitocin. It's a synthetic hormone that has side effects. A lot of times it causes too strong a contraction making the pain more difficult AND affecting baby's heart rate. IMO, Pitocin, and other induction drugs, are the beginning of the drug rollercoaster. Also, because it's administered intravenous you must be hooked up to the machine which will limit your movement and your ability to change positions. I know that women can be induced with Pitocin and still have a epidural free vaginal birth, but I personally would not take the chance unless baby MUST come out. A lot of times doctor's don't think of the idea that the due date that you have is an ESTIMATE. 43 weeks could actually be your 42 or 41 week and baby would be on time. Do some research on natural ways to induce... walking, sex, castor oil, spicy food, etc and work with those first before going straight to pharmecuetical drugs that IMO aren't made in your best interest or babies but for the doctors to control timing. Good luck with everything. Regardless of what happens I hope that you have a safe delivery.

mysticporter · August 2010

FWIW, I would talk to your doctor specifically about what restrictions go into play with AROM and/or pitocin. I was induced for medical reasons with my last LO, and in hindsight, I would have avoided AROM. The pitocin was fine (I avoided pain meds), but although I was allowed out of bed to move around on pitocin, once they broke my water, I was stuck. That made things a lot harder and I believe caused some slowing of labor.

d.cubed · August 2010

AutumnBride929:
d.squaredII:

I would not have my bag of waters broken, however, because then you've just put yourself on the clock and breaking the bag does not always lead to contractions. By breaking the bag, you may have just set yourself up for a c/s. Also, it seems that contractions are MUCH harder once the bag is broken.

I don't think AROM means you may have set yourself up for a c-section (and, obviously, that wasn't the case for me but I know you didn't say it guarantees one). If you're going to get Pitocin anyway (whether it be because you had your water broken first and then didn't progress or straight away before the water breaks), I would opt for having it later rather than sooner. But, obviously, it's a personal decision... you will just have to weigh the pros and cons as you see them.
But if you are far enough along (like 42 weeks), your chances of an AROM alone working are quite good than if you were to get an AROM at 40 weeks, ykwim? So it all depends on your favorability no matter the induction method that you choose. I have heard of starting on Pitocin and then being taken off of it because your contrax are coming along nice and strong so there are lots of different circumstances. It's hard to decide what you want to do though, especially when you have a Pit happy doctor! The stuff just freaks me out with all of the risks that come along with it.

It's crazy how many options there are! I totally agree that it depends upon your situation. At 42 weeks, with a ripe cervix, breaking the bag could be all that you need to get things going! I am personally just a little leery of it because the hospitals around here only give you 24 hours to deliver once the bag is broken before a c/s. If it were even 48 hrs, I'd probably consider it before cervidil/pitocin. I would probably consider stripping the membranes before going to cervidil/pitocin too...

This is what makes it all so difficult. Every woman's body is going to respond differently to each of these suggestions!

christina627 · August 2010

AutumnBride929:
d.squaredII:

I would not have my bag of waters broken, however, because then you've just put yourself on the clock and breaking the bag does not always lead to contractions. By breaking the bag, you may have just set yourself up for a c/s. Also, it seems that contractions are MUCH harder once the bag is broken.

I don't think AROM means you may have set yourself up for a c-section (and, obviously, that wasn't the case for me but I know you didn't say it guarantees one). If you're going to get Pitocin anyway (whether it be because you had your water broken first and then didn't progress or straight away before the water breaks), I would opt for having it later rather than sooner. But, obviously, it's a personal decision... you will just have to weigh the pros and cons as you see them.

But if you are far enough along (like 42 weeks), your chances of an AROM alone working are quite good than if you were to get an AROM at 40 weeks, ykwim? So it all depends on your favorability no matter the induction method that you choose. I have heard of starting on Pitocin and then being taken off of it because your contrax are coming along nice and strong so there are lots of different circumstances. It's hard to decide what you want to do though, especially when you have a Pit happy doctor! The stuff just freaks me out with all of the risks that come along with it.

My options were AROM or PIT at 1 unit and increasing every hour. Our OB said that since I was very ripe and dialated to 3 already PIT was the best bet and wouldn't put me on the clock yet. I was only up to 2 units of PIT for about an hour bc they lowered bc they thought LO was under distress that high. My waters broke naturally about 3 hours after PIT was started and after about 6 hours of PIT, they turned it off completely.

Make sure he knows you are very admeant with natural birth plan. We were homebirthers, but our MW suggested induction after a BP at 43 weeks. The OB she set us up with used to teach Bradley classes and serviced as appretience MW for awhile so she was very aware of what we wanted and only suggested PIT bc induction was best for DS and my body was ready and she knew it would work well for us in our situation.

I would suggest if your body isn't ready yet and your baby is fine, than go as long as you can. And your body can dialate and ripen quickly, or you can be dialated and ripe for days before (a friend was at 5cm for like 5 days before she delivered.) Good luck!

triumphantreturnofplanningbug · August 2010

In addition to the other great suggestions for natural methods, I know several women who've had great results from moxa (lighting incense near a certain point on the pinky toe, usually done by an acupuncture professional).

If you have a naturopath in your area who is used to working with pregnant women, you can also consult about herbs that might help to ripen your cervix and start the labor process, but just like you wouldn't try your own chiropractic adjustment based on internet how-tos, you really don't want to just start making tinctures and popping tablets without well-trained guidance!

c1kaestner · August 2010

If you choose not to use pitocin my only suggestion is don't let the doctor use Cytotec. Although it is used for inductions and does work it has not been officially approved for Induction use. It is still only approved for ulcer treatment.

Do your research on natural and chemical induction methods then make a choice. That's my two cents.

pinkeggs · August 2010

c1kaestner:
If you choose not to use pitocin my only suggestion is don't let the doctor use Cytotec. Although it is used for inductions and does work it has not been officially approved for Induction use. It is still only approved for ulcer treatment.
Do your research on natural and chemical induction methods then make a choice. That's my two cents.

I was going to add this. Do not use cytotec. It's meant for stomach ulcers and is also used to help D&Cs along after a miscarriage. It is not approved for pregnant or laboring women.

FWIW, my doctor told me I was zero cm dilated and had at least a week to go. My baby was born 36 hours later after a quick labor. You just never know what your body will do!

molli_q · August 2010

ladies thank you soooo much for all this help! I read through it all and learned a lot. I knew you all would have some good things to say! We have an appt on Thurs and my hubby and I are going to discuss our other options. My doc has actually been very open until this point about all our other concerns with wanting as natural a birth as possible. I am anxious to see what he will say. We have a doula who is very knowledgeable too so I am going to mention this to her and see what she thinks. I again truly appreciate all of your help!

mamaweebie · August 2010

I was induced with DS because of low fluid levels, and I was given misoprostol to soften my cervix (2x, as a vaginal insert) and then started on a pitocin IV a few hours later.

I will say, the pitocin is very...intense. It makes contractions very hard, and mine were coming between 2-3 minutes apart the whole time. I did end up having a 'natural' delivery otherwise--I didn't have any pain medication. I don't think I would 'recommend' it to anyone. I do consider myself to have a fairly high pain tolerance, and I know that all of the nurses in my ward-although they were all very supportive-were super-surprised that I never got an epidural. They had never seen anyone on pitocin NOT have any pain medication.

Pitocin will also cause a LOT of swelling, which takes at least a couple of weeks to go down. I couldn't wear shoes out of the hospital! It was a good 14 days postpartum before I had ankles again.

I would recommend exploring other methods of induction before going the medical route again--accupressure, walking, some docs are ok with nipple stimulation, having sex, etc. I can also say that I had accupressure massage done on my legs and ankles the day before my induction, and by the time I went to the hospital, I was already 2 cm dilated (I had been soft but closed earlier at my doc's office, before the massage). And, many studies have shown that the use of pitocin ups your chances of having a c-section. (Once the docs start to administer it, if your contractions/labor don't pick up the way they want, they have a tendency to increase it, which can put the baby into distress due to the very strong contractions).

Lori

Wife to Morgan, Mom to Sebastian (almost 4)

Little BOY #2 on the way! Due 11.02.2010

PlainandTall · August 2010

Holy cow- there are so many opinions and experiences!! It's also tough to say what's what because medical protocols vary year to year- and may also vary depending on the patient or their history. Every woman's experience is valid and

I had two all natural VBACs... and my 3rd VBAC was drug free EXCEPT pitocin. Although I was nervous about the pit for all the above mentioned reasons- for me- I was on a deadline due to the fact that my water had broken (before labor began) Whats interesting is that in my first VBAC that happened as well- back then I was given a very strict 12 hr deadline to deliver- this time around I had a 12 hr deadline to be in serious labor- with, what I presume was a 24 hr deadline to deliver. Very different deadlines "set in stone" by protocol... also the first time I was not to get any sort of chemical induction due to the VBAC situation- but this time that was not a concern at all !!! It's crazy how some "RULE" will totally drive their approach to your care- an a few years later, same hospital different doctor- the rule is just no where on the radar! I wound up taking the offered pit at hr. 11 rather than 12 when it would have been much more strongly advised- and delivered by hour 13.5 ... although I am quite sure I did not *need* the pitocin to deliver- I probably did need it if I was going to deliver within the time limit they'd set. We used the lowest dose possible.

Things to consider- my water WAS broken AND I was dialated to about 6 when we started the pitocin- it wasn't just a totally cold cervix starting... but I did not need pain drugs and I've delivered drug free twice before and didn't feel that the pain this time was any worse. I'm also thankful that Eva and I don't appear to have experienced any other the other bad side effects I've heard about.

sbabe214 · August 2010

I was in the same situation as you - baby's head was low & I wasn't dilated - my cervix had thinned though. I tried every induction I could come up with! sex, acupuncture, moxa, adjustments, nipple stim, etc....(the list goes on) At 42 weeks (still no change) I was induced with cervical ripening agents for the 1st day/night, then pit was started the 2nd day @ 10am - by 1pm I was having mild contractions, by 4 I was in active labor. the OB did take me off of the pit @ about 10pm, I was contracting fine on my own - then I was put back on it @ about 1am because I had stalled at 9 1/2 cm. I didn't have any drugs other than for the induction, and although I have no other birth to compare this to - I didn't feel like the contractions were unbearable. I did have a doula & a very supportive DH - I moved a LOT during labor & used ThermaCare heat wraps (they were a godsend) for my back labor - which was worse then the contractions themselves. As a complimentary medicine practioner, I really wanted to stay away from all drugs, & my OB was supportive. Our DS was born after 12 hours of active labor, with 5 minutes of pushing. He was very alert afterwards & BF like a champ. Hope this helps - GL!

molli_q · August 2010

thanks again! I am going to hold out as long as I can. I believe I can hang there as long as we are both healthy. But as previous posts have mentioned there are so many options and so many outcomes that can occur with different women. I will keep you all updated. Right now I am trying my best to not focus on it and realize I am not in charge here

I am at the state where I believe this baby is going to come out when ready. And who knows maybe the due date is off and we are just jumping the gun. We'll see Wink

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