Pitocin use

blue_elle · December 2013

I was searching some info on the web and landed on the All Nurses site. They have an L&D board that I've been perusing and it really is an interesting look inside the nurses view of L&D - https://allnurses.com/ob-gyn-nursing/

Some of it is funny (strangest baby names?) and much of it is just general chatter. And then I came across the "Pit to Distress" thread on page 2 and discussions of pit use in spontaneous delivery.Clicking through the first few pages or doing a quick search will bring up thread after thread discussing what many of these nurses seem to feel is overuse or unnecessary use of pitocin. This is something I'll be discussing with my doc at my next visit; I'm all for doing what we've got to to reach the end result of healthy mom and baby, but I'm not on board with doing things when there's no need to.

Interested to hear what other's experiences have been with pitocin. Those of you who have had spontaneous labor before - were you administered pitocin? Did you feel like you were given time to progress on your own before, or do you feel like it was done as a matter of routine?

tesskerr · December 2013

I live in New Zealand, and it's pretty in heard of to be given pitocen. I think it is used as a last resort in an induction, and also as a last resort for stalled labours.
We generally labour at home for most of it, and only go to to hospital to deliver the baby, so it's a bit different.

Our rate of epis and cs is much lower as well.

waterlily2k2 · December 2013

My only experience is with inductions, so I have no choice but to get pitocin. I didn't read the link. But I feel that if labor is progressing really slowly, it may help to have a small dose of pitocin to get things going quicker so that you have the energy to push. 36-48hr labors are exhausting. My induction with DS very much failed, and it was 5 days from start to delivery, and I pushed for 3 hrs total (I got a break somewhere in the middle). Not only was his head huge, but I was SO exhausted when it came time to push that I just couldn't do it. I was able to get him far enough down to where we could get some forceps to help. So I think it absolutely has its place in helping outside of inductions. I may get flamed for saying that, but I don't care.

*Obviously I'm in a bad mood today.

MrsGraham06 · December 2013

My 1st, my water broke at 6:30 AM. I was 9 days past EDD, and contractions never got closer than erratic 10-18 minutes apart. My MW talked to me about pitocin at 2, but my mom had told me of a bunch of studies showing the damaging effects of pitocin, so I was really trying to avoid it. However, with only being dilated to 2 cm at 4 PM, it was almost a necessity to get things moving faster to have the baby within 24 hours of my water breaking.

I honestly don't remember how things went with that L&D, besides not good (and I don't want to scare all FTMs here). But he is a great kid and has never shown the negatives of using pitocin (I never did the research myself, just went with what Mom said).

My other 2 were inductions, and they went fine. My OB made sure my cervix was "favorable" for induction, otherwise she wouldn't have gone through it. I think they started the pitocin higher for DS2 because he had tried turning, they used the pitocin to keep him head-down.

I would love to experience non-medicine-induced contractions at least once, but we'll see if I get that. I keep hoping that my body would figure things out by #4, but baby might not cooperate.

Stffhappns · December 2013

I have heard this term used, but you're only hearing part of the story. The full phrase is "pit to delivery or distress". This is going to be complicated to explain, and I'm not always good with words, so please bear with me.

Doctors use this phrase when we can't seem to get labor going without the baby suffering from fetal heart rate decelerations (the heart rate drops), when this happens, we do different interventions to include ultimately stopping the Pitocin. After so many hours of this game, if we are unable to start active labor the decision will be made (with the patient) to continue with the Pitocin so long as the baby can tolerate it. This means that either mom will deliver the baby vaginally or will need to be delivered via c-section.

I'm sure that in print this sounds much worse than it really is.

ac1259 · December 2013

Personally, my doctor was quick to jump on the pitocin train as soon as I had my epidural. As a FTM, my water broke at 3:30 in the morning, by the time I arrived at the hospital I was at 4 cm dilated, got my epidural around 5-6 cm an hour later. I was fully dilated by 2 pm but baby hadn't dropped and the doctor was headed in to be ready to push. She just told my nurse that if baby didn't drop we'd just "give you a little pitocin, you have an epidural anyway"....I was not really on board with that idea just for kicks because it slowed down slightly...and luckily by the time the doctor arrived baby girl had dropped and I was ready to push. But just from that experience I wasn't thrilled that my doctor was so quick to jump on giving pitocin at the first sign of labor slowing down- I seriously delivered my daughter in 12 hours with 2 hours of pushing...that is nothing for a FTM and I couldn't believe she wanted to push it to go faster! Luckily I didn't wind up needing it but I was not impressed by that. But...this is just my experience.

mj0413 · December 2013

I took a neuroscience class in college and the professor told us about pitocin being linked to higher instances of PPD and that it can block the chemicals that allow mom to bond to baby. That terrified me. I haven't done a ton of research about that in particular, but he is a super smart dude, so I trust him on that.

That said, if you need it, you need it. And I feel like each mom has to make her own labor decisions, so I'm certainly not trying to sway/shame anyone for any labor choice. That's just something I heard and thought may be of interest to some people!

LabPupLuv · December 2013

Thank you for posting this link! I just learned my OB wants to induce me no later than 39 weeks and pitocin is probably the only way he means to do this. I've heard heinous things about this drug but more than the harder labor contractions, PPD and lack of bonding associated with this, I worry about the effects on the baby. I'm just starting my research into this drug tho. Again, I don't think I will really have a choice about this.

Roses87 · December 2013

From working in L and D. Pit is definitely overused. We have nick names for the docs that love pit. Their pts def have a higher risk for a c section. I luckily work with my dr so I chose her knowing her practices first hand.

Just remember ladies you can refuse anything your dr brings fourth. Be a advocate for yourself and your baby!

rowanthefrog · December 2013

Pitocin is highly overused IMO and many docs jump to it too quickly. You DO have a choice, you can decline and ask to let your labor take its own course. Delay going to the hospital at the first sign of labor. Wait until those contractions are 5 minutes apart. Once you get into the hospital you get onto their "clock" and they start wanting to rush what is a natural..and sometimes slow...process. Sometimes labors will stall out and restart, it does NOT mean you NEED pitocin!!

Pitocin causes VERY intense contractions, which can sometimes put a baby in distress...and a baby in distress puts the OB in distress and then BAM...C-section for you, which could have possibly been avoided if the pitocin wasn't used.

There are other ways to get labor to get going again, nipple stimulation is a good one. (Try it at home now...rub your nipples a bit and watch those BH contractions kick up...don't worry, it won't put you into labor.)

In a way I'm lucky bc they won't use pitocin if you are trying to VBAC...I HAVE to go into labor on my own, I can't be induced and my labor has to progress naturally on its own. With my last VBAC I was in labor for 36 hours. I'm positive that had it not been a VBAC they would have wanted to use pitocin to make things go faster, but bc of the risks involved with pitocin and VBACs my labor had to take it's own natural course...and while it was a longer labor, I did deliver my baby in the end.

LabPupLuv, I'm not being snarky, but why does your OB want to induce you at 39 weeks? Is there a medical reason for it? If so, that is one thing, but you DO have an option to decline and ask to wait to go into labor on your own.

A

Bwhitten · December 2013

Both of my labors didn't progress "fast enough" while at the hospital so they gave me pitocin. I refused both times because they said the baby was fine but told me I had to leave if I didn't take it. I wanted to leave but my husband thought we should stay, I wasnt in the mood to make a big deal so I stayed. It happened at 2 different hospitals and I have wondered if they can just kick you out for refusing. I was 5 cm the first time and 6cm the second time.

rowanthefrog · December 2013

Bwhitten said:

Both of my labors didn't progress "fast enough" while at the hospital so they gave me pitocin. I refused both times because they said the baby was fine but told me I had to leave if I didn't take it. I wanted to leave but my husband thought we should stay, I wasnt in the mood to make a big deal so I stayed. It happened at 2 different hospitals and I have wondered if they can just kick you out for refusing. I was 5 cm the first time and 6cm the second time.

That's crazy

rowanthefrog · December 2013

And for the record, I'm not knocking anyone who HAS used pitocin. It certainly has it's time and it's place...but I do think that a lot of docs jump to use it way too often and unnecessarily.

A

LabPupLuv · December 2013

@rowanthefrog You are not snarky at all! I actually started an entire discussion yesterday about high bp and early induction to try and get some good advice from you all about this. I've had high bp for 10 years and have been on medication for around 6 or 7. My new OB in NC wants to induce me by 38 or 39 weeks bc of the risk I might turn pre-e. He doesn't want me to make to 40 by any means. I don't know how I feel about this considering I don't have any protein in my urine, no swelling, no vision issues, no headaches and baby is not at all on the small side in the 78th percentile. Yet when I google this, it looks like early induction for high bp is encouraged internationally. The articles make no distinction between GHB versus pre-pregnancy hb. @Roses87 What do you see in L&D re early induction for high bp alone?

AnnikaD20 · December 2013

One advantage of delivering with a practice that has OBs working on shifts is that they don't really care if your labor takes a while. They get to go home when their shift is over, whether you've delivered or not. They have a very low c-section rate because they don't push interventions just for "failure to progress."

The down side is that I don't really know a lot of the Drs who might deliver me. There are six in my group, and I've met 2. I hope I get my OB, cause she's great, but honestly being allowed to take my damn time is probably worth the trade off.

It's good to know your hospital's philosophy and policies. And be willing to say no if you don't think you really need something.

Roses87 · December 2013

Many ppl Are induced with chtn. Normally to be induced before 39 weeks you need to have a "good" reason. Well anyways a pt i had once was 38 weeks and here only thing was chtn. So I questioned her induction and brought it up to the dr and the charge rn (who agreed with me) and was informed by the dr that per ACOG chtn is a indication and she rattled other stuff off. And I saw some articles to back her up.

Sometimes pts that are before 39 weeks come in for an induction and actually are sent home because there dr made a mistake and they don't qualify to be induced. This is why I questioned it.

Anyways That pt i had That night ended up with a c section the next night due to failure to progress. (Probably because her body was not ready). This pt had controlled bp her entire pregnancy due to meds. Her labs we're completely normal, no signs of pre e. Many was beautiful on the monitor asc well. I personally thought her induction was unnecessary and she ended up with a c section for no reason.

I believe inductions are necessary if its due to the mother or baby are at risk to have there health compromised if she remains pregnant.

nbbride06 · December 2013

Let me preface this by saying that I was scheduled for an induction, went into labor on my own that morning, but went ahead and went to the hospital for my scheduled induction - so I was in really early labor. For me, pitocin=intense contractions without a break in between which=early epidural (2.5cm) which=stalled labor at 7cm=c-section after 28 hours. I'll be attempting a VBAC this time which means no use of pitocin. So wish I would have refused the pitocin with DD since I was just in really early labor, baby was not in distress, etc.

LabPupLuv · December 2013

@Roses87 Thank you! I think I might get a second opinion. My chtn seems to have nothing to do with pre-e and I don't want to end up like your patient in L&D. Baby is happy in every NST and I'm told he has a strong heartbeat. I'm not dilated yet at all. My fear is that my body won't be ready either and I'll suffer through hours of painful pitocin fueled labor, only to end up w a c-section and not be able to do skin to skin for 2 hours or more while healing from a major surgery all because of chtn that I've managed to control with Methydolpa for a decade pre pregnancy. I appreciate your feedback.

forevergraceful · December 2013

@labpupluv, can you let me know when you make a decision? I haven't had my dr mention inducing due to high bp yet, but I wouldn't be surprised if he does down the road. I really don't want to induce unless me or my baby are truly at risk.

JaneW2 · December 2013

Okay, can I just add one thing to the Pitocin = Bad Things reports being thrown around?

All those studies did not and could not control for the reason pitocin was used. Pitocin is often used in labors that are longer or more difficult than usual, therefore it is not surprising that some mothers and babies might have more problems after pitocin-augmented labor. It's the problems causing the pitocin, not the pitocin causing problems. Also, most of the associations were pretty weak, a "slight increase in risk" kind of thing, not a smoking gun.

So, if your doctor says you need it, DON'T PANIC!

kteeswei · December 2013

Thank you @JaneW2 from a preeclamptic mom about to be give pitocin (at 37 weeks).

waterlily2k2 · December 2013

I'd also like to point out that I was induced using pit with DS just shy of 38w due to possible pre-e. My liver counts were high (later found it was due to gall stones blocking it), and there was protein in my urine. My bp was elevated as well. It wasn't crazy numbers, but enough. Baby looked great on all NST's. As we found out later, it actually was not pre-e. 2.5wks after he was born, I had a stroke due to every vein in my brain being clotted as well as bilateral hemorrhages (this is why my bp was elevated and I had headaches). The clots had been there for approximately a month (so they developed 2 wks before I delivered). Had they waited for me to go into labor on my own, I may have stroked out either before or during labor, easily killing me and DS. I labored 5 days with him, and at no point was he under any distress. I did not end up with a c/s and successfully delivered him vaginally. He's a happy, healthy, completely normal 2yo. And there are plenty of stories of pit inductions that have happy endings. So if you need pit, you need it, and there's really no reason to freak out about it.

It honestly really bugs me that all I ever seem to hear/see are stories and "studies" about how awful pitocin is. I completely agree with @JaneW2 that there generally are underlying issues that cause problems with pit, instead of pit causing the problems. It all seems pretty biased to me.

I have no choice but to be induced this time. I'm on blood thinners, and this is the only way to have control over it and make sure I don't bleed out and have an increased chance of being able to have and epi. I'm nervous about it, sure. But it is what it is, and I fully trust my OB and the team of nurses and doctors.

moosebaby2011 · December 2013

I didn't go into labor on my own with DS, but instead had a pitocin-only induction that went very smoothly. It took 12 hours from the time they started the drug to the time that he was born. I didn't experience any issues with bonding with my son or with nursing.

I was really scared to be induced. I was afraid that the induction would fail, and afraid of all of the horror stories I'd read about different complications from pitocin. However, I agreed to use it because it seemed like the best choice at the time for my baby and for me. My birth experience ended up being an extremely positive one, and wanted to share that for the ladies who are nervous and facing induction.

MamaP19 · December 2013

mj0413 said:

I took a neuroscience class in college and the professor told us about pitocin being linked to higher instances of PPD and that it can block the chemicals that allow mom to bond to baby. That terrified me. I haven't done a ton of research about that in particular, but he is a super smart dude, so I trust him on that.

That said, if you need it, you need it. And I feel like each mom has to make her own labor decisions, so I'm certainly not trying to sway/shame anyone for any labor choice. That's just something I heard and thought may be of interest to some people!

@mj0413 - this is true. Pit is a synthetic form of oxytocin, the hormone that your body releases naturally when in labor. Oxytocin is the "love" hormone that helps mom bond to baby and gives you a post-birth "high." It also helps to block some of the pain from contractions. Pit stops your body from releasing oxytocin. Epis and spinals also affect how much oxytocin is released.

BuckeyeANG · December 2013

I had a pitocin only induction as well. My cervix was favorable and I was 40w. It was very smooth...less than 14 hours from the time the pit was administered to baby in my arms via a vaginal delivery. The only downside (and who knows if this was because I was induced) was getting stuck at 4cm for several hours because baby's head was tilted and he wasn't lined up quite right. A few position changes fixed that, although he did end up with a large bruise on his head which broke down and caused jaundice. Despite the pitocin and an epidural as well as a history of anxiety, I didn't have PPD or any bonding or breastfeeding issues. Just wanted to share my story for others who want to hear about a positive induction.

JaneW2 · December 2013

I wouldn't stress about birth bonding. We're human beings, not ducks. Many many mothers do not bond intensely at first sight, but still love their children desperately, both before and after birth. Some fathers don't see their children born, don't see them for days or weeks, and still love them well. And many many people can love children without even being a biological parent.

I think the idea of birth bonding is one more bit of unnecessary pressure on mothers, to do Everything Right Or Else.

rowanthefrog · December 2013

JaneW2 said:

I wouldn't stress about birth bonding. We're human beings, not ducks. Many many mothers do not bond intensely at first sight, but still love their children desperately, both before and after birth. Some fathers don't see their children born, don't see them for days or weeks, and still love them well. And many many people can love children without even being a biological parent.

I think the idea of birth bonding is one more bit of unnecessary pressure on mothers, to do Everything Right Or Else.

I agree with @JaneW2 on this one. I feel like a constant scare tactic thrown around for just about EVERYTHING is "you won't be able to bond with your baby!" Formula, C-sections, god knows what else.

For the vast majority of women the bonding is immediate regardless of circumstances of birth, breastfeeding (or not) etc. Yes...there are extenuating circumstances that can happen, PPD, sometimes a traumatic birth or experience might interfere but with time and recognition of the issue it can be overcome.

Do not fear your ability to bond with your baby. It is there, it is innate and it will happen, whether immediately or over the course of days or weeks or months as you learn all about this new little person in your life.

A

LabPupLuv · December 2013

@BalletLover I just PM'd you about this.

Thank you @JaneW2 and @waterlily2k2 and @moosebaby2011 for sharing your positive experiences with Pitocin. I've read a ton over the weekend on high bp and early induction and I think I will do what my doctor recommends. I would never want to hurt LO and I appreciate knowing that Pitocin may not be so scary after all, which is great because I most likely will use it.

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