Where to find objective Pitocin info

Sballerina · August 2015

I am quite set in my mind to aim for natural birth. My birth plan will have a lot of "No, unless medically necessary" on it. My group OB/midwife practice follows the national association recommendation of delivery by 42 weeks. I asked one of the doctors about their induction procedures for women who go past their EDD. She said at 41 weeks they will check you and the baby frequently. As long as you are ok, they will wait until just before 42 weeks to induce (41 weeks 6 days, I suppose). I was a little irritated (what if baby were to come naturally just a LITTLE past that? Ah but no, I don't have that option) but I have read that indeed the risks to the baby go up after reaching 42 weeks gestation.

I said that I had heard contractions brought on by Pitocin are stronger or more painful (not sure what I said) than those begun without intervention. The doctor said Pitocin contractions are the same as natural ones, and that the reason women say they are worse is because they start suddenly and strongly. I've read a lot of anecdotal reports in this forum from STMs (who may have reason to really legitimately compare Pitocin and non-Pitocin labor) that the contractions are different, if for no other reason than they last longer with less of a break in between. The doctor did not say anything about that, or give information to counteract it. She said nothing addressing the possibility it can cause fetal distress which then leads to them wanting to do C-section. She was running behind so it wasn't the best conversation. At the end, she said it is their goal to help us deliver as naturally as possible. Which makes no sense because I heard from an acquaintance that this exact doctor put alot of pressure on her to get an epidural delivering her second child, and she did.

So where can I get some objective information? Anyone found some links to explanations/summaries of research? Does Pitocin labor differ if the Pitocin is very gradually introduced? Whether you already have mild to moderate dilation and effacement? Does labor go better with Pitocin, and the risk of ending up in C-section go down, if prostaglandin suppositories or gel are used to help the cervix dilate and efface? Can cervical prostaglandin treatment induce labor successfully on its own or in combination with membrane stripping? How soon after membrane stripping will they "have" to administer Pitocin? Does it contain the risk of introducing bacteria in the same way breaking the waters does?

amberrmariee20 · August 2015

I never had pitocin, my water broke and my contractions started right away, and lasted 2 minutes each and about 3 minutes apart. I would consider that strong. My sister had pitocin with her 3rd baby and her 4th. Her 3rd baby she was 8 days over due, (they will only let us go 11 here) and her labor was long and hard, lasting 15 hours. With her 4th she was induced on her due date due to GD, baby came within 2 hours and he was born on the bed in the hospital before the doctor got in the room. With her 3rd she was dilated 1 cm, with the 4th she was dilated to 2 cms.

I guess the use of pitocin would depend on many factors, like if the baby's ready to come, if your body's ready for labor and stuff along those lines.

I'm also hoping I can go naturally again this time too, but I'm not aloud to go past my EDD because the size of my last baby was big and I had complications .

mandy903 · August 2015

I had pitocin during both my labors. The first I ended up getting an epidural at 8cm and the second time no pain meds just pit. Both my labors started and progressed on their own but my Dr at the time is a med pusher and liked to rush things. From my experience my contractions weren't unbearable until around 7cm. That's when things got really intense. And they get more uncomfortable when your water breaks to Of course. Even without pitocin contractions will get more painful toward the end. Pitocin just makes it that way the whole time you are on it. But I was still able to have a pain med free birth with pitocin. This time I am choosing to avoid any and all interventions unless me or baby are in danger.

leighann1 · August 2015

There is a chapter or two on this in the book Expecting Better by Emily Oster. I think it would help answer a lot of your questions. She has many references to reliable studies.

maiatene · August 2015

I think pitocin gets a bad rap. Before I went into labor I watched the business of being born and the basically called it the devil lol. Then I went to web md and livestrong.com to get the medical perspective, and I discussed my concerns with my doctor. I think doing so prepared me for when I was induced and everything worked out well. I really think how your doctor views it (an aide vs a quick means to an end) will affect your experience. In the beginning it was fine (not more or less painful than regular labor) then about 6 hours in I felt horrible and asked for an epidural. It turns out the dumb ass nurse upped the dosage every time she came in the room bc she felt I wasn't progressing quickly enough, so I was getting double what I was supposed to. The pain was unbearable and because I was stressed baby went into distress. The dr came in and saw what happened and turned the dosage back down which made a huge difference. I honestly believe if that idiot minded her business I could have progressed at the same rate and maybe even forgone the epidural, which I only got bc of her shenanigans.

twogirlsandagreen · August 2015

I do not have links, but can share with you my experiences. With my first I was dead set against any medication, but thankfully she was only three days overdue when my water broke. My labor was 11 hours and I never had drugs. My dd experienced heart rate decels, but being so against a c-section, I refused. She was born unresponsive (scored a 1 on apgar) and had code blue resuscitation - we are extremely lucky, and I cannot stress the extremely lucky part enough, that she did not suffer brain damage from oxygen deprivation. It still makes me cry to think about it 5 years later. Lesson learned. Heart rate decels are a very good reason for an emergency c-section no matter how much one is against it.

With dd2 I asked to be induced one day before her EDD because she was measuring large and I was just so uncomfortable. She wasn't dropping at all, thus hardly any effacement or dilation beyond 1cm. They broke my water first since I wanted to try with no pitocin first. My labor just didn't progress after walking the halls for a few hours so dr ordered pitocin. The contractions are night and day from natural ones. Natural contractions build slowly, peak, then go back down (picture a mountain). Pitocin contractions slam to the peak very suddenly and then taper off (picture a sheer clif). They didn't last longer or anything like that, they were just much more intense in that there is no warning and BAM you are at the peak of a contraction. I couldn't use any of my visualization or breathing techniques to cope, so asked for an epidural around 6cm. Within 10 minutes of the epidural, I was at 10cm. I relaxed just enough for my body to dilate even though the Epi only numbed my left side. Dd2 never experienced distress at all. She was 9lbs with an off the chart head and it took all I had to get her out. I know if I had let her stay in there longer I would have ended up with a c-section after unsuccessful pushing.

So, the bottom line is, every labor is very different. My drug free baby experienced fetal distress, where my pitocin and epidural baby didn't at all. Overall, I enjoyed the drug free labor more, not because I prefer the pain, but it was such a peaceful experience and a mental challenge.

I hope this baby will come on his own so that I can go med free, but if he is large and needs to be induced I won't fight it (my pelvic floor is so damaged from dd2 that it can't handle another huge baby) and if he experiences drops in his heart rate I will consent to a c-section immediately (I have met too many children with brain damage from oxygen deprivation during labor and delivery through my friend's special needs dd and it makes me hit my knees and pray and thank God that dd1 was ok).

Prepare for the experience you desire, have a plan, but be flexible because sometimes things happen that might not be in the plan but are best for your baby.

komorebi · August 2015

https://www.childbirthconnection.org/article.asp?ck=10652

This might help and there are various links you can follow from here.

I would avoid cytotec like the plague, have them take your bishop score and if you and baby are not showing any negatives, don't allow them to break your water because inductions can be stopped if your water is in tact. If you know the average length of your cycle and conception date (even roughly) your can look into how accurate your edd is and honestly most of us go in the window we are given.

DeeGreer · August 2015

@komorebi isn't cytotec used in the plan b pill?? I've never heard of that being used during labor; that just sounds sketchy!

komorebi · August 2015

It's routinely used in labor and yes, it's also used in abortion pills, but not plan b thats just hormones. Google cytotec in labor and you'll find a bunch of information. It's scary stuff.

komorebi · August 2015

https://www.cochrane.org/CD000941/PREG_vaginal-misoprostol-is-effective-in-inducing-labour-but-more-research-is-needed-on-safety

@DeeGreer

wildbutterfli2001 · August 2015

The pitocin wasn't so bad for me. I could handle the contractions. However they used cervadil to help my cervix to thin and that was a nightmare. I ended up getting my epi at 2 cm because I couldn't handle the feeling of getting my cervix checked for progress. It made me physically ill because it hurt so badly. I have a fairly high Tolerance for pain but this was unreal.

I did however end up with a c-section after 30 hours of labor due to fetal distress. I was induced at 41+5 I believe.

twogirlsandagreen · August 2015

komorebi said:
https://www.cochrane.org/CD000941/PREG_vaginal-misoprostol-is-effective-in-inducing-labour-but-more-research-is-needed-on-safety

@DeeGreer

YIKES!!! I've never heard of that drug - how scary!

Sballerina · August 2015

Thanks everyone for the personal stories and resource recommendations. I will try to read them soon. @twogirlsandagreen, I will consent to a c-section if baby is that distressed. I couldn't deal with the guilt either if he was hurt. I just want to avoid medical interventions that are just because the staff is inpatient. Thank you for the tip to specifically stay aware of the danger of heart decel.

@komorebi, so you're saying that as long as your water isn't broken that even if they start induction process and you don't respond, you can stop it? I know my cycle was pretty much 28 days, and I tended to ovulate (based on cervical mucus and I think some occasional mittelschmerz) right around day 14. Pretty textbook. I think I remember spotting around 14 days before my missed period would have started. I'm thinking I may have ovulated early that time. I have spotted only extremely rarely since puberty. Is it possible that it may have been implantation bleeding, even though those early signs of pregnancy articles say spotting for that reason would happen closer to the period?

komorebi · August 2015

They might not like it but yes, water breaking is what seals you in. Distress in induced labor is caused by too frequent or strong contractions. The reason contractions aren't non stop is so the baby can recover and if you have all these drugs going they can cause piggyback contractions and eventually the baby will not be able to recover unless the contractions settle down. All drugs used to induce run the risk of uterine hyperstimulation, and the trick is to use enough to get your body moving but not too much. The problem is that some hospitals have a system of using too much and then pulling back once things get going and your body might not adjust and the baby might not handle. See if you can find out your obs induction rate (they might not want to give you that number and it could be higher than average depending on several factors). And if you have to be induced for post dates discuss baby steps to get it going. If you have normal menstrual cycles you'll probably go into labor in time and none of this will matter.

Sballerina · August 2015

Ok, thanks. Cytotec must be a brand name for one of the cervical softeners?

Am I justified in being a bit frustrated with this particular OB for at best giving a glossed-over picture of Pitocin contractions vs. natural?

twogirlsandagreen · August 2015

Sballerina said:
Ok, thanks. Cytotec must be a brand name for one of the cervical softeners?

Am I justified in being a bit frustrated with this particular OB for at best giving a glossed-over picture of Pitocin contractions vs. natural?

Pitocin contractions can function exactly like natural contractions if the dosage is right. I got lucky in terms of them turning my pitocin up very slowly until just the right amount was established, but regardless, the way they come on is very sudden when you really get going, where natural contractions build to peak (in terms of hoping to avoid epidural they are much more difficult to cope with)

komorebi · August 2015

@twogirlsandagreen that's how it should be done.

@Sballerina misoprostol is the other name (I'm spelling it wrong, I'm sure).

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