Pitocin Induction For Labor – Benefits And Side Effects

What Is Pitocin?

Pitocin is a synthetic hormone often used as a substitute for oxytocin. Oxytocin is a vital hormone for reproduction, delivery of the child, and periods after pregnancy (1). Our body naturally secretes oxytocin hormone at the time of childbirth which results in the vaginal contractions to initiate the labor (2). Pitocin works similarly to oxytocin if it is given in a controlled amount under medical supervision.

What Is Pitocin Used For?

Pitocin is a synthetic counterpart of oxytocin hormone that is used for artificially inducing labor or making the process of labor quicker (3). Pitocin can also aid in controlling postpartum bleeding, hemorrhage, and menstruation just like oxytocin does (4).

So your doctor can use pitocin under your consent if you have weak or unusual contractions during labor. The doctor will then inject pitocin into your arm through an IV. They will gradually raise the pitocin level until you have got the ideal contraction rate i.e. one strong contraction every 2 to 3 minutes (5).

Is Pitocin Ok For Babies?

Pitocin is okay for babies only if it is given in a controlled amount with constant monitoring. An overdose of it can cause hyperstimulation and seriously endanger both the lives of the mother and the baby.

Excessive contractions lead to the risks of uterine rupture and internal hemorrhage in the mother (6). On the other hand, overstimulation of the uterus due to pitocin induction can cause brain damage to the baby (7). Intense pressure on the baby can restrict the blood flow and lead to fetal death (8).
That is why experts suggest the use of pitocin only when it is extremely necessary.

What Are The Benefits Of Pitocin Induction?

There are certain risks of artificially inducing labor but there are some benefits too. The benefits of pitocin induction are;

Manage Risky Medical Conditions 

It reduces the chances of complications during childbirth in women with high blood pressure or preeclampsia. Pitocin reduces the risks of macrosomia (large baby) and meconium aspiration (9).

Initiate Labor In Prolonged Pregnancy

If no sign of labor occurs after completing 40 weeks of pregnancy then pitocin induction can be helpful. Prevent sudden complications before birth – Pitocin is helpful in situations when water breaking is not followed by labor or the intensity of labor is not up to the mark (10).

Avoid Cesarean Delivery

With pitocin induction, you can avoid c-section delivery. Different studies show that the rate of cesarean delivery is very low in women with pitocin induction (11).

So pitocin induction is beneficial in situations where the risk of the baby staying inside the womb is greater than the risk of the induction.

How Long Does A Pitocin Induction Take?

The first sign of uterine contraction shows up within 30 minutes to one hour of the first IV pitocin induction. But how long does a pitocin induction take to start active labor varies in different pregnancies. In general, pitocin induction leads to contractions of labor within a few hours. Your doctor will check and increase pitocin doses until you get the ideal rate of contractions for the delivery. The factors that regulate the duration of pitocin induction are;

1. Dilation of the Cervix

Your cervix needs to be prepared for the delivery of the baby before injecting pitocin. If the cervix is ripened before pitocin induction then it will not take much time to get active labor pain. The dilation or ripening of the cervix is measured by the bishop score. The induction will only lead to active labor if the bishop score is 8 or more (12).

2. Number of Previous Pregnancies

For first-time mothers, pitocin induction can take a longer time in comparison with the mothers who already have given birth.

3. The Stage of Pregnancy

Inducing labor artificially at an early stage of pregnancy will take longer time than if it is done after 39 weeks. This is because with time the cervix softens and the body prepares for a natural delivery. Besides, the health of the mother, the position of the baby, and the dosage of pitocin also decide the duration of labor.

Are There Any Side Effects Of Pitocin Induction?

Yes, just like any other medical intervention, pitocin induction for labor also has some side effects. The possible side effects of  are listed below:-

• Intense and very strong contractions due to overstimulation of the uterus
• Painful and frequent labor that leads to internal damage
• Nausea
• Uterine rupture internal bleeding and infection
• A drop in the fetal heart rate
• Fetal distress
• Death of the fetus
• Breastfeeding problems such as less breastmilk lead to dependency on formula (13)

So, to avoid any mishaps during labor, have a detailed conversation with your doctor about the risks and precautions.

Who Should Not Consider Pitocin Induction?

With proper care and constant monitoring, pitocin induction can successfully lead to active labor and speedy delivery. But the induction is not advisable for women who have conditions like;

• Previous c-section delivery or any surgical incision in the uterus or lower abdomen
• Placenta previa or when the placenta covers the cervix (14).
• The transverse position of the baby or if the baby’s head is not downwards during labor
• Active genital infections like herpes in the vaginal tract
• Umbilical cord prolapse

So, it is very important to share your medical history during prenatal checkups and conduct every prenatal test the doctor suggests.

So, to conclude we can say that using pitocin is necessary when the chances of survival of the baby are affected by the prolonged labor. But you must not unnecessarily risk your and your baby’s life with pitocin induction just to get a quick, on-time delivery.

FAQ’s

1. How Long After Pitocin Do You Deliver?

The duration of labor after induction of pitocin varies from woman to woman. You can start having mild to moderate contractions within the first hour of induction. And within 6 to 12 hours of the induction, you can deliver your baby.

2. What Stage of Labor Is Pitocin Given?

Doctors usually give Pitocin in the third stage of labor or when the bishop score is 8 or more. In simple words, the cervix needs to be open for up to 2 to 3 centimeters to initiate labor artificially. Cervidil, a medicine, helps dilate the cervix.

References

1. The Role of Oxytocin and the Effect of Stress During Childbirth, National Library of Medicine, USA. –
   [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578887/]
2. Oxytocin, Heathwise. –
   [https://www.cham.org/HealthwiseArticle.aspx?id=tj8006]
3. Inducing labor, Medline Plus. –
   [https://medlineplus.gov/ency/patientinstructions/000625.htm]
4. Intravenous oxytocin reduces severe bleeding after vaginal delivery, NHIR, UK. –
   [https://evidence.nihr.ac.uk/alert/intravenous-oxytocin-reduces-severe-bleeding-after-vaginal-delivery/]
5. Physiology, Pregnancy Contractions, National Library of Medicine, USA. –
   [https://www.ncbi.nlm.nih.gov/books/NBK532927/]
6. Postpartum hemorrhage, March of Dimes.org –
   [https://www.marchofdimes.org/find-support/topics/postpartum/postpartum-hemorrhage]
7. Two patterns of perinatal brain damage and their conditions of occurrence, Science direct. –
   [https://www.sciencedirect.com/science/article/abs/pii/000293787290124X]
8. Intrauterine Fetal Demise, National Library of Medicine, USA. –
   [https://www.ncbi.nlm.nih.gov/books/NBK557533/]
9. Induction of labour at or near term for suspected fetal macrosomia, National Library of Medicine, USA. –
   [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7032677/]
10. WHO Recommendations for Augmentation of Labour, National Library of Medicine, USA. –
    [https://www.ncbi.nlm.nih.gov/books/NBK258881/]
11. Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis, NLM, USA –
    [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4049989/]
12. Bishop Score, NLM USA. –
    [https://www.ncbi.nlm.nih.gov/books/NBK470368/]
13. Synthetic oxytocin and breastfeeding: Reasons for testing an hypothesis, Science direct. –
    [https://www.sciencedirect.com/science/article/pii/S030698771300368X]
14. Induction of Labor, NLM USA. –
    [https://www.ncbi.nlm.nih.gov/books/NBK459264/]