When the Doctor or Midwife Suggests Pitocin: What Mothers Should Know

Pregnancy is an exciting time, but the delivery date is what most parents are looking forward to. However, labor is not always easy.

Though expecting parents often eagerly count down to the baby’s due date, labor is not always easy or on schedule. Many women continue to carry a baby past their original due date; others may have their water break but then not experience contractions afterward. In these situations, many doctors or midwives may choose to induce labor. One of the drugs used for this purpose is Pitocin.

Pitocin is a synthetic form of oxytocin, a naturally occurring hormone that plays a role in the birthing process. Oxytocin signals the body when to start having contractions. During a slow labor—or in case of delay—your care provider may administer Pitocin to do the same job. Unfortunately, the drug can cause dangerous side effects, and should only be used for specific medical reasons

What Should Parents-to-Be Know About Inducing Labor with Pitocin?

Though Pitocin does reliably cause contractions, it is not identical to oxytocin, and therefore comes with a few hazards. First, when (naturally secreted) oxytocin is driving contractions, the body can self-regulate the amount of hormone in your blood. Pitocin, administered through an IV, cannot be controlled in the same way.

Further, because it is meant to encourage contractions, Pitocin may not allow the uterus sufficient rest time, which can reduce oxygen to the baby. Oxytocin’s self-regulatory abilities include ensuring the mother does not push too hard and endanger the baby. Contractions tend to temporarily interrupt the blood flow to the baby, in the same way a garden hose will stop flowing when it gets a kink. Continuous contractions can stress the blood flow to the fetus, leaving it in a hypoxic (low-oxygen) state. Oxytocin, on the other hand, may prevent such hypoxic episodes. It is thought to have neuroprotective mechanisms that protect a fetus from brain damage. Pitocin does not have this benefit, making it doubly dangerous for the baby.

Reducing the Risks of Pitocin Use

Of course, you may find yourself in a situation that calls for induction of labor, and not taking this step could be more dangerous than electing to use Pitocin. If your providers advise you to induce with Pitocin, your care team should take extra precautions to keep you and your baby safe during labor and delivery. This means closely watching both of your vital signs.

Any team that oversees childbirth should provide fetal heart rate monitoring because it is one of the most reliable ways to sense fetal distress. Whenever a risk factor—like the use of Pitocin or another complication—is introduced, your care team should use continuous fetal heart rate monitoring (CM) rather than intermittent auscultation (IA). CM will alert providers to fetal distress immediately, whereas with IA, your doctors might miss the initial signs. When it comes to hypoxic injury, just minutes can be the difference between a close call and a serious birth injury.

Hospitals and birth centers must also make sure their teams overseeing childbirth are trained in how to safely administer Pitocin and monitor its use and effect on mother and baby.

What About Other Uses for Pitocin?

Pitocin is not just used to induce labor. Doctors and midwives also rely on the drug to help treat postpartum hemorrhage. Caused by complications like uterine atony, retained placenta, or uterine rupture or inversion, postpartum hemorrhage follows almost 20% of births. The condition can be fatal if not treated immediately.

When used after labor and delivery, Pitocin cannot affect the fetus at all. Though like all drugs, it does come with the potential for side effects, the risk of not using it to treat postpartum hemorrhage is much greater than the risk of an adverse event in the mother. Therefore, we don’t recommend parents take a hard line against their doctor or midwife ever using this drug. Instead, you should have a nuanced discussion about Pitocin (and other potential medical interventions) with your doctor before you go into labor.

How to Talk to Your Doctor or Midwife About Pitocin

Even if you plan to have an all-natural birth, you should have a discussion with your doctor or midwife beforehand to discuss what steps he or she will take if your labor drags out or you experience other complications. The first thing you can do is ask your OB-GYN which pharmaceuticals he or she uses with patients. If Pitocin comes up, you should determine whether your doctor or midwife uses the drug as a standard matter of course, or if he or she only administers it in specific circumstances. You should also ask if the hospital where you are delivering has policies about when and how Pitocin should be used.

Your doctor should be willing to discuss the potential risks of Pitocin use with you. He or she should also know when Pitocin should not be used. You can read the full drug information online from the FDA (link opens a PDF) and make a note of any specific questions you have. If your doctor discusses the possibility of using Pitocin, it is a good idea to ask what steps he or she will take to ensure both you and your baby come through labor and delivery without suffering the injuries linked to its use.

Pitocin-Related Birth Injuries? We Can Help.

Unfortunately, Pitocin use is implicated in many cases of obstetrical malpractice. Though this drug has its place, doctors and midwives alike should proceed with caution when using it to start or continue labor. Hypoxic-ischemic encephalopathy (HIE) and other hypoxic brain injuries can upend a family.

If your baby suffered HIE during birth, you deserve answers—and the chance to hold any negligent caregivers accountable. We can investigate your case to determine whether Pitocin use may have been linked to fetal distress and your baby’s injury. Our team can put our full efforts and resources toward helping you find justice and win the compensation you need to afford the care your child needs.

Call McGinn Montoya Love Curry & Sievers PA at (505) 405-4441 to schedule a free consultation with our trusted birth injury lawyers. Our legal advocacy has directly changed state regulations and institutional processes to protect patients.