What Is Pitocin?

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Pitocin is a synthetic version of the hormone oxytocin. In spontaneous labor, natural oxytocin is what controls the contraction of uterine muscles that initiates labor.

If you aren’t contracting quickly enough or aren’t in labor at all and need to deliver for any reason, Pitocin can be administered as a medication to kick-start those contractions.

Pitocin is delivered intravenously in a hospital setting and usually results in increasingly strong contractions.

Young pregnant woman sleeping in her hospital bed

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Pitocin use is common in induced labor. According to the National Partnership for Women and Families, 63% of induced labors include the use of Pitocin.

Uses

If your labor needs to be induced, your doctor might begin with procedures like:

  • Cervical ripening: This is often the first step in inducing labor. It involves encouraging the cervix to become softer, thinner, and wider.
  • Membrane stripping: This can expedite the onset of labor when the cervix is only partially dilated. To do this, your doctor inserts a gloved finger into your cervix and gently separates the amniotic sac, or membranes, from the uterine wall.
  • Breaking your water: Purposefully breaking the water to induce labor is called amniotomy or artificial rupture of membranes (AROM). To do this, the membranes will be snagged using an amnihook (a large device with a small sharp end, similar to a crochet hook) or an amnicot (a glove with a small sharp hook at the end of one finger). After a tear in the bag is created, the amniotic fluid will begin to flow out. 

Pitocin may be introduced if the above procedures do not cause your labor to progress quickly enough.

Reasons for Inducing Labor

Typical reasons for inducing labor include:

  • Health problems in the mother, including diabetes and kidney disease
  • Ruptured membranes (without the start of labor)
  • Low amniotic fluid levels
  • Preeclampsia or high blood pressure
  • Slow fetal growth
  • Uterine infection

Labor may also be induced electively to alleviate the discomforts of pregnancy in the mother or prevent potential complications from occurring.

Sometimes inductions are performed for reasons other than medical necessity, including timing and convenience of either the practitioner or the patient.

How Pitocin Induces Labor

The liquid Pitocin is diluted with a standard saline solution and given in an intravenous (IV) drip. The IV drip will be set to deliver a specific amount of Pitocin per minute. Depending on the orders written by your doctor, the Pitocin drip is usually turned up approximately every 20 minutes until you reach a certain contraction pattern.

When given in low‐dose intravenous infusions, Pitocin induces rhythmic uterine contractions that are indistinguishable in frequency, duration, and strength from contractions observed during spontaneous labor.

The protocol used in your case will depend on why you are being induced and other factors specific to your medical needs. The speed of the drip (and how much you end up needing) also correlates to how well you and your baby respond to the drug.

Speeding Up Labor

Pitocin can also be used to speed up your labor. A review of studies found that, on average, Pitocin results in a relatively small decrease in total labor time. However, even a small reduction in laboring may provide significant relief to the pregnant mother.

Slow progress in the first stage of spontaneous labor may be caused by weak contractions of the womb. The belief is that administering Pitocin will enable progression to normal vaginal delivery and reduce the need for cesarean section.

Other methods known to speed up slow labor in addition to or instead of Pitocin include:

  • Breaking the waters
  • Acupressure
  • Movement, such as walking and bouncing on a yoga ball

How Long Does Pitocin Take to Work?

Pitocin affects each pregnant woman differently, so it’s hard to say when labor contractions might start. When contractions do start, they can come on strong and can be faster and more regular than if labor had begun on its own.

Postpartum Uses

Postpartum hemorrhage (PPH) is a serious condition, commonly defined as a blood loss of 1000 cc or more within 24 hours after birth. Globally, nearly one-quarter of all maternal deaths are associated with PPH.

The Association of Women’s Health, Obstetric and Neonatal Nurses recommends giving Pitocin after birth to prevent and treat PPH, which affects around 3% of women in the United States.

Pitocin is the first choice for the prevention of postpartum hemorrhage because it is shown to be effective, with few side effects.

Side Effects

Pitocin can cause your contractions to start off stronger and faster than those where labor has begun naturally. That has the potential to put added stress on your baby as well as your uterus, so both you and your baby will be monitored continuously.

Monitoring

When given Pitocin, you’ll need to wear a fetal monitor belt to assess stress on you and the baby. This can restrict your movement and make it harder to change positions during labor.

The following side effects have been reported in Pitocin:

  • Allergic reaction, although this is rare
  • Pelvic hematoma
  • Cardiac arrhythmia
  • Nausea
  • Vomiting
  • Water intoxication

Potential Risks

As with any medication or intervention, using Pitocin carries risks. However, it’s important to note that this medication is generally safe and has a low risk of serious complications.

Some possible complications of using Pitocin include:

  • Overstimulation of the uterus, which could make your contractions come too fast or too often
  • Changes in fetal heart rate
  • Fetal distress
  • Higher likelihood of requesting pain medication, like an epidural
  • Uterine rupture

There are also certain situations when Pitocin should not be used. Some examples of contraindications include the following:

  • In obstetrical emergencies where the benefit-to-risk ratio for either the fetus or the mother favors surgical intervention
  • You are allergic to Pitocin or any of the medication’s ingredients
  • You have a pregnancy complication, such as placenta previa

In cases where Pitocin is contraindicated, other methods of induction may be used, including:

  • Intentionally rupturing the amniotic sac
  • Waiting for labor to occur naturally
  • Performing a cesarean section

Oxytocin and Neurological Concerns

Although some experts have raised concerns that Pitocin may have detrimental effects on the neurodevelopment of children, research has shown otherwise. In a systematic review of observational studies—looking at over 1 million births—there was no association between Pitocin use in labor and:

  • Autism
  • Cognitive impairment
  • Problem behavior
  • Attention deficit hyperactivity disorder

A Word From Verywell

Pitocin can be a useful way to start or speed up labor, but the drug does carry a small element of risk. If you are presented with the option of inducing labor with Pitocin, make sure that you discuss with your healthcare provider the reasons why this route is best for you and your baby.

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