We’ve all seen birth scenes in movies and TV shows where a woman’s water spontaneously breaks, she’s rushed to the hospital, and five minutes later, her sweet baby is born. It makes for a tidy plot, sure. But it rarely works that way in real life.
In fact, around 1 in 5 labors get a nudge in the form of an induction or augmentation. Among the tools your provider can use to jumpstart the birth process or speed it along is Pitocin. It’s a powerful drug that can often get contractions started in less time than it might take to properly install your little one’s new car seat. But it can come with some potential downsides too. Here’s a closer look at what Pitocin induction is, how it works, and the side effects and risk factors you’ll want to consider.
What is Pitocin?
Pitocin is a synthetic version of the naturally-produced hormone oxytocin. This hormone’s main function is to help with milk excretion during breastfeeding, but the hormone also plays an important role during labor by stimulating the uterus and making it contract. In some cases, giving an extra oxytocin boost in the form of Pitocin is helpful to get things going or keep labor on track.
What is a Pitocin induction?
Pitocin is one of a few different tools your health care team can use to induce labor or speed it up if your progress has stalled. But it’s not always the first option they turn to.
If your labor has to be induced, your doctor might begin with a procedure like cervical ripening (which prepares your cervix for labor) or membrane stripping or breaking your water. All of these things can — and often do — induce contractions within a couple of hours.
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But if cervical ripening and membrane rupturing don’t trigger your contractions, or your contractions aren’t coming fast enough, your doctor might opt to administer Pitocin, which is given through an IV drip. Your practitioner will start off by giving you a small dose and gradually increase it until your contractions are two to three minutes apart.
While you’re getting Pitocin, your medical team will keep a close eye on you and your baby to see how you’re both dealing with the stress of labor. Your Pitocin might be stopped or dialed back once things have kicked off, or if your contractions get too long or strong. Regardless, once your labor is in full swing, it should progress just like a non-induced labor.
How fast does Pitocin 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 tend to be faster and more regular than if labor had begun on its own. If you’re planning on getting an epidural, it’s a good idea to ask about it when your Pitocin is given, so it’s in place once labor does start.
Are there any side effects of using Pitocin during labor?
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 little one will be monitored continuously. That means you’ll need to wear a fetal monitor belt, which can restrict your movement and make it harder to change positions during labor.
Some women who’ve given birth both with and without Pitocin say that Pitocin induced labors feel harder and more intense, too. And indeed, findings show that women who receive Pitocin are more likely to get an epidural for pain relief. But if it’s your first baby, you won’t have anything to compare it to.
What are the risks of Pitocin, if any?
Pitocin has the potential to overstimulate the uterus, which could make your contractions come too fast or too often. That can pose certain risks, and some of them can be serious. They include:
- Changes in fetal heart rate
- Increased chance for C-section
- Uterine rupture
These potential risks can be scary to think about, but Pitocin is generally considered to be safe and has been used in millions of births for over 50 years. There are plenty of instances where it’s the best option for inducing labor. Your provider can help you weigh your individual risks and benefits and help you make the best decision for you and your baby.
Is there really a connection between Pitocin use during labor and autism?
It’s thought that faulty oxytocin signaling pathways could play a role in autism spectrum disorder. That has led some people to theorize that giving Pitocin during labor could impact fetal oxytocin receptors and raise autism risk.
But the research doesn’t support this. A major Harvard JAMA Pediatrics study looking at more than 1 million births concluded that using Pitocin for induction doesn’t increase autism risk. And indeed, the American College of Obstetricians and Gynecologists (ACOG) says there’s no good evidence that Pitocin causes autism — and it shouldn’t factor into the decision of whether to use Pitocin for labor induction.
Is Pitocin ever used after birth?
Yes. The Association of Women’s Health, Obstetrics, and Neonatal Nurses as well as the World Health Organization recommend giving Pitocin after birth to prevent and treat postpartum hemorrhage, which affects around 3 percent of U.S. women. That doesn’t mean you have to have it, though. If you’re at low risk for postpartum hemorrhage and would prefer not to get Pitocin, let your provider know. Together you can determine whether other options can be used to manage your postpartum bleeding.
Pitocin can be a useful way to start or speed up labor, but the drug does have some downsides. If your health care provider recommends it, have a conversation about the pros and cons of Pitocin induction to decide what’s best for you and your baby.
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