If you’ve been looking into labor techniques, you may have heard about Pitocin inductions. There’s a lot to learn about the benefits and drawbacks, and we’re here to guide you through it.
An induction with Pitocin means your doctor or midwife will help start your labor using a medicine called Pitocin, which is a synthetic version of oxytocin.
Oxytocin is the hormone that your body naturally produces to induce contractions, as well as serving as the famous “love” hormone.
Pitocin is delivered through an IV in your arm and your nurse will gradually raise the level of Pitocin you are receiving until you are having regular contractions about every 2 to 3 minutes.
At that point, your Pitocin will either be left on until you deliver, adjusted if your contractions become too strong or fast or taper off, or your healthcare provider may shut off the Pitocin all together.
Sometimes, an initial dose of Pitocin is enough to “kick” your body into going into labor on its own.
No induction will start with Pitocin unless your cervix is favorable. What does that mean? Essentially, a “favorable” cervix is one that’s already gearing up for labor.
If your body is nowhere near ready to have a baby, your cervix will be “closed, thick, and high,” meaning it won’t be dilated or effaced at all. It will also still be facing “backwards.”
As your body preps for labor, your cervix softens and opens. It “rotates” to the front to get in the right position for letting your baby out.
You can’t be induced with Pitocin unless your cervix is ready, because Pitocin won’t change your cervix. Pitocin can induce contractions, but unless your cervix is prepped and ready to go, those contractions aren’t going to actually do anything.
It’s kind of like how you need to warm up an engine before it’s ready to go. Without the prep work, it’s just not going to work properly.
Doctors “rate” a cervix with a Bishop score before deciding if it’s ready for an induction. Anything less than a six means the cervix may not be ready for labor.
If your cervix is ready, however, Pitocin could become an option.
There are some benefits to being induced including getting your baby delivered if you’re overdue. Other benefits include:
- Avoiding a cesarean delivery. A 2014 review of studies found that the risk of having a C-section was actually lower with inductions for women at term or post-term than for those who were medically observed until delivery
- Avoiding complications with risk factors such as high blood pressure, preeclampsia, or an infection.
- Avoiding complications with a ruptured amniotic sac [aka your water breaking] that isn’t followed by labor or if your labor has stalled.
Simply put: Inductions are medically necessary in cases when the risk of the baby staying in utero exceeds the risk of the induction.
As with many medical procedures and interventions, there are risks with a Pitocin induction. These include:
- overstimulation of the uterus
- infection
- rupture of the uterus
- fetal distress
- drop in fetal heart rate
- fetal death
Starting an induction is usually the start of a long process, so your doctor will likely proceed with caution and with your input.
You’ll likely start with a cervical ripening agent [medication], if needed, which can take hours to work. After that, Pitocin could be the next step.
Once you are on Pitocin, you must be strictly monitored and remain in bed. Contractions typically start about 30 minutes after starting Pitocin.
You’re also not allowed to eat. This is because of the risk of aspiration in the event that you need an emergency cesarean delivery. Pitocin-induced contractions might interfere with rest, too, so both you and the baby can get tired out.
It isn’t uncommon to see inductions stretch out for days, most commonly for first-time moms who have not gone through labor yet.
Most of the time, the parents-to-be don’t expect it to take that long. Mental and emotional frustration can have an impact on labor, too.
Check in with your medical team to make sure you’ve got what you need to rest and stay calm.
If you’re considering an induction [with a favorable cervix!] or your OB says one is medically necessary [if your blood pressure is high, for example], talk to your doctor about the risks and benefits. We know an induction can sound scary, and understanding exactly what it involves is key.
Unless a Pitocin induction is medically necessary, it’s often better to let labor happen on its own. But if you end up inducing, don’t worry — communicate with your doctor to make sure you know what’s going on and how they can help you deliver safely and happily.
Description and Brand Names
Drug information provided by: IBM Micromedex
US Brand Name
- Pitocin
Descriptions
Oxytocin is a hormone used to help start or continue labor and to control bleeding after delivery. It is also sometimes used to help milk secretion in breast-feeding.
Oxytocin may also be used for other conditions as determined by your doctor.
In general, oxytocin should not be used to start labor unless there are specific medical reasons. Be sure you have discussed this with your doctor before receiving this medicine.
This medicine is available only with your doctor's prescription.
Novartis Pharmaceuticals removed Syntocinon® nasal spray from the market in March 1995.
Before Using
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:
Allergies
Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Pediatric
No information is available on the relationship of age to the effects of oxytocin in the pediatric population. Safety and efficacy have not been established.
Geriatric
No information is available on the relationship of age to the effects of oxytocin in geriatric patients.
Breastfeeding
Studies suggest that this medication may alter milk production or composition. If an alternative to this medication is not prescribed, you should monitor the infant for side effects and adequate milk intake.
Drug Interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Ephedrine
Other Interactions
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:
- Bleeding problems [e.g., subarachnoid hemorrhage] or
- Hypertension [high blood pressure]—May make these conditions worse.
- Cephalopelvic disproportion or
- Cervical cancer or
- Fetal distress or
- Grand multiparity [giving birth more than five times] or
- Major surgery on the cervix or uterus [e.g., caesarean delivery], history of or
- Overdistended uterus or
- Premature fetus or
- Problems with uterine contraction [e.g., uterine atony, strong uterine contractions] or
- Toxemia, severe or
- Unfavorable fetal position [e.g., transverse lies] or
- Other conditions that may require caesarean delivery [e.g., cord prolapse, total placenta previa, vasa previa, or during an emergency]—Should not be used in patients with these conditions.
- Kidney disease—Use with caution. Effects may be increased because of slower removal of this medicine from the body.
Proper Use
A nurse or other trained health professional will give you this medicine. This medicine is given through a needle placed in one of your veins or as a shot into one of your muscles.
Precautions
Oxytocin can be very useful for helping labor. However, there are certain risks with using it. Oxytocin causes contractions of the uterus. In women who are unusually sensitive to its effects, these contractions may become too strong. In rare cases, this may lead to tearing of the uterus. Also, if contractions are too strong, the supply of blood and oxygen to the fetus may be decreased.
Oxytocin may cause jaundice and eye problems such as retinal hemorrhage in some newborn infants. If you have concerns about this, ask your doctor.
This medicine may cause a serious condition called water intoxication. Tell your doctor right away if you start having have confusion, drowsiness, headache, or seizures while you are receiving this medicine.
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur:
Rare
- Confusion
- convulsions [seizures]
- difficulty in breathing
- dizziness
- fast or irregular heartbeat
- headache [continuing or severe]
- hives
- pelvic or abdominal pain [severe]
- skin rash or itching
- vaginal bleeding [increased or continuing]
- weakness
- weight gain [rapid]
Incidence not known
- Abdominal pain or cramping
- blood clotting problem that causes prolonged bleeding
- chest pain or discomfort
- cough
- difficulty swallowing
- extra heartbeats
- fainting
- lightheadedness
- pounding or rapid pulse
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- severe bleeding after giving birth
- shortness of breath
- tightness in the chest
- unusual tiredness or weakness
- wheezing
Get emergency help immediately if any of the following symptoms of overdose occur:
Symptoms of overdose
- Restlessness
- shakiness
- sleepiness
- slow to respond
- slurred speech
- unconsciousness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Rare
- Nausea
- vomiting
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Portions of this document last updated: Feb. 01, 2022
Original article: //www.mayoclinic.org/drugs-supplements/oxytocin-intravenous-route-intramuscular-route/side-effects/drg-20065254
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