Pitocin is a synthetic form of oxytocin, your natural “love and bonding” hormone. Doctors recommend Pitocin in 40% of pregnancies for artificially “starting” labor. The manufacturer of Pitocin advises against using it for the elective induction of labor due to a lack of safety data. What can explain these opposing recommendations? And how does Pitocin interfere with natural birth? Read on to find out what your doctor might be hesitant to talk about.
Disclaimer: This post is for informational purposes only. It’s not meant to provide medical advice.
Contents
Pitocin is not safe for the elective induction of labor
FDA label warns against its use
The manufacturer of Pitocin states that it shouldn’t be used for the elective induction of labor due to a lack of data on the possible risks vs. benefits.
Synthetic oxytocin goes under the names of Pitocin® and Syntocinon®.
The official drug label states the following:
“Since the available data are inadequate to evaluate the benefits-to-risks considerations, Pitocin is not indicated for elective induction of labor.”
The elective induction of labor refers to all non-medical reasons for artificially starting labor, which can be a tricky category in itself.
Induction rates are skyrocketing for no reason
Sadly, some doctors still recommend elective labor induction in perfectly healthy pregnancies at 42, 40, or even 39 weeks, although evidence strongly goes against this practice (Rydahl et al 2019).
In 2013, more than four out of ten mothers in the U.S. said that their care provider tried to induce their labor (Declercq et al., 2013).
According to the U.S. Centers for Disease Control and Prevention Vital Statistics report, induction rates have more than doubled from 1990 (10%) to 2010 (23%) (Martin et al., 2012).
Pitocin is not the only way to induce labor, but it’s a frequent choice. Any kind of labor induction carries risks.
It’s a big red flag if your provider doesn’t present you with the potential pros, cons, and alternatives of labor induction with Pitocin. Remember that it’s your right to decline any medical procedure if you wish, including the induction of labor.
Pitocin makes your uterus work harder than it would naturally
Pitocin is a synthetic form of oxytocin, your body’s main “love hormone.”
How natural oxytocin works
Your body releases oxytocin during sex, childbirth, breastfeeding, and bonding with your partner and baby. These are all intimate events and the release of oxytocin in all cases depends on having a safe, nurturing environment (Magon & Kalra, 2011).
Oxytocin is produced in the brain by a deep brain structure known as the hypothalamus. It’s then released into the bloodstream via the pituitary, sometimes called the “master gland” and the main hormonal link between the brain and body.
During birth, oxytocin comes in waves and pulses. It starts off slowly, preparing the uterus, softening, and opening the cervix. Gradually, its waves become more intense. It powerfully surges and so do uterine contractions, as your body works hard and in sync to bring your baby earthside.
Natural, physiological contractions are always followed by a pause. They’re also part of the hormonal matrix via which the mother and baby are unconsciously communicating during labor.
How Pitocin is different
Pitocin is nothing like your body’s own oxytocin. For one, Pitocin is administered directly into your bloodstream in much higher concentrations than your body would produce. The way it’s given differs greatly from the natural waves of your body’s production.
Pitocin often causes extremely painful and long contractions. The pauses in between contractions are short, so little time is left for much-needed physiological rest. As a result, Pitocin exerts your uterus, and it can stress your baby.
The drug label states that Pitocin can cause overstimulation of the uterus even when it is used for the medical induction of labor.
Imagine doing extremely intense training and someone giving you additional muscle stimulation that you have no control over. Something similar happens to the uterus under the influence of Pitocin, but its implications are far more severe.
Pitocin triggers a cascade of interventions
Pitocin is often the first step in what’s called the “Cascade of Interventions.” This is when one intervention leads to another, each subsequent one often carrying additional risks. A normal physiological event often becomes transformed into a serious medical procedure (Jansen et al., 2013).
More likely to take painkillers
Since the contractions caused by Pitocin are so difficult to manage, they frequently lead to women accepting pain relief that they wanted to avoid. The available pain relief options include an epidural, narcotics, and other drugs that can further disrupt the birthing process.
Baby more likely to suffer fetal distress
Uterine overstimulation caused by Pitocin is a frequent cause of fetal distress. On a cellular level, fetal distress happens because the baby is lacking oxygen. Uterine contractions that are too long, strong, and frequent reduce blood and oxygen supply (Lipshitz & Klose, 1985).
No wonder Pitocin contractions are harder for babies to tolerate. They squeeze the baby more tightly, for a longer period of time, and with shorter breaks. Babies often don’t have enough time to recover, and they start suffering. Medicine calls this fetal distress. The baby’s heartbeat goes up or down too much, as it frantically tries to fight the drug’s effects and find safety.
Naturally released oxytocin protects the baby’s brain from the consequences of low oxygen that may normally happen for short periods of time during labor. It’s not known how Pitocin affects the baby’s brain (Bell et al., 2014).
Fetal distress often leads to a C-section, forceps, or vacuum delivery
Fetal distress often leads to an “emergency” Cesarean section or instrumental delivery (using vacuum or forceps, both of which can leave long-lasting consequences on both mother and baby) (Muraca et al., 2019).
Although fetal distress can sometimes be dangerous, diagnosing it is usually inaccurate. A baby may appear to be under distress but will actually be fine and seem healthy once born. One study concluded that (Ajah et al., 2016):
“The clinical diagnosis of fetal distress is accurate in 29.1% of the cases. However, it has led to an unnecessary caesarean section in the remaining 70.9%.”
That means that the C-section, forceps, episiotomy, and other violent interventions the doctors used to “save the baby and mother” weren’t really needed.
Elective induction by itself makes you more likely to have a C-section
A 2021 study once again showed that women whose labor was induced were more likely to have a C-section. The authors say:
“Awaiting the natural onset of labor, if there are no maternal or fetal reasons to intervene, may yield no worse a perinatal outcome than an earlier induction of labor. The consequences of a cesarean delivery are known to be associated with immediate and longer-term maternal morbidity, and this may be potentially avoided, if elective inductions of labor can be minimized.” (Levine et al., 2021)
Pitocin disrupts bonding with your baby and transitioning to motherhood
Natural oxytocin prepares you for bonding and bliss
Your natural oxytocin is produced in your brain. It makes you feel bliss and intimacy. It synchronizes with your natural feel-good chemicals, endorphins and enkephalins. Researchers have confirmed that oxytocin has many positive effects on the mother’s brain during labor, and prepares her for motherhood (Uvnäs-Moberg et al., 2019).
The waves of oxytocin your body is capable of naturally releasing reduce anxiety, stress, and pain in labor. They switch on your pleasure and reward centers. Oxytocin makes you relaxed and happy to meet your baby for the first time—a normal, mammalian reaction (Uvnäs-Moberg et al., 2019).
Pitocin doesn’t reach your brain
However, Pitocin doesn’t cross into your brain (it can’t pass the so-called blood-brain barrier). It does not influence your brain and emotions in the same way as oxytocin during physiological labor does.
Pitocin may disrupt your feelings of safety, pleasure, and intimacy during birth. It may disturb bonding with your newborn.
Pitocin reduces your natural feel-good chemicals
One study found that women given oxytocin don’t experience a rise in endorphins. Women experiencing spontaneous labor went through a gradual increase in endorphins, the levels of which peaked at the baby’s birth. This confirms that Pitocin has major negative effects on the natural hormonal matrix of childbirth (Genazzani et al., 1985).
The actions of natural oxytocin are considered to be critical for a successful transition to motherhood. Researchers think it may have long-term effects on mothering behavior well past birth (Bell et al., 2014).
According to one theory, the massive amount of oxytocin your body naturally produces during birth helps buffer the stress, fear, and increased demands that come with early motherhood. Pitocin may disrupt this process (Carter et al., 2001).
Pitocin has unknown effects on your stress axis
There’s also evidence that natural oxytocin balances the hypothalamic–pituitary–adrenal (HPA) axis, your body’s main stress response. An overactive HPA axis has been linked with anxiety, burnout, and many mental health disorders. The effects of Pitocin on the HPA axis are unknown (Bell et al., 2014; Faravelli et al., 2012).
Added risks of Pitocin for speeding up labor
Aside from being used to induce labor, Pitocin is also commonly given to augment or artificially speed up labor.
The best current estimate of the augmentation rate in the U.S. is 57% (Bell et al., 2014).
That means over half of women are given synthetic oxytocin during labor! This is another way to disrupt physiological birth that doesn’t come without risks.
Increased risk of perineal injury and postpartum hemorrhage
Studies show that the use of Pitocin for labor augmentation also sets off the cascade of interventions. It increases the risk of fetal distress, operative delivery, instrumental delivery, perineal injury and more severe tearing, and postpartum hemorrhage (Jonsson et al., 2007; Indraccolo et al., 2010; Rygh et al., 2014; Tran et al., 2017).
Ironically, Pitocin is often given to reduce excessive bleeding or postpartum hemorrhage in medicalized childbirth because the natural oxytocin surge is blocked. Doctors call this “ third stage management.” Normally, a rise in oxytocin during birth followed by its release while the baby sucks at the breast reduces excessive bleeding (Bell et al., 2014).
Lower rates of breastfeeding success
In one study, women exposed to Pitocin in labor combined with an epidural had much lower oxytocin levels during breastfeeding. The more synthetic oxytocin that was administered during labor, the lower their oxytocin levels were for two days following birth (Jonas et al., 2009).
Pitocin use during labor may reduce breastfeeding success. Another study revealed that oxytocin administration during labor inhibits breastfeeding during the first hour after birth (Gomes et al., 2018).
The first hour after the baby is born is commonly called the golden hour and it’s so important for bonding and the future relationship of mother and baby. Establishing breastfeeding early on also helps expel the placenta and bring the uterus contract back to a smaller size, again with the help of natural oxytocin.
Resources
If you want to learn more, check out:
- These amazing resources from Sara Wickham
- Why Induction Matters, by Rachel Reed
- Sara Buckley’s post about synthetic oxytocin
- Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices, by Sara Buckley
I don’t get any commission from posting these links but consider them great educational materials that can help you in making the decision that’s right for you.
In Summary
What we’ve learned from the massive medicalization of birth that started in the last century is a simple truth: birth usually works best when left undisturbed.
Labor usually starts when mom and baby are ready. Our bodies know how to create a complex cocktail of natural hormones that supports safe and ecstatic childbirth.
Pitocin can disrupt that and trigger a cascade of other interventions that make the birth a less satisfactory (and often traumatic) experience. You can always decline Pitocin if you want to have a completely natural childbirth.
Was your labor induced or augmented with Pitocin? What was your experience like? Did your doctor discuss the pros and cons of labor induction with you?
Please share your experiences and thoughts in the comments. <3
Ana
The founder of Herbal Doula.
Home-birthing mama, independent scientist, natural pharmacist, doula, birthkeeper, and holistic health and birthrights advocate. Endlessly passionate about creating and sharing empowering health information and birth support. Ana has written 150+ and edited 800+ articles, some of which reached over 1 million people
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