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The discovery of synthetic oxytocin is one of the most profound advances in obstetrics. How does Pitocin facilitate labor, and what adverse effects do you need to be aware of?

Labor induction and Oxytocin (Pitocin)

Oxytocin — the love, cuddle, and trust hormone — does more than enhancing social bonds, treating autism and schizophrenia, and putting smiles on our faces when we see a loved one.

Doctors and midwives could advise women in labor to hug or get cuddled by a loved one. This act naturally increases oxytocin’s production, and when oxytocin is secreted, it causes contractions of the uterus, which speeds up labor.

During pregnancy, there is an increase in the numbers of oxytocin receptor cells in the uterus. The secretion of this nano-peptide stimulates uterine contractions, thereby initiating labor and cervical dilation. The word oxytocin comes from the Greek terms "oxy" (quick) and "tocos" (birth), and it's easy to see why! [1]

What Is Labor Induction?

The most influential event in medical history is the shift from home births to giving birth in the hospital in the early twentieth century. This, in turn, led to medical technology and discoveries to aid labor and delivery, including labor induction. [1]

When labor starts, it triggers a complex and amazing process between the mother and the child. The child relays a message to which the uterus and the brain respond by releasing oxytocin. This causes the uterus to contract, dilates the cervix, and pushes the baby out.

As the process goes on, there is a rise in oxytocin levels, which instigates the brain to release endorphins — a natural painkiller.

If this process is altered or stopped for any reason, medical practitioners can augment labor or speed it up to achieve a safe delivery.

Labor induction is the artificial start or stimulation of the labor process through the use of medication or medical techniques to speed labor or induce contractions. [2]

Before an induction, midwives or doctors often use the bishop's score to determine if the cervix is ready for labor. If it is low, a cervical ripening agent (primarily used to achieve a favorable cervix) is used to attain a higher bishop's score during the start of the induction process. Labor is then induced with the use of synthetic oxytocin, known as Pitocin or Syntocinon.

Reasons For Labor Induction

  1. If the baby is not getting enough oxygen and nutrients from the placenta
  2. If the amniotic sac ruptures before the start of labor and labor does not begin within 24 to 48 hours.
  3. When there are complications such as preeclampsia, hypertension, bleeding during pregnancy, or gestational diabetes.
  4. When the pregnancy has exceeded 42 weeks with a decrease in the supply of nutrients to the baby from the placenta.
  5. When the uterus is affected by chorioamnionitis (infection inside the uterus). [3]

Pitocin

Pitocin is the synthetic version of the naturally occurring oxytocin. It is used by doctors and midwives to induce labor. It is also used to abort a fetus in cases of miscarriage or incomplete abortion.

Pitocin is a uterine stimulant that alters the concentration of calcium in the uterine muscle cells, leading to uterine contractions, and also controls bleeding after childbirth. Pitocin is only administered through an IV if the cervix is ready and without the softening of the cervix, the administration of Pitocin for induction is useless. [4]

Concerns About Pitocin

1. The use of Pitocin can cause labor to progress too quickly, thereby causing a difficulty in the management of contractions without pain medication [5]. Hence, a discontinuation of the dosage is advised if the contractions become too powerful.

2. Pitocin should not be administered to those with:

  • Allergies to ingredients in Pitocin.
  • A small birth canal — too small for the head of the fetus.
  • Complications that require medical help for birth.
  • Blood bacteria.
  • Difficulties in having a child through spontaneous vaginal delivery as a result of cervical cancer, genital herpes, or other medical conditions.

3. According to a study, the use of Pitocin can also cause adverse effects in the mother, like anaphylactic shock, nausea, and vomiting, postpartum hemorrhage, cardiac problems, hematoma, water intoxication, uterine spasm or rupture, and hypertension. [1] [6]

These adverse effects can result in other problems. For example, coma may be induced by prolonged or severe water intoxication. For the fetus, Pitocin can lead to seizures, retinal hemorrhage, jaundice, low Apgar scores, damage of the central nervous system, and even death. [7]

In summary, synthetic oxytocin (Pitocin) may have its advantages, yet, it is not advisable to turn a blind eye to its adverse effects.

Although there are other natural ways of inducing labor, such as nipple stimulation and sexual intercourse (no strong scientific evidence), these two ways can aid labor induction because they have the capacity to naturally increase oxytocin secretion.

Yet, if Pitocin is taken under the right conditions and under good medical supervision, it can play an important role in facilitating safe childbirth. 

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