05/29/2025
Pitocin: Synthetic oxytocin
Commonly used as a routine method to jump start or speed up/intensify contractions.
Pitocin was first synthesized in 1953, and became available for use two years later. By 1974, it was an established medical fact that its failure rate was 40-50 percent. In 1978, an FDA advisory committee removed its approval of Pitocin for the elective induction of labor. Interestingly, the drug was never approved by the FDA for use of augmenting labor.
Despite the above, hospitals routinely use Pitocin as a means of induction and convenience. When you are in the thick of it and your nurse or doctor suggests "speeding things up", you may be inclined to scream "yes" without knowing the risks of this rash, desperate and uninformed decision.
The natural rhythm of labor is supported by the release of oxytocin in bursts, as needed. Pitocin, in contrast, is administered as a constant IV drip that confines most women to bed. This decreases their ability to control pain caused by drug-induced uterine activity, and laboring women on Pitocin are more likely to require pain medication that slows labor. Think of the paradox: Pitocin is administered to speed up labor, but the increased level of pain requires medication that slows it down. In addition, Pitocin often has no effect on cervical dilation, even though the contractions it induces are much stronger, thus potentially leading to dangerous consequences.
Use of Pitocin has many side effects, including allergic reaction, headache, nausea and vomiting, fever, increased risk of emergency C-section, uterine rupture and hemorrhage, fetal stress and changes in heart rate leading to invasive fetal monitoring, reduced blood flow to the placenta, water retention, increased postpartum anxiety and depression and lower APGAR score.
This is not to say that Pitocin cannot be medically necessary and beneficial. Here are some instances when Pitocin should be considered:
1. When certain health conditions affect mama or baby
There are a number of rare, but serious health conditions and infectionsāgestational diabetes, preeclampsia, intrauterine growth restriction, and moreāthat may make it too risky for mama to carry baby to 40 weeks or beyond.
2. Water broke, but contractions havenāt started in 24-48 hours
If mamaās water breaks and contractions donāt start within 24 hours, many practitioners will want to induce. This is based on research performed in the 1950s and ā60s suggesting the chances of infection go up dramatically if babies are born any later than 24 hours after the membranes rupture. However, new research shows that women who meet certain criteria can safely wait 48 hours for contractions to begin (expectant management). To do so, mama needs meet the following criteria:
Term, uncomplicated, singleton pregnancy
Fetus in vertex position (head down)
Clear amniotic fluid
No infections (including GBS)
No fever
Normal fetal heart rate
No vaginal exam at baseline
Keep vaginal exams to a minimum (vaginal exams increase infection risk)
3. Labor stalls
If mom is more than 6 cm or if baby is in distress, Pitocin may be needed. If labor slows or stalls, but both mom and baby are doing well (and labor was not induced and mom is less than 6 cm dilated), evidence suggests that itās best to let birth unfold on its own.
4. After labor, if bleeding cannot be stopped
Even after birth, Pitocin causes contractions in the uterus. These contractions squeeze down on the raw blood vessels that are exposed as the placenta is released, reducing bleeding and hemorrhaging. These contractions also help the uterus contract back to its normal size. Therefore, Pitocin can be a great tool for managing excessive blood loss or even to push out a stubborn placenta that doesnāt want to come out.
Find a provider that supports and encourages the progression of labor through the natural physiological process and holds space for the hormonal exchange shared between the mother and baby. Ask questions, read books, educate yourself on the birthing process and routine hospital protocols, and of course, hire a doula that offers educational, informational, emotional and physical support!
