Belly Up

* bellies * birth * babies * breastfeeding *


Friday, February 24, 2012

Pit is (not) Evil

I admit it, I am sucker for this type of  moment.
Did I type that title?  Yes...pitocin in and of itself is not evil.  I do hope that anyone who is reading this post about pitocin will go back and read Pitocin Part 1 (http://bellyupbaby.blogspot.com/2012/01/pit-stop-pitocin-part-1.html ) as they really do go together, however the truth is that some women need inductions and sometimes the risks of a pregnancy continuing are higher than the risk of whatever it takes to get that baby out. Of course too often the risks of a continued pregnancy are over emphasised while the risks of induction are often under emphasised (or not mentioned at all) but medical reasons to induce do exist.  Another reason to induce is that a woman may have reason to request an elective induction.  I am going to stand by this reason, though I may sometimes be standing by scratching my head.  I 'll also just admit that I am sucker for those hallmark moments where a father is about to be deployed and wants to meet his child before he is put in harm's way.  Given that penchant for sentimentality and the reality that elective inductions *do* happen, I will leave that topic for another day and continue addressing using pit for good and not evil.

The biggest pro of pitocin is that for a woman who needs to deliver her baby, pitocin offers a fairly reliable way to get labor going.  Used in conjunction with other drugs and interventions, it offers women a chance to have a baby on-demand that does not automatically involve major abdominal surgery.  Yes it increases the odds of having a surgical birth as compared to spontaneous labor but if a c-section is scheduled the chance of a c-section is 100%...so the odds are more in favor of a vaginal birth with a pitocin induction.  Pitocin gives these women a chance for a vaginal birth and all the benefits that come with it.

If your OB looks like this,
it is probably best to say
no to the pitocin
A common theme I hear from women is that once they are told they are going to be induced they feel it will be impossible to have a natural birth, and by natural I mean pain med free - not a birth sans drugs since obviously pitocin is a pharmaceutical.  I would argue that in an induced birth it is even more important to delay or forgo an epidural in order to increase the odds that the induction will be successful.  Yes, mom will have to get creative but the constant fetal monitoring that comes along with pitocin still gives women room to stand, do a bit of walking and swaying and the bed itself offers endless position opportunities.  Her pelvis is at a disadvantage already because it doesn't have all those lovely labor hormones to help it stretch, so whatever mom can do to help it will be appreciated by her baby and her pelvis.

However, contrary to popular belief, the contractions caused by pitocin are not stronger than those of normal labor, they just become intense and closer together more quickly and unlike a spontaneous labor they don't ebb and flow as much.  An induced labor that is going well will probably look like the active to transition stages of labor from early on and this is where pit gets its bad reputation.  The good news then is that a pitocin induction is usually shorter than a spontaneous labor so if a mom can see the "light at the end of the birth canal" she can deal with these contractions just as a woman can deal with the contractions of late labor....induced moms just get there quicker (or not at all depending on how mom/baby respond to the meds of course). 

Pit is also used commonly to augment, or help intensify and make a labor more effective.  This method is way over used (especially in 1st timers) due to false obstetric expectations of the course of normal labor, however there are labor patterns that will benefit from pit.  Well timed pit truly helps some women avoid surgical birth.  Perhaps if these moms were given endless days to labor and the full compliment of chiropractic adjustment, nutrition and proper relaxation they would deliver, but most women are literally exhausted after a day or two of labor and lack of sleep, especially if they do not have an epidural.  These are the women that have no energy to push even if they eventually reach full dilation (though being able to eat and drink at the hospital would certainly help in this regard!) .  Usually a little pitocin will get these moms to the finish line with enough energy left to push out a baby thus avoiding a c-section or assisted delivery.

So my final thoughts regarding pit:
* If you are having labor induced, be nice to your pelvis and say no the epidural for as long as possible.  If you had your heart set on a natural birth, don't give up just because pitocin is a part of your new birth plan.  Instead get a new mindset and get creative.

* If the choice is laboring to the point of exhaustion just to avoid pit, really think through your options and make an informed choice about the use of pitocin in your labor.  A little pit is occasionally the difference between a vaginal birth and a c-section.

* Most importantly, pitocin is way overused in births.  It carries risk and is often given unnecessarily and in a way that increases the inherent risks of the drug.  Choose a careprovider that does not routinely use pitocin in the way,