Pitocin Induction: What Are the Risks and Benefits?

Pitocin Induction: The Risks and Benefits

What Is a Pitocin Induction?

An induction with Pitocin means your doctor or midwife will induce 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 2-3 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 nurse may actually shut off the Pitocin all together. Sometimes, the Pitocin is enough to "kick" your body in natural labor on its own.

No induction will start with Pitocin unless your cervix is favorable. And 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 woman's cervix with a Bishop's score before deciding if she is ready for an induction. Anything less than a six means her cervix may not be ready for labor. If your cervix is ready, however, it's time for Pitocin!

What Are the Benefits?

There are some benefits to being induced. Of course, there’s the obvious benefit of getting that baby out early if you're just over being pregnant.

A study published in the Canadian Medical Association Journal also found that the risk of cesarean delivery was actually lower with inductions for women at term or post-term than for those who were medically observed until delivery.

The same study found that the benefits of a Pitocin induction were significant for the baby, without any added risk for the mother.

Will I Need to Be Induced?

Inductions are medically necessary in cases when the risk of the baby staying in utero exceeds the risk of the induction.

Reasons for induction include conditions like polyhydramnios, pre-eclampsia, fetal growth restrictions, and other dangerous complications. If your water has broken but you haven't gone into labor on your own, if you are more than two weeks overdue, or if your labor has stalled, your doctor may also suggest using Pitocin to help get your labor moving.

Risks of a Pitocin induction

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

These risks make sense, especially for first-time mothers. Starting an induction is usually the start of a long process. A woman will start with a cervical ripening agent (medication), if she needs it, which can take hours to work. Then she will move on to Pitocin, which is slowly increased in her IV.

Once you are on Pitocin, you must be strictly monitored and remain in bed so your labor progresses more slowly.

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. This often leads to hunger and exhaustion. Pitocin-induced contractions might interfere with rest, 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.

Next steps

If you're considering an induction, especially if you’re a first-time mom, talk to your doctor about the risks and benefits.

Unless a Pitocin induction is medically necessary, let labor happen on its own.

When my doctor brought up an induction during my fourth pregnancy, I panicked. An induction? Me? I’m a labor and delivery nurse, and I have preached firmly against inductions unless absolutely necessary. But my doctor suggested an early induction at 37 weeks because of a condition I had called polyhydramnios. On one hand, I felt like someone was handing me a get-out-of-the-last-weeks-of-pregnancy-free card. But I also felt wracked with guilt and stress over the decision. But sometimes, inductions are medically necessary. And in those cases, you have to ask yourself: What are the risks and benefits?
– Chaunie Brusie, RN, BSN
chaunie brusie

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