Pitocin: Risks and Side Effects

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Pitocin has become a go-to solution of convenience for managing labor, whether used for induction or to speed up a slow progression. Hospitals across the United States use Pitocin as a regular part of the birth process - often as a time management tool - which means that longer labors will either deliver faster or may result in a C-section.

In some high-risk cases, Pitocin can be valuable when used correctly. However, our medical system is pushing Pitocin more and more when unnecessary, frequently causing complications where there were none to start with. 

Birthing Interventions in the U.S.

Maternity care in the U.S. involves a lot of interventions. According to the Listening to Mothers III report [1]:

  • 89% of women had electronic fetal monitoring (66% continuously)

  • 62% received IV fluids

  • 79% weren't allowed to eat during labor

  • 60% weren't allowed to drink during labor

  • 67% of women who had vaginal births got an epidural

  • 31% were given Pitocin to speed up labor

  • 20% had their membranes artificially ruptured

  • 17% had an episiotomy

  • 31% had a C-section

Sometimes there are true birthing emergencies. But why does every birth suddenly “need” so many medical interventions? 

Such heavy use of interventions comes from a mindset of expecting problems and viewing birth as a medical emergency. However, research is showing that a routine use of interventions in the past several decades has actually caused more complications for both moms and babies.

The Paradox of Pitocin

Pitocin is a synthetic form of the naturally occurring hormone, oxytocin. It’s used for inductions: when the birth is scheduled, when the pregnancy goes beyond the due date, or when there is a high-risk medical reason such as preeclampsia or diabetes. It is also used for labor augmentation to strengthen and regulate contractions if labor is not considered to be progressing.

Did You Know? It’s actually super normal for pregnancies to go beyond their due date! The due date is just an estimation, and there’s no reason to be worried if the baby hasn’t arrived a week or two after (as long as there are no medical concerns). 

Here is where the paradox of Pitocin comes in: while it is supposed to facilitate labor, Pitocin often leads to complications that can slow the process and increase the chance of a C-section. Forcing a pregnant woman’s body to labor before it is ready can cause several issues, usually related to uterine hyperstimulation or protracted labor.

  • Uterine Hyperstimulation: Pitocin can cause overly strong and frequent contractions, known as uterine hyperstimulation.

  • Protracted Labor: Even though Pitocin is supposed to progress labor, it often does the complete opposite. For many women, it actually prolongs labor. The uterus can become fatigued or the cervix may not dilate as expected, leading to a slower, more painful labor process.

Other Side Effects and Risks of Pitocin

Maternal Side Effects: 

  • Nausea, fever, or headaches

  • Increased risk of postpartum depression and anxiety

  • Breastfeeding problems

    • Study shows that half of the women who received Pitocin had less optimal breastfeeding outcomes than those who did not receive Pitocin [2]

  • Rare cases of uterine rupture

Fetal Side Effects: 

  • Hyperstimulation can cause fetal distress, often leading to an emergency C-section

  • Oxygen deprivation from hyperstimulation is a leading cause of birth injuries such as cerebral palsy [3 , 4]

  • If Pitocin leads to a C-section, the baby misses out on the huge benefits of traveling through the birth canal (improved microbiome, less allergies, less risk of obesity, diabetes, or asthma)

Pitocin When Used with Other Interventions

Using Pitocin often sets off a domino effect of interventions. Pitocin usually goes hand-in-hand with electronic fetal monitoring, which can restrict the mother’s mobility and make labor more uncomfortable. This, in turn, can lead to an increased use of pain relief such as epidurals, which often slows labor down even further and increases the risk of more interventions, including C-sections.

Epidurals and Pitocin are often used together, which tends to cause a downward spiral in speed and ease of labor. 

To navigate the birth canal, the baby needs SPACE. To give the baby space in your pelvis, we recommend walking, squatting, or laboring on all fours so gravity can help. With an epidural, you are typically confined to a bed, which means you cannot walk around or get into natural positions that will help the baby engage.

At the same time, if Pitocin is administered, your body will start to experience strong contractions. If you are in a less-than-ideal position that does not give the baby enough room to move down, yet your uterus is being forced to contract, labor can easily stall, possibly putting the baby in distress and making a C-section more likely.

We recommend caution when dealing with Pitocin - there are certainly times when it works as intended and women have the births they want! Unfortunately, there are also many times when it only hinders labor and causes preventable problems. Our goal at the Cincinnati Birth Center is to help women make informed decisions for their births so they can choose what is best for them and their babies.