I wonder how often pitocin is really necessary

One of the blogs I keep up with is a new L&D nurse. She worked over the Christmas and New Year’s holidays, and blogged about it. One of the stories she told was that of a first-time mom who came into the hospital in labor on the holiday, when her doctor was off and didn’t want to disrupt his holiday to come in to catch the baby, so he didn’t want to do anything to speed her labor up, so didn’t order Pitocin. The nurse sounded like this woman was one of the few women if not the only woman she had ever attended who did not have Pitocin to induce or augment labor.

But this mom — a first-time mom, you will remember! — actually managed to dilate without any Pitocin! At all! Can you believe it? (Yes, I’m being sarcastic.) Wow — her body actually was able to contract the uterus and open the cervix without any help from artificial substances. Incredible.

When the nurse got off of her shift, the mom was almost fully dilated — stll without a drop of Pitocin, because it was still before office hours and the doc hadn’t showed up yet.

Judging by the tone of the post, most if not all of the women this nurse attends in labor get Pitocin — or at least the first-time moms who tend to have slower labors. Probably these women think that it is necessary. Somehow, I doubt that it is “necessary” for any reason other than speeding up a normal labor so that it is more convenient for the doctor.

4 Responses

  1. Pit is way over used in every hosptial I have ever attended a birth.

    Active Management of Labor without the benefits of continuous support and hey we have a nice expensive c-section…makes ya wonder huh?

  2. How does the Friedman’s curve for labor play into the overuse of pitocin/syntocinon and cesarean section for failure to progress/dystocia? Apparently independant midwives, and some more ethically minded OB’s are advocating for a rethink on the allowed time for women’s labors, calling the currently used curve obsolete.

    (The Friedman Curve: An Obsolete Approach For Labor Assessment, womens-health.jwatch.org)

    Changing the imposed limit on labor time would probably vastly reduce the use of routine and unnecessary obstetric procedures and profit, while at the same time increase the need for more all-hours in house staff. Necessary cesareans would probably also be reduced as pit/synto actually causes fetal distress, hemorrage, and uterine rupture to name just a few.

    Cesareans are the biggest hospital moneymakers as the most performed surgeries in the US/AUS, second only to hysterectomies. This money is not being pumped back into maternity services in the form of increasing facilities/staff/positive results.

    If medical centers are forced to give up the Friedman Curve as a concession to evidence based medicine women and babies will benefit vastly, but hospital profits will suffer. When will families draw the line?

  3. As far as I know, hospitals can only charge a set fee for a birth (as far as charging for a room), regardless of how long a woman is actually in the hospital laboring or giving birth. If she’s in the hospital 20 minutes or 20 hours prior to the birth of the baby, I bet the reimbursement will be the same by the government or insurance companies. This means that hospitals certainly have a vested interest in speeding up normal labors. One L&D nurse’s blog I keep up with recently talked about how busy they were one night, with all of their rooms full (most with “false alarms” or women just getting checked out — having slipped in the snow or something) — they were so full that there were several women in the waiting room who were scheduled for inductions but they had to wait until there was an open room for them to labor in. Speeding up labors for medically unnecessary reasons *may* be good for the bottom line, but certainly unethical.

  4. My experience with Petocin during my first delivery was a trauma, the nurse told me it was going to help me, but it didn’t my body was kind of out of control, I experience a lot of pain. My mother in law made a comment to my husband that the same happened to her so she didn’t take it the second time and it was way better, so I did the same for my second delivery, and it was easier, faster and way less pain. I have a friend who has 8 children and she adviced me that the best way for her to handle contraction pain before the delivery was talking to your body positively and agreing with it about the process because contractions are important since they prepare the whole body for the delivery, so I did that the second time because I was very scared and it did worked with me, I waited until I couldn’t almost walk and went to the hospital and in 3 hours I was done. I had a natural delivery, no Petocin and no Epidural. This is my personal experience I share with you. God bless you.

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