…but reducing the rate of Pitocin reduced the rate of emergency C-sections and vacuum or forceps deliveries. Click here to read the whole article. One thing that was (negatively) intriguing to me, is that the hospital’s Pitocin rate prior to the change was 93.3% — almost every woman planning a vaginal birth (at least, I assume the numbers would exclude planned C-sections; and didn’t include postpartum Pitocin use) got Pitocin either to augment or induce her labor. Even after the protocol change, over 3/4 of the women still received Pitocin.
h/t to Empowering Birth for the link
Also, in light of the whole “Pit to Distress” conversation, the above article had a link to a AJOG paper, which it cited as evidence for suggesting that pitocin not be increased more frequently than every 30 minutes (although many hospitals currently increase it every 20 minutes). The paper had the following abstract:
Oxytocin is the drug most commonly associated with preventable adverse perinatal outcomes and was recently added by the Institute for Safe Medication Practices to a small list of medications “bearing a heightened risk of harm,” which may “require special safeguards to reduce the risk of error.” Current recommendations for the administration of this drug are vague with respect to indications, timing, dosage, and monitoring of maternal and fetal effects. A review of available clinical and pharmacologic data suggests that specific, evidence-based guidelines for the intrapartum administration of oxytocin may be derived from available data. If implemented, such practices may reduce the likelihood of patient harm. These suggested guidelines focus on limited elective administration of oxytocin, consideration of strategies that have been shown to decrease the need for indicated oxytocin use, reliance on low-dose oxytocin regimens, adherence to specific semiquantitative definitions of adequate and inadequate labor, and an acceptance that once adequate uterine activity has been achieved, more time rather than more oxytocin is generally preferable. The use of conservative, specific protocols for monitoring the effects of oxytocin on mother and fetus is likely not only to improve outcomes but also reduce conflict between members of the obstetric team. Implementation of these guidelines would seem appropriate in a culture increasingly focused on patient safety.
Filed under: birth choices, C-section, induction, studies & stuff | Tagged: augment labor, baby, birth, C-section, cesarean section, childbirth, delivery, emergency C-section, hospital, hospital birth, induce labor, labor, oxytocin, pitocin, pregnancy, pregnant |