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| |    Pitocin: Friend or Foe? by Marjorie Greenfield, M.D. reviewed and revised by Marjorie Greenfield, M.D. Pitocin, a medication used to induce or augment labor, has gotten a bad reputation-that it makes contractions much more painful, for example, or that it necessitates some invasive high-tech procedures. But while there are certainly downsides to injudicious use of this medication, keep in mind that, when used correctly, Pitocin sometimes can prevent the need for cesarean delivery. What is pitocin? Pitocin is the brand name of a synthetic form of oxytocin, a contraction-causing hormone made in a woman's brain. When used in medicinal form, Pitocin can initiate or augment labor by making contractions stronger and more frequent. Pitocin usually is given in liquid form, through a woman's intravenous (IV) line. Reasons for the use of Pitocin Pitocin can be used when labor needs to be induced, or during labor if the contractions are not strong enough to progress normally. Sometimes labor isn't going well despite apparently strong contractions. In these cases, where a cesarean is the only alternative, a doctor can use Pitocin to see if slightly stronger or more frequent contractions can help the labor progress. Downsides to Pitocin Because every woman responds differently to Pitocin, the dose must be carefully monitored and adjusted by the medical staff. Too mild or infrequent contractions won't bring the baby. Too strong or prolonged contractions, or too little rest between contractions, can stress the baby. Usually Pitocin is begun at a low dose, and increased every 15-60 minutes until a normal labor pattern is reached. This means that the mom must have an IV and be continuously hooked up to the fetal monitor while she is on the medication. Often an intrauterine pressure monitor, a thin tube that is placed up into the uterus next to the baby, is used to measure the strength of the contractions. Pitocin inevitably makes the labor experience more high tech and may preclude some anticipated comfort measures, such as standing in the shower, getting in the tub, or walking the halls. Some women also believe that Pitocin creates an unnaturally painful labor. For more information, see our article on Pitocin and Pain. Pitocin prevents cesareans! If the baby needs to be born because of a risk to the mom or baby, the ability to induce labor often prevents the medical staff from having to do a cesarean. In addition, in situations where the progress of active labor is slow (after a woman has reached four-five centimeters' dilation), the risk of cesarean is actually decreased if Pitocin is begun early, rather than waiting until labor has completely stalled. Finally, some couples who think of Pitocin as an unnecessary medical intervention should consider that, if labor stalls, the drug actually may help them achieve their goal of a natural vaginal birth.
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