Are you planning a natural birth and facing the possibility of needing an induction? Maybe you’re worried about how it would impact your desire to have an unmedicated childbirth. Or perhaps you just want to learn about Pitocin in case a situation arises where your doctor offers or recommends it. Educating yourself about it is a great idea, and it will help you to feel empowered to make a decision if the need arises. So, let’s talk about the upsides and downsides of natural birth with Pitocin.

Estimated reading time: 8 minutes

Natural Birth With Pitocin: What Is Pitocin?

Oxytocin is a hormone that stimulates your uterus to contract when you’re in labor. Pitocin is a synthetic form of oxytocin (1). This means that it’s an artificial, chemical substitution for the actual hormone. Therefore, Pitocin can also be used to cause your uterus to contract.

Here is the FDA’s official “label” or information sheet for Pitocin, in case you want to read about it.

What Does Oxytocin Do?

In the natural process of a spontaneous (non-induced) labor, oxytocin production in the mother’s body increases to initiate labor. Surges of oxytocin are produced by the mother, and the baby’s body produces oxytocin as well. The delicate balance of oxytocin with other hormones guides the body through the process of labor and birth.

Natural Birth With Pitocin: Why Is Pitocin Used?

Sometimes, if labor progresses excessively slowly or stalls, doctors suggest Pitocin to encourage it to move along. Other times, if labor hasn’t even begun but your doctor thinks it needs to happen sooner rather than later, he or she may suggest inducing labor with Pitocin. Essentially, it boils down to this: When a body isn’t contracting well enough on its own, Pitocin can be used to help to increase your contractions’ frequency, duration, and intensity (1, 2).

How Is It Used in an Induction?

Before a labor induction is started, your doctor or midwife will first evaluate your cervix to see if it is soft and ready to efface and dilate easily. If so, it is considered “ripe.” If your cervix isn’t ripe, meaning that it’s still closed and firm, your doctor may give you an oral or cervical ripening agent to help encourage softening and dilation. This is an important first step because although Pitocin causes contractions, but it doesn’t help ripen your cervix.

Once the cervix is deemed ripe, you are given Pitocin through an I.V. A pump controls the dose so that they can change the amount you’re getting quickly and easily or stop it if you or baby don’t tolerate it well. They will gradually increase the dosage until labor begins. Both you and baby will be monitored throughout the process.

Read more about inductions: Inducing Labor Pros and Cons

How Does Pitocin Help Stalled or Ineffective Labor?

Maybe your labor has stalled, and you’ve been in labor for too long for doctors to feel safe waiting for contractions to pick back up on their own. Or maybe your contractions are too weak and/or far apart to cause effacement and dilation of the cervix. Either way, Pitocin can be used to help encourage labor contractions and ultimately keep the process of giving birth moving forward.

Natural Birth With Pitocin: Pros and Cons

Now that you understand what Pitocin is, and how and why it may be used, let’s get into the pros and cons. It is a very valuable tool to have in the right situation. However, like anything artificial that you put into your body, it is not without risks. Learning about the pros and cons allows you to prepare for making decisions, if the need arises.

Pros

• Pitocin can often jump-start labor in cases where there’s a medical necessity. Sometimes baby needs to be born immediately due to conditions that affect the mom (like preeclampsia or gestational diabetes) or affect the baby (like IUGR or low amniotic fluid).
• It can help prevent a C-section in cases where mom’s water has broken, but labor hasn’t started. Doctors will typically wait at least 24 hours after the water breaks before encouraging intervention, and research shows that even 48 hours is often safe (3). But after that, the risk of infection rises quickly. Using Pitocin to start labor can prevent having to deliver surgically.
• If labor stalls (particularly after 6 centimeters dilation) or baby is showing signs of distress, Pitocin can help the birth proceed quickly and hopefully prevent a C-section. Fortunately, 75% of induced labors result in vaginal delivery (4).
• When mom is losing too much blood after delivery, or the placenta doesn’t detach easily, Pitocin can stimulate contractions that help reduce bleeding and hemorrhage.
• Pitocin puts you more quickly into active labor, and may help you avoid a long, tiring early labor.

Cons

• Patients and providers both agree that Pitocin-induced labor is more painful than spontaneous labor. The synthetically-induced contractions can be closer together, stronger, and longer than those stimulated by oxytocin. Additionally, the uterus never fully relaxes between contractions (5).
• Pitocin can’t perfectly mimic natural oxytocin or the way the body releases it. Your body releases oxytocin in bursts, not a steady stream. And your body can give you exactly the right dose at the right time. For instance, oxytocin surges at the end of labor to help with the pushing stage (8).
• Pitocin inductions lead to more interventions than labors that begin naturally (6). More women who have had Pitocin choose an epidural for pain management — 78% vs 61% (7) — likely due to the fact that Pitocin produces more intense labor.
• Mom can’t move as freely as she otherwise would because Pitocin induction requires continuous fetal monitoring. This means that mom must be hooked to monitors to carefully monitor baby’s reactions to the Pitocin. While the monitors don’t completely restrict mobility, labor pain can be more difficult to manage when you can’t move freely.

Cons for Baby

• May lower baby’s oxygen and heart rate. It is normal for baby’s heart to briefly decelerate, or slow, during a contraction. In most labors, this brief deceleration doesn’t typically cause baby any problems. However, the fact that Pitocin contractions last longer, come closer together, and don’t fully relax can cause stress on the baby (5) and can lower his oxygen and heart rate (4).
• Baby may have lower APGAR scores (7).
• May increase risk of jaundice (7).

Can You Still Have a Natural Birth With Pitocin?

Yes! Despite some challenges, natural birth is still very possible, even with a Pitocin induction. In our Kopa Members facebook group, moms frequently share their natural birth stories following Pitocin inductions. These moms report using the very same labor coping tools that they would use in a spontaneous labor, such as breathing techniques, deep relaxation, and position changes. They simply have to get more creative about how to incorporate movement, and may get less of a rest in between contractions.

I personally experienced a Pitocin induction with the birth of my second son. Despite my best efforts to encourage contractions, I was 10 days past my due date with no signs that labor was starting. To decrease the risks that develop as the placenta ages, I decided to induce labor. Read about my experience and how I was able to have a natural birth with Pitocin in Induction Without Epidural: My Natural Birth Baby #2

Natural Birth With Pitocin: The Takeaway

Pitocin is an incredible tool for those times when medical necessity requires labor to begin immediately, or when the labor pattern has a dramatic stall. Still, it poses legitimate challenges and drawbacks for a mom who is attempting a natural childbirth. As with all labor interventions, weigh your options carefully, and use this “labor help” only if the help is really needed.

References:

1. The American College of Obstetricians and Gynecologists.  (2010).  Your Pregnancy and Childbirth Month to Month, 5th edition.
2. Simkin, P. (2010). Pregnancy, Childbirth and the Newborn, 4th edition. Meadowbrook Press.
3. Pintucci, A., Meregalli, V., Colombo, P., & Fiorilli, A. (2014). Premature rupture of membranes at term in low risk women: how long should we wait in the “latent phase”?. Journal of perinatal medicine, 42(2), 189–196. https://doi.org/10.1515/jpm-2013-0017
4. Labor induction. (2020, May 13). https://www.mayoclinic.org/tests-procedures/labor-induction/about/pac-20385141
5. Lothian J. A. (2006). Saying “No” to Induction. The Journal of Perinatal Education, 15(2), 43–45. https://doi.org/10.1624/105812406X107816
6. Alfirevic, Z., Kelly, A. J., & Dowswell, T. (2009). Intravenous oxytocin alone for cervical ripening and induction of labour. The Cochrane database of systematic reviews, 2009(4), CD003246. https://doi.org/10.1002/14651858.CD003246.pub2
7. Doreen, Maria, Faith, Kayte, Tl, Penny, . . . P., R. (2020, August 08). The truth about pitocin (and when it’s worth the risk). Retrieved May 08, 2021, from https://www.mamanatural.com/pitocin/
8. Buckley S. J. (2015). Executive Summary of Hormonal Physiology of Childbearing: Evidence and Implications for Women, Babies, and Maternity Care. The Journal of perinatal education, 24(3), 145–153. https://doi.org/10.1891/1058-1243.24.3.145

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

Here are some other natural birth articles we know you’ll love!

• Natural Birth Pros and Cons
• How to Have a Natural Birth in a Hospital: The Ultimate Guide
• Natural Birth With Doula: Boe’s Birth Story
• How Long Does It Take for a Natural Birth?
• Top Natural Childbirth Benefits for Babies & Parents