Pitocin - When It's Used, What It's Like, and How to Avoid Unnecessary Use

Pitocin^® is the brand name of synthetic oxytocin. Oxytocin is the body's hormone responsible for causing contractions and promotes the movement of milk for breastfeeding. Oxytocin, which is present in all people, is also responsible for certain human behaviors like romantic attachment, sexual arousal, and the parent-child bond.

Pitocin, a synthetic hormone, is used in labor and birth as an injection (via IV or needle) for a variety of reasons. As a person preparing for birth, it's important to learn about the use of Pitocin -- the when, how, and why -- as well as understanding the effects, alternatives, and when Pitocin is used unnecessarily. This matters because Pitocin, like any medication, is not without risks. If you can avoid its use, or use only when the benefits outweigh the risks, you can help improve the likelihood of healthier outcomes for you and your baby. 

When Is Pitocin Used in Labor and Birth?

Pitocin is used for a few different reasons during labor and birth. It is primarily used during an induction (a medical process that causes labor to begin instead of allowing labor to begin on its own) and is administered in the hospital starting at a low dose through an IV. Pitocin is also used to "augment" or speed up labor, causing contractions that are stronger and more frequent. Pitocin also is commonly used as an injection after birth to prevent hemorrhage. 

When Is Pitocin Necessary?

Pitocin may be necessary if there is a medical reason to induce or augment your labor. For example:

• Your labor is slow, as determined by your care provider, and doesn’t respond to movement, position change, and hydration.
• You don’t go into labor spontaneously by 42* weeks of pregnancy.
• You have a uterine infection.
• You have severe pregnancy-induced hypertension.

*There is evidence that induction at 41 weeks can reduce stillbirth and poor outcomes. Talk to your provider to review the many factors that can impact the decision to induce or wait for labor to begin on its own.  

What Is an Experience with Pitocin Like?

When Pitocin is used during labor, your baby will be monitored more closely to make sure the medication is being tolerated, as Pitocin creates stronger contractions, which can cause stress for baby. This means you will have continuous external fetal monitoring (EFM) in place via bands that wrap around your abdomen. Pitocin for induction or augmentation is delivered via IV, which means you will have an IV in place throughout. Both an IV and continuous EFM can make moving around and changing positions significantly more difficult. This can be problematic because contractions enhanced with Pitocin can be a lot more challenging to cope with, and moving/changing positions are known ways to cope with the pain of contractions. Because Pitocin makes it harder to cope, many people who have Pitocin opt for medicinal pain relief, like epidural. An epidural brings its own set of challenges and risks. 

The most frequent complications people experience with Pitocin include very intense contractions, difficulty coping with the pain, troublesome fetal heart rates on the monitor, and the increased incidence of c-section due to fetal distress or "failed" induction. 

Pitocin Alternatives 

Unfortunately, Pitocin is overused by some care providers. In some situations, waiting it out is all that's needed, whether waiting for labor to begin on its own or waiting for a slowed or stalled labor to get back to a regular pattern. Be wary of providers who put labor on an arbitrary deadline. If mother/parent and baby are determined to be healthy despite a slowed labor, use of Pitocin is likely unnecessary. 

If Pitocin is recommended for a slowed/stalled labor, ask your provider the following questions:

• What are the benefits of using Pitocin?
• What are the risks?
• What are the alternatives?
• What would happen if we do nothing right now?

Then, ask yourself: What is my gut/intuition telling me to do?

If labor has slowed, there are other effective alternatives to Pitocin, including: 

• Waiting
• Moving around; try walking, sitting up, standing, getting into a shower
• Changing positions, like sitting on a birth ball or in a rocking chair
• Nipple stimulation to encourage contractions

Learn more about Pitocin and alternatives to Pitocin by taking a virtual or in-person Lamaze class! Search our directory to find one that meets your needs.