Doula Blog
All about Pregnancy, Birth, & Postpartum
You may have heard that Pitocin and Oxytocin are essentially the same, but there are crucial differences that are helpful to know when making decisions before, during and after birth. What is Oxytocin? Oxytocin is a naturally occurring hormone produced in the hypothalamus and released by the pituitary gland into the bloodstream and circulates throughout your entire body including your brain. What is Pitocin? Pitocin is a synthetic version of oxytocin that is chemically identical although they have significant differences. Pitocin is injected into your bloodstream through an IV (usually) and is not able to cross what's called the blood brain barrier, therefore it does not have an effect on the brain. (3) What does Oxytocin do to help labor? Oxytocin is sometimes referred to as the love or cuddle hormone. It is produced when we feel safe, warm, and loved. Sex, kissing, hugs, lactation, and labor contractions all cause increased oxytocin production. Oxytocin is produced by your body to increase intensity and frequency of labor contractions to bring your baby earth-side but because it crosses the blood brain barrier, it also signals to the brain to produce beta-endorphins- which have been shown to be 18-33 times more potent than morphine! (1) This calming, pain reducing, protective mechanism, that our body creates for us during labor, is helpful for moving through the pressure and strong sensations of labor. Oxytocin peaks towards the end of labor, giving the mother a rush of the morphine-like effects to decrease pain sensations in the pushing stage of labor as well as immediately after birth. This peaking of oxytocin also creates what's known as the fetal ejection reflex in some women, where the baby is birthed more quickly and easily, without the mother working hard to push the baby out. Oxytocin also improves mother/baby bonding and improves breastfeeding in the initial time after birth known as the “Golden Hour.” Why is Pitocin used during birth? Often Pitocin is offered for induction of labor (starting), augmentation of labor (speeding up), and to prevent or treat postpartum hemorrhage. Because Pitocin is given as a slow, continuous IV medication during labor, it has been shown to make labor pains more intense without the protective, pain reducing effects that naturally occurring oxytocin provides. This increase in pain sometimes leads women to choose an epidural which can decrease ability to move around during labor, cause labor to slow down, and decrease ability to push on your own because of decreased sensations. The slowing down of labor with epidural use can increase the need for a higher rate of Pitocin which leads to even stronger contractions. These stronger contractions brought on by Pitocin can increase the risk of fetal distress and may result in the necessity of a cesarean birth. “Mothers who have labored with and without Pitocin usually report that contractions augmented by Pitocin are much more painful, which may be due to increased intensity of contractions and low levels of beta-endorphins.” (2) Why is Pitocin used after birth? Some hospital policies having standing orders- meaning automatically done for every mother, to infuse Pitocin immediately after birth to prevent postpartum hemorrhage by increasing uterine contractility. The nurses also massage the fundus- the name for the uterus, which helps to stimulate the uterus to contract and shrink into a ball, so you don’t bleed too much after birth. To learn more about the current evidence of using Pitocin to prevent postpartum hemorrhage I encourage you to read the article from Evidence based birth linked here: Evidence on: Pitocin® During the Third Stage of Labor - Evidence Based Birth® To summarize, Oxytocin and Pitocin are both chemically identical hormones that facilitate the progression of labor by bringing on contractions and causing the uterus to contract after birth to prevent hemorrhage. However, they are different in important ways because the synthetic form called Pitocin does not have the morphine-like effects of Oxytocin that decrease pain and thereby decrease the risk of requiring other interventions during labor. Cuddle, kiss, dance, hug, ask for a back massage- these intimate things may help your body release protective endorphins that can decrease pain and promote baby's progress through your body and into your loving arms! For some women, using Pitocin to induce or augment labor is a medically indicated choice (ie. induction related to high BP, preeclampsia, postdates etc). However, many women are encouraged to use Pitocin during labor to “speed things up,” when it can lead to increased pain and medical interventions. Women should be educated on the risks and benefits of using Pitocin during labor and the incredible benefits for both mom and baby of allowing natural oxytocin to flow when possible. References/resources if you’d like to learn more!
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