On this page, we will talk about the use of Pitocin to stimulate or accelerate labor, and how the negligent use or administration of this hormone can lead to complications and serious birth injuries.
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What is Pitocin
Pitocin is a synthetic version of the hormone oxytocin which is released by the pituitary gland during childbirth. Oxytocin plays a crucial role in labor by stimulating uterine muscles to contract, initiating the birthing process. It further supports labor by prompting the release of prostaglandins, intensifying contractions. Administered intravenously, Pitocin swiftly enters the bloodstream, replicating oxytocin’s effects. Binding to uterine receptors, it activates muscle contractions in the uterus.
OB-GYNs use Pitocin primarily for two purposes: to induce labor in overdue pregnancies and to enhance contractions in cases of slow progress during childbirth.
Risks of Pitocin
Numerous studies have revealed a heightened risk of birth injuries and adverse events associated with Pitocin administration during childbirth. Two primary concerns underlie these risks: dosage response variability and hyperstimulation.
The challenge lies in determining the appropriate dosage of Pitocin due to significant variations in its effects among women. While some individuals experience overly strong and frequent contractions, others show minimal to no response to the drug. Complicating matters, there is no reliable method for measuring Pitocin’s impact once administered. Moreover, the drug’s effects typically manifest 30-45 minutes post-administration, leading to instances where subsequent doses are administered before the full effects of the initial dose can be evaluated.
Hyperstimulation presents another significant issue with Pitocin usage. Overdosing or an individual’s hyper-responsiveness to oxytocin can lead to dangerous overstimulation of uterine muscles. This overstimulation may result in excessively forceful, frequent, or prolonged contractions, potentially jeopardizing the health of the baby by placing undue stress on the placenta. Uterine tachysystole is when the mother has six contractions during a ten-minute interval. When tachysystole occurs during induced or augmented labor, it is time to turn off the Pitocin. Too many doctors and nurses ignore the standard of care and the hospital’s own protocols and continue to use Pitocin.
During labor, contractions can impact blood flow and oxygen delivery to the placenta, the organ that supplies oxygen and nutrients from the mother to the baby until the baby begins independent breathing after birth. With each uterine contraction, the placenta experiences momentary compression, temporarily restricting blood flow to the baby until the contraction subsides. Therefore, sufficient rest time between contractions is essential as it allows the baby to replenish oxygen levels before the next contraction.
If there’s any compromise in the fetus’s oxygenated blood flow for any reason, contractions can exacerbate the issue, placing the baby in urgent need of oxygen.
What Pitocin Cases Are Really About
There are doctors and nurses who are opposed to the use of Pitocin. The naysayers’ argument is that synthetic Pitocin is not real labor because while it can make the uterus contract, it cannot connect with the mother’s receptors in your nervous system. There is also the argument that Pitocin caused the natural oxytocin hormone to shut down and you need the organic oxytocin’s protective effects.
Pitocin is a dangerous drug, and it is probably overused. But the argument that there is no place for Pitocin is a tough sell. Medical malpractice lawyers skip this entire debate. You will not win malpractice lawsuits by alleging that Pitocin is a bad drug that should be recalled. That is a losing argument. Plaintiff’s lawyers have to concede that Pitocin is properly used to accelerate labor when the mother’s membranes have ruptured, but contractions have yet to effectively commence.
What is often a successful argument in courts around the country is that the doctors and nurses misused Pitocin. Virtually everyone, included defense experts, agrees that excessive doses of Pitocin can hyperstimulate the uterus and cause injury to the fetus. When Pitocin is started and continued despite non-reassuring fetal heart tones, it is can be a breach of the standard of care and form the basis of a malpractice suit not only against the OB/GYN but also against the labor and delivery nurses.
The Harm of Pitocin
Even Pitocin advocates have to concede that Pitocin is a dangerous drug that can cause harm to a mother and her baby. Pitocin’s purpose is to speed up delivery. However, in some cases, Pitocin can dramatically extend the duration of labor. If Pitocin is administered at the improper time during labor, it can hyperstimulate the uterus. This causes contractions that are longer and more painful. There is also less time between contractions, which decreases the recovery time for the mother and her baby.
How Much Pitocin?
The initial dose of Pitocin varies. Most typically, the initial dose for induction is .5 mU/min to 3 mU/min. For augmentation, the initial dose increases to 6 mU/min. Can you go higher? Sure. Some protocols for women not in labor are higher to “jump start labor.” But, often, this jump start is used when the mother is already in labor and the excessive dose is a breach of the standard fo care because it hyperstimulates the uterus in a way that is simply unnecessary.
Guidelines for Pitocin Use
The inherent dangers of Pitocin have led to the development of very strict medical guidelines for the appropriate use of the drug. These guidelines instruct that Pitocin should be administered conservatively starting at a very low dose with careful fetal stress monitoring. Once uterine contractions reach a normal pattern no further Pitocin should be given. Finally, if labor is still not progressing even after Pitocin has triggered normal contraction activity doctors should resort to C-section delivery NOT more Pitocin.
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