The Hot Topic Tuesday prompt of the week is “Pitocin is safe.”
At thirty-eight weeks, an expectant mother often becomes eager to welcome her new baby into the world. If her pregnancy extends past the thirty-eight week mark, a woman might start thinking that her baby is overdue. Her doctor will often confirm her fears about an overdue birth and suggest using pitocin to induce labor. Even if her unborn baby is not showing any signs of fetal distress, an expectant woman will often agree to induce her allegedly overdue baby simply because she thinks that she is overdue after her due date. One of the most common medications used to induce labor is pitocin. However, using pitocin to induce labor is a medical intervention that is disturbingly overused but alarmingly under-questioned.
The first question that must be asked before inducing with pitocin is whether or not a baby is actually overdue. First, the due date that a woman is given at the beginning of her pregnancy is an estimated due date (EDD). An estimated due date is, by definition, an estimate. For example, even though I knew the exact day that I conceived my daughter, she was not born on her due date. In fact, she was born almost four weeks before her due date. My due date was January 7, which was at the forty week mark in my pregnancy. My daughter chose to make her debut into this world on December 12 at thirty-six weeks and two days. A due date is a guess, not some magical number or even an expiration date.
Predicting the date on which a baby will be born is not an exact science because so many factors can interfere. For example, the most common method for estimating a due date is to use a mathematical formula based on the date that a woman began her last menstrual period (LMP). However, the LMP method depends both on a woman accurately remembering the date of her last period and on the assumption that ovulation is predictable and consistent. Ovulation can and does occur on any day of the menstrual cycle. Menstrual cycles can and do vary in length. For example, my cycles are irregular, ranging anywhere between twenty-nine days and forty-two days. Furthermore, women often do not keep track of their periods. Therefore, a baby who is considered overdue based on an estimated due date may not actually be overdue in terms of gestational age and development. Using pitocin to induce an allegedly overdue birth can therefore result in the premature birth of an underdeveloped baby.
Additionally and most important, a baby is not considered overdue until after the end of the forty-second week of pregnancy. I repeat: A baby is not overdue until forty-two weeks and six days. An estimated due date tells an expectant mother about the beginning of her fortieth week of pregnancy. Even if a baby has not arrived by his or her due date, he or she still has almost three more weeks to bake until he or she is truly overdue. Some babies simply need longer inside the womb to grow and develop. Thus, even though a baby born through an induced labor may not technically be premature in terms of gestational age, he or she may personally have needed more time in utero for growth and development. Unless the mother or the baby is in imminent danger for which an immediate birth is the only solution, then nature should decide when a baby should be born, not a pitocin-wielding doctor.
Second, using pitocin to induce labor can lead to other serious problems in addition to the birth of a premature baby. Pitocin is a synthetic hormone similar to the natural hormone oxytocin. As a manmade drug, pitocin can cause some really nasty side effects in certain individuals. Unlike the uterine contractions triggered by the natural release of oxytocin during labor, the contractions produced by pitocin are often stronger, longer, and more painful. Such unnatural contractions often cause distress in both the mother and the baby and are actually the result of an overdose of pitocin. According to the information provided by the manufacturers of pitocin, pitocin should “stimulate uterine contractions comparable to those seen in normal labor” when “properly administered.” (For more information about the manufacturer warnings for pitocin, check out the interesting article 21 Scary Reasons to Say No to Pitocin, According to the Manufacturer.) That pitocin so often causes more intense contractions means that most doctors are overdosing pregnant women with the drug. An overdose of any drug is never safe.
Furthermore, because of the increased pain resulting from the use of pitocin to induce labor, women often request pain medications like an epidural to manage the pain. Epidurals often come with the unfortunate side effect of slowing or stopping labor. To get the labor moving forward again, more pitocin is given. More pitocin means even more painful contractions, which means the need for more anesthesia. After a while, the woman will give up on a vaginal birth at the urging of her doctors and consent to a cesarean section. Using pitocin to induce labor is therefore often the first step in an unnecessary chain of events that leads to a surgical birth.
Third, like other medical interventions deemed safe without supporting evidence, I have reservations with pitocin because of largely unstudied link between pitocin and autism. A handful of midwives and other birth professionals have asked a disturbing question: Does a link exist between pitocin and autism. With rising rates of both pitocin induction and autism in our country, I have to wonder about a possible relationship between pitocin and autism. Could the use of pitocin, a synthetic hormone, be a trigger for autism?
Of the little bit of research currently available, some researchers conclude absolutely no relationship between pitocin and autism. For example, in “Brief Report: Pitocin Induction in Autistic and Nonautistic Individuals” as published in the April 2003 issue Journal of Autism and Developmental Disorders, the researchers found no differences in induction rates of children with and without autism. However, other studies on inducing labor with pitocin have found a correlation between pitocin and autism. For example, in the thesis Pitocin’s Relationship to Autism and Determining the Existence of a Link between Them, the author concludes that, although pitocin is not a definite autism trigger, exposure to the drug might be linked to the development of autism. Furthermore, with only a handful of small studies on pitocin and autism to date, the long-term effects of inducing labor with pitocin have not yet been studied fully. In other words, doctors continue to rather indiscriminately use a drug for which the safety of has not yet been conclusively determined.
Is pitocin safe? As far as the link between pitocin and autism goes, maybe, maybe not. In terms of other factors, no, not really. If inducing labor with pitocin were necessary, then the human species would have died off long ago. I firmly believe in letting nature decide when a baby should be born. Inducing with pitocin not only causes labors that are unnecessarily difficult for mothers but can also result in babies who are born prematurely or otherwise developmentally immature. By decreasing the unnatural and unnecessary use of inducing labor with pitocin, labor and birth will certainly be better for mothers and for babies. Pitocin might be safe but only when used properly and discriminately.
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21 scary reasons to say no to pitocin, according to the manufacturer: http://briobirth.com/articles/21-scary-reasons-say-no-pitocin-according-manufacturer
Broderic, Jessica. 2010. Pitocin’s relationship to autism and determining the existence of a link between them. Thesis. Caldwell College. http://gradworks.umi.com/14/75/1475279.html
Gale, Susan, Sally Ozonoff, and Janet Lainhart. 2003. Brief report: Pitocin induction in autistic and nonautistic individuals. Journal of Autism and Developmental Disorders 33(2). 205-208. http://www.springerlink.com/content/l164107p23276740/
Pregnant Belly: http://commons.wikimedia.org/wiki/File:Pregnant_vulva_belly.jpg