Postpartum Pitocin
One of the most commonly used interventions during the early postpartum period is Pitocin. But what exactly is Pitocin, and why is it used after delivery?
What is Pitocin?
Pitocin is a synthetic version of oxytocin, a hormone that naturally occurs in the body. Oxytocin is the “love hormone” and plays a crucial role during labor by stimulating contractions. After birth, oxytocin continues to help the uterus contract so that the placenta can detach from the uterine wall. It also reduces bleeding and assists the uterus in shrinking down to return to its normal size and location.
Pitocin is routinely administered in a hospital setting via IV, immediately after birth, often times without your knowledge or consent (a story for another day). At a home birth, Pitocin is only given after delivery if there is an active issue with bleeding, via an intramuscular injection.
This is a big difference! Hospitals give postpartum Pitocin to every mom to (potentially) prevent excess blood loss, assuming there isn’t enough oxytocin. In contrast, it’s only given if needed to manage blood loss in a home birth setting.
What are the risks?
Although the evidence is mixed, at best, postpartum Pitocin may help reduce the rate of postpartum hemorrhages (too much blood loss). However, it’s not without risk. Some risks of Pitocin, both in labor and postpartum, include:
Uterine hyperstimulation: This occurs when the uterus contracts too frequently or too intensely, which can lead to discomfort, fetal distress (if the mother is still in labor), or even uterine rupture in rare cases.
Increased risk of postpartum hemorrhage: Although Pitocin is given to prevent hemorrhage, high doses, long-term use, and overuse can lead to more extreme bleeding and uterine atony, or a tired uterus that will no longer contract. If this happens, more medication, interventions, and complications occur.
Delayed milk production: The use of Pitocin, both in labor and postpartum, can delay bringing in your mature milk.
Diminished postpartum experience: Unlike natural oxytocin, Pitocin doesn’t cross the brain barrier and it interrupts organic oxytocin production. Research shows that it can lead to difficulty in bonding, breastfeeding, and even impact mental health into those early weeks of postpartum.
What are your options?
Consent to Pitocin, knowing the risks and benefits.
Politely decline, you don’t even need research or a reason to say no.
Wait and see if you have a bleeding issue and assess at the time of delivery.
Decide what’s right for you
No matter what you choose, you will want to have a conversation with your care provider before birth about the use of postpartum Pitocin. I have found it’s one of the harder interventions to decline in the hospital (along with Vitamin K) without a lecture or a lot of persuasion. Make sure your partner knows your decision so they can speak up for you if needed. Remember that everything in birth is your call and you should feel confident in knowing what is best for you.
