Latest / The Birth Lounge Podcast / Ep. 495: Pitocin in Labor: 5 Things to Know Before It’s Hooked Up to Your IV

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Ep. 495: Pitocin in Labor: 5 Things to Know Before It’s Hooked Up to Your IV · The Birth Lounge Podcast

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  something I have harped on for a long time, but it seems like still not a lot of people know, and that is you can turn Pitocin down or off altogether.
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  Now, understanding why you're having an induction, why Pitocin has been added to your labor, what the goals are with the Pitocin, are you reaching those goals, why are you wanting to turn it down or off, are really important to that decision-making process, right? Hello, and welcome back to another episode of the Birth Lounge Podcast.
• Did you know that doctors and nurses and actually midwives and your anesthesia team, your entire care team in the medical system actually practices simulation births? Did you know that? They go through and they practice different situations, different deliveries, different positions, different tools that they have, different scenarios that might happen in labor.
• And this allows them to bridge that gap between actually knowing what to do and being able to do it in the moment, in that high intensity, high pressure environment there's actually quite a bit of data out there that says the more that our healthcare providers are provided this environment that they can practice these skills, the more confident they are in actually doing those skills when the time comes, which actually obviously gives us better results for both moms and babies.
• So it's like a natural thing.
• It's the natural next step to getting better results.
• And then I started to think, what if you could practice a simulation? What if you could actually practice going through labor before you were actually giving birth? That way, you could show up with that same confidence that your, your doctors and your nurses and your midwives and your anesthesiologists get to show up to your birth with.
• But this is your birth, so how come everybody in the room is prepared and has done simulations about this moment except you? I didn't like that at all.
• I really want everyone to come with the same preparedness so that we can continue to center you in this process.
• And so I created a place that you can actually run through a birth simulation.
• It is the Labor Live Challenge, and it's a live simulation of three days of what your birth could actually be like.
• It's based on a real birth.
• And so for three days, you're gonna get these prompts that step you through each stage of labor and decisions that you're gonna encounter conversations that you're gonna need to have with your healthcare team and choices you're gonna need to make.
• And I'm gonna help you understand how do you take the knowledge that you've gotten in childbirth education and all the reels you've watched and all the podcasts you've listened to and the books that you've read and the friends that you've asked, how do you take all the things that you've learned and actually make it work for you in labor and apply it? 'Cause remember, you're gonna be in labor, so you are gonna want this to be a muscle that you have just worked so incredibly intentionally that it's a reflex when you get into labor You will know what you want, how to advocate for it, how to be flexible if things need to change, and what your options are if things pivot away from your original birth plan The challenge starts on November 1.
• You can go to joinlaborlive.com
• to sign up.
• I'm super stoked for this.
• We do this inside of The Birth Lounge in my closed paid community, and it has done so well, so I wanted to bring it out to everybody.
• Joinlaborlive.com,
• and I will see you at the Labor Live Challenge on November 1.
• All right, Today, we're talking about Pitocin, which is a great and needed drug in a lot of scenarios.
• It's not a bad drug.
• Drugs are neutral.
• However, how we use these drugs in labor matter greatly, and that's what we're going to talk about today.
• So before you agree to Pitocin, you should understand these things.
• Number one, it is different than endogenous oxytocin.
• Now, oxytocin is something that is made in our brain.
• As our body makes it and responds to it, our body has this push and pull.
• The more that you need, it will make more, and if you need less, it will back off.
• However, when we introduce Pitocin, which is a synthetic form, it's very similar, but it's not the same as oxytocin that is made in our brain, then our brain gets confused, and it doesn't always keep up with this.
• So sometimes you can ramp up Pitocin too fast for your brain to really register how much is being dumped into your body.
• And so your body needs to back off because the endogenous does mix with that synthetic, and so if you have too much, your body can dial it back since the syn- synthetic is not going to know how to do that.
• However, it doesn't always happen like that.
• Sometimes our bodies need a little bit longer to register than the time that we're giving them with the administration of the Pitocin, meaning that we're giving you more Pitocin than your body can actually handle.
• Now, that will never happen with endogenous oxytocin.
• Because it's made in your body, and your body has that feedback receptor, your body will never make more than what your body can handle and what you can handle, right? And in a lot of cases, what your baby can handle.
• That's not the same for Pitocin.
• Because Pitocin is synthetic, and it messes with your body's receptors of being able to understand how much is needed and how much it should be producing, whether it should be dialing back or not, we sometimes see that that Pitocin can interfere with your labor.
• It can make you have some funky vitals.
• It can make you feel like your contractions are too intense, or it can cause your contractions to become too close, too frequent, too hard, too fast.
• And sometimes when that happens, we see your baby not tolerating labor very well.
• Sometimes endogenous oxytocin will cause a baby to kind of be funky in there, too.
• And in both scenarios, it's something to look into, but I'm saying that with endogenous oxytocin, it happens a lot less.
• With Pitocin, we see that, that misstep, that miscalculation between endogenous oxytocin feedback receptors and the Pitocin that is actually being administered to you Number two follows right behind that.
• Because you can't overdose on endogenous oxytocin, there's obviously no limits.
• We can't limit what your body does.
• However, because Pitocin can be used at too high of doses, or maybe it's being administered too fast, there are actually limits and recommendations on how it's used set out by the FDA that your hospital's policy should be based around.
• This is a wonderful conversation for you to have in your prenatal appointments.
• In a lot of hospital births, Pitocin is often introduced.
• If that's really important to you, make sure that you download our Pitocin guide.
• It'll step you through how to understand if it's right for you and how to understand different scenarios and how you can say no or you can ask for it.
• You can request it or decline it.
• But if you want to be prepared for Pitocin in your labor, regardless of whether it's your plan or not, you just want to be prepared, then I think understanding what those limits are and how it is recommended to be used can be super important for you to have going into your birth.
• That way, when the discussion of Pitocin happens, you'll understand, "Do I really need this now? Are there other options or alternatives? Um, should I be thinking about X, Y, and Z?" You'll also know if how it's being administered is not necessarily right or wrong, but is it following the recommendations that have been set out? And if it's not, what's the reason behind that? Why is that happening, and is that something that you're comfortable with? Number three, and this is really important for inductions, it's that Pitocin is used for dilation because oxytocin is what gets contractions started.
• So if we're trying to match what oxytocin would be doing in our bodies, or we're trying to add more to the endogenous oxytocin, right, to ramp things up, then you want to be using it at the right time.
• Something called prostaglandins are in charge of the effacement during labor, and that has to happen before dilation can happen.
• So your cervix has to be squishy and thin and malleable in order for it to open up.
• That squishy and thinness is called effacement.
• That's gonna happen because of prostaglandins in your body.
• So there are two pieces to this puzzle of inducing, right? Is we first need to start with effacement, like the body naturally would.
• This doesn't happen because of oxytocin, so Pitocin would not truly really help that too much.
• What we want to do is focus on prostaglandins, which is what would normally do this in the body, okay? So if we're thinking about Pitocin and we're thinking about the timing, we want to make sure that your cervix is effaced enough to the place that the body would naturally do this in spontaneous labor, and then think about adding Pitocin.
• If you're adding Pitocin outside of the equation, the timing, then you're probably going to get some lopsided results.
• That makes sense.
• Everything in the body is very calculated.
• It is an equation.
• You go through this sequence of things.
• And so when we're inducing someone, we want to make sure that what we're doing on the outside is actually matching that sequence as closely as Number four is something I have harped on for a long time, but it seems like still not a lot of people know, and that is you can turn Pitocin down or off altogether.
• Now, understanding why you're having an induction, why Pitocin has been added to your labor, what the goals are with the Pitocin, are you reaching those goals, why are you wanting to turn it down or off, are really important to that decision-making process, right? And here's what I mean by that.
• If you are there for a medical induction because your baby was starting to show signs that they really would do better on the outside, then maybe slowing things down or turning it off completely, if that's only gonna prolong your baby still being on the inside and they really need to be on the outside, that may not be a super great choice.
• Is it your choice at the end of the day? Yes, the law says that it is, right? That's consent.
• But is it advised? Probably not.
• But on the other hand, if you are there for an elective induction, you and your baby are looking good, and you feel like your contractions are just a little too strong and they are...
• You're, you're starting to be worried that maybe if they continue like this and they need to get stronger later, you're not really gonna be able to handle it if you don't kind of slow things down now and get a handle on it, that would probably be a great time to discuss turning down Pitocin.
• There's also some interesting data that says once your body has started to actually make a good amount of its own endogenous oxytocin, which is typically when that active labor period starts to happen, that data suggests that maybe turning down or off Pitocin at that time can have some benefits for your labor, right? So we wanna really think about that Pitocin is not all or nothing.
• It is, um, it's a use as needed and use intentionally type of medication, right? And that's why I think so many people need to understand what we just talked about, your FDA regulations.
• How does your hospital use it? What are the policies and protocols that your doctor is used to and gonna, gonna recommend to you? Are you comfortable with those things? What other alternatives do you have? Pitocin can be used at a time that you need it.
• It can be turned off.
• It can be turned down, and then of course, something everyone knows is it can be turned up as needed, too And that leads me right into number five because as we have seen Pitocin use, um, more widespread and more inappropriately, I mean, we are just using Pitocin for so many things, so many labors that actually don't need it, and we're using it at really high doses and volumes, and we are seeing that we are having worse and worse outcomes.
• Our birth trauma rates are up, our C-section rates are up, induction rates, of course, are up.
• But one of the things that we need to be really cognizant of is the fact that postpartum hemorrhage is one of the leading killers of women after having a baby.
• And if we use too much Pitocin in labor, then it actually desensitizes your uterus and your brain, your body, to the Pitocin, right? And so you're gonna need more and more and more and more, higher and higher doses in labor to achieve the result you are hoping to get or your care team is hoping to get.
• And then in postpartum, if you were to need support with postpartum hemorrhage, that first line of defense is usually Pitocin.
• Now, if we have filled up all of your receptors with Pitocin, now your body is not getting the message, and so you're gonna need further intervention.
• And do you see how a decision that we made at the very beginning of your labor, whether that was to introduce Pitocin when it wasn't needed or to choose an elective duct- induction when you or your baby did not need it, it introduced Pitocin, which is not a bad thing.
• It just can set off a cascade of things.
• And if you don't know how to reverse engineer that to make sure that those things don't happen, then that is actually where you find yourself in trouble in terms of slipping down a slippery slope of losing control of your And the problem is not that women are going in undereducated or uninformed.
• You guys are reading the books.
• You're listening to the podcasts.
• You're saving the posts online.
• You are following the right educators.
• You have a birth plan written out.
• You've shared it with everybody.
• You have it screenshotted on your phone.
• You've memorized it word by word.
• But what you haven't done is practiced, right? So you have all this information, but that is different than preparation.
• Information is education.
• Preparation is action.
• And the action that you need in order to be able to actually take all of that information that you have from childbirth education and apply it to your birth is that practice, right? That's the knowledge gap that you have.
• You have all this information, but you're still wondering, "Am I actually going to be able to do this? Am I gonna be able to speak up? Am I gonna be able to remember this stuff? Am I gonna be able to think enough to ask the questions and make good, solid decisions in birth?" And you don't have to go in hoping and wishing and praying and like, "Ah, hope I've got this."
• You can go in knowing, "No, I've got this.
• I have practiced and practiced and practiced and practiced, and I know not only what my options are, but what I would say and what I would choose in every situation that I can think that I might find myself in."
• And for the situations that are unpredictable that I can't really fathom, those are the ones that I'm actually having, like, a base response.
• I have this canned response that will help me get to the next level of information that I need to know.
• And so that's what it really means to go in with birth confidence.
• Not only have you prepared for your, your ideal birth, your, your best birth, your plan A, but you've also prepared for plan B, C, D, and E, which you don't even know what that is, and you still have a plan of how you're gonna extract the information that you need in order to make the best decision for you possible.
• Your decisions are gonna look different than your neighbor's, different than your sister's, different than probably what your mom or your mother-in-law want for you, but that's the thing.
• You have to be so utterly confident in what you're choosing, why you're choosing it, and how you're going to communicate that, plus where you're gonna be flexible, enough that you can hear all that outside noise and still say, "I know what I've chosen, and this is what I want.
• This is why.
• How can we make sure this is what I get?" I built the place for you to be able to do exactly that.
• I built the place for you to be able to practice your labor before you're actually in birth.
• It's called Labor Live.
• It's a three-day challenge, and you are going to be getting real time birth updates in the order that it really is happening of a real live birth, and you get to practice doing it alongside thousands of other women just like the day you're actually gonna have your baby.
• It's a community.
• I love it.
• Not only that, but you're gonna be able to see your decisions play out in real time.
• So as you lock in your choices, you are gonna see how that impacts decisions later on in labor, and this is going to help you learn how do you reverse engineer your birth so that you can extract that information that you need to make your best decision ever.
• I'm so excited, you guys.
• The challenge starts on the first of each month, so you get to decide who you want to be walking into your birth room.
• You can be the person you are today that has a bunch of information, you have studied your butt off, but you still are not sure if you're really going to be able to apply it in birth.
• Or you could go in knowing that you're going to be able to apply it, knowing that you have the right questions, knowing that you know how to confidently and respectfully communicate with your care team to help them feel safe in the decisions that you're making and understand why you're making them, and also to help you have your best birth possible.
• That's the difference.
• Labor Live gives you a place to actually practice.
• Three days directly delivered to your phone.
• You get to see your decisions play out in real life and learn some new information along the way.
• Challenge starts on the first, and I cannot wait to see you there.
• Thank you so much for tuning in today.
• I love hanging out with you and it is an honor to be your go-to gal when it comes to preparing for your baby.
• If you've enjoyed today's episode, please leave a five star review and tell others why they should be listening to the Birth Lounge Podcast too.
• You deserve to have a birth that you love with a provider that values your autonomy and respects informed consent without all the trauma that you so commonly hear about on social media.
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• I'm HeHe and this is the Birth Lounge Podcast.