Three New Articles on Adverse Effects of Pitocin

The past few days there have been a total of three articles about the dangers of a common occurrence in American births-augmentation.

Augmentation can happy for a variety of reasons, both medically "warranted" and for the sake of convenience for either a busy doctor or mother. Augmentation is usually done by administering pitocin, a synthetic form of naturally occurring oxytocin, through an IV. While pitocin usually has the same effects of oxytocin (uterine contractions) there are certain other risks. The pitocin can sometimes cause fetal distress because the contractions come on stronger, more closely together and for longer periods of time than naturally produced oxytocin. And, as some of the studies have seemed to find, pitocin may be linked to Autism.

One of the most lasting impressions of The Business of Being Born was when one of the doctors said just this. Pitocin is a rather new drug with, until now, not much research into the long-term effects of its use. Am I against inductions? Do I think that mothers are "bad" for having their labors induced? Do I think that mothers who have inductions are some how putting their children in harm's way? No. What I am saying is that we as women have to remember our voices.

Throughout history our voice has tried to be stifled and throughout history we make it heard. Educate yourself on the procedures that are often suggested or offered as normal and regular and ask questions.
Why do we need to do this procedure?
    What will happen if we don't?
        Is that bad?
            Why is it bad?
                What are the alternatives to this procedure?

In terms of speeding along labor or inducing labor there are natural alternatives. Raspberry leaf tea and Thyme tea will both bring on contractions. Clary Sage, an active ingredient in my Birthing Sprays, is also thought to bring on contractions. Walking or other types of exercise can bring on contractions as well as boy-girl sex (chemical reaction of the sperm) as well as any sexual activity that brings orgasm. Nipple stimulation can also help bring on contractions.

I'm linking the articles below not to shake a finger, but so that we read, learn and research our options and alternatives.

From the American Congress of OBGs: New Study Finds Adverse Effects of Pitocin in Newborns
From the BBC News Induced Labor Linked to Autism
From MedPage Today Induced Labor Linked to Higher Autism Rate

Another Article About the Cost of Birth in the U.S

Image from CNN.com

This is the third article this month that talks about the high cost of giving birth in the United States. As I've said before, there are many reasons that women birth in hospitals; familiarity, a sense of safety and more. It should also be noted that, and I'm quoting Ina May Gaskin and a number of birth advocates, birth is not a medical procedure. Sure a c-section is medical, but the natural process of giving birth is quite natural and happens just fine when left alone.

I'm a woman with multiple fibroids in my uterus. Did I mention I'm want to start trying to get pregnant in the fall? I'm well aware that because of my fibroids some midwives and birthing centers will automatically make my pregnancy and me "high risk" which basically means that I might not find a midwife willing to let me give birth at home and the only freestanding birthing center in NYC may not accept me...which means that I may be a woman who births in a hospital.

It happens to even the most determined woman.

But you know what:? It's okay. When we, as women, are knowledgeable about our rights, knowledgeable about hospital norms and express those wants and desires through our partners, doulas, and doctors that listen it's still possible to have a natural birth in the hospital.

Of course, hospitals work on schedules and the odds are stacked against you: You may be hooked up to an IV and unable to move around; You may have to labor and give birth on your back (gravity doesn't work that way!); You may only be able to labor for a set amount of time before they try to induce which may lead to a c-section; They may automatically give you a dose of pitocin (that IV is handy, eh?) to help birth the placenta (the placenta usually will birth itself if the baby is sucking at the breast-oxytocin!); They may cut the cord before it's done pulsing; They may wash the baby; They may not put him directly on you...the list goes on and on. But if you know your rights and the hospital's practice (none of these things are necessary and you can decline all of them) you have just as easy a shot (and a cheaper bill) than if you aren't aware.

My point? Educate yourself. Your doctor isn't smarter or more in tune to your body, because it's your body.

"Newer equals improvement" and "More is better than less" have long been effective marketing themes in American culture. But the problem is that in the case of medical technology, the results don't consistently bear that out.

While other countries have set up elaborate systems to assess new medical interventions for their cost effectiveness compared to existing practices before approving them, until recently that has not been a priority in U.S. medical care. The result is that public infatuation with newer technologies merges smoothly with the medical industry's desire to profit from providing more services.
A prime example of this problem is the failure to take advantage of midwife-led birthing centers. These have been found in the U.S. and overseas to be a safe andcost effective alternative to universal reliance on large hospitals. Freestanding birthing centers (as opposed to hospitals which refer to their maternity ward as a "birthing center") are usually directed by midwives and are affiliated with hospitals that serve as a referral site for transfers. The cost savings stem from less reliance on expensive medications and technologies, a shorter stay (mothers typically return home within 24 hours) and lower personnel costs.
While the numbers of birthing centers have increased in the last decade, less than 1 in 300 U.S. births occur in a center. How come?.... The U.S. needs to seriously rethink how we approach maternity care. The first question that needs to be addressed is: Do more tests and reliance on the biggest, most expensive hospital settings actually improve the health of mothers and babies? When they do, great. But when they don't, we need to overcome the financial, institutional and cultural barriers to use reasonable options like birthing centers.Medical technology has done wonders for our lives, especially in select, high-risk cases. But rising maternity care costs reflects the downside of our societal obsession with newer, bigger and shinier technology.

Read the full article here.

The American College of Obstetricians and Gynecologists Warns Against Inductions

I think it's important that birth professionals; whether OBs, midwives, doulas or childbirth educators keep an open mind. This, I realize, is hard because it's very human to form ideas, thoughts, or convictions, but when it comes to birth it's really up to the mother to decide what she feels is best for her.

Keeping that in mind, I'm aware that sometimes a mother will have ideas about birth that may not necessarily align with my own thoughts about birth, but those thoughts, my opinions, must be pushed aside so that I'm able to fully-support a mother. I do, however, think that women should look into all of their birthing options and educate themselves on the many options available to them. If I can think of one criticism of the medical and healthcare system it would be that it doesn't empower patients, especially women who are pregnant. Instead a woman, under the care of an insensitive or authoritative physician, can sometimes feel small and inadequate. She is made to fear her body and the birthing process and doubt whether her body is "big enough" "strong enough" or "young enough" to do what it's supposed to do.

I love this quote by Ina May Gaskin:

Remember this, for it is as true and true gets: Your body is not a lemon. You are not a machine. The Creator is not a careless mechanic. Human female bodies have the same potential to give birth well as aardvarks, lions, rhinoceri, elephants, moose, and water buffalo. Even if it has not been your habit throughout your life so far, I recommend that you learn to think positively about your body.

 Read the ACOG's complete article: Five Things Mothers and Physicians Should Question

Don’t schedule elective, non-medically indicated inductions of labor or Cesarean deliveries before 39 weeks 0 days gestational age.

Delivery prior to 39 weeks 0 days has been shown to be associated with an increased risk of learning disabilities and a potential increase in morbidity and mortality. There are clear medical indications for delivery prior to 39 weeks 0 days based on maternal and/or fetal conditions. A mature fetal lung test, in the absence of appropriate clinical criteria, is not an indication for delivery.

Don’t schedule elective, non-medically indicated inductions of labor between 39 weeks 0 days and 41 weeks 0 days unless the cervix is deemed favorable.

Ideally, labor should start on its own initiative whenever possible. Higher Cesarean delivery rates result from inductions of labor when the cervix is unfavorable. Health care practitioners should discuss the risks and benefits with their patients before considering inductions of labor without medical indications.

Study Finds Adverse Effects of Pitocin in New Borns

Cross-posted from The American College of Obstetrics and Gynecology

New Orleans, LA -- Induction and augmentation of labor with the hormone oxytocin may not be as safe for full-term newborns as previously believed, according to research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists. Researchers say this is the first study of its kind to present data on the adverse effects of Pitocin use on newborns.

Given intravenously, Pitocin (a brand of oxytocin), is often used to start labor when a pregnant woman is overdue. It is also used to keep a lagging labor going by increasing the frequency, duration, and intensity of uterine contractions.

Primary Investigator Michael S. Tsimis, MD, and fellow researchers at Beth Israel Medical Center in New York City, conducted a retrospective analysis of deliveries that were induced or augmented with oxytocin. The study included more than 3,000 women delivering full-term infants from 2009 to 2011. The researchers used the Adverse Outcome Index, one of several tools used to measure unexpected outcomes in the perinatal setting and to track obstetric illness and death rates.

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I believe that every mother's birthing choices, whether she delivers vaginally via c-section, in a hospital, at home or a birthing center should have her choices validated. I also think it's vitally important to learn about the risks and benefits of any intervention.