You may have heard of the medication oxytocin, or Pitocin, as a tool used to induce labor. But you may not be aware that even if you go into labor spontaneously, your medical team might still recommend the use of Pitocin to help your labor progress. Here’s what pregnant people should know about labor augmentation.
Tell Me More…What is Labor Augmentation?
Labor augmentation is the process of stimulating the uterus in order to increase the frequency, duration or intensity of contractions after labor has already begun. There is a difference between labor augmentation and labor induction. Labor induction is the process of starting labor before it begins on its own. Augmentation of labor is when labor is already in progress, but needs a little help to move along.
When Should Augmentation of Labor Happen?
Once you’re in labor, it can be a long journey from the first contraction to baby’s entry into the world. And in some cases, your medical team may feel that your labor isn’t progressing as quickly as it should. If your contractions aren’t coming frequently or strongly enough to dilate your cervix, your baby isn’t moving down the birth canal, or an epidural has slowed or stalled your progress, your provider may suggest augmenting your labor.
Medical reasons your provider may want to speed up your labor include:
- Prolonged labor: Also known as “failure to progress,” this can cause low oxygen levels and abnormal heart rhythms in your little one. If your baby isn’t born after 18-24 hours of regular contractions, augmentation of labor may be recommended.
- Preeclampsia: If you’ve been diagnosed with preeclampsia, delivery is the recommended treatment to ensure your and baby’s safety. The stress of delivery paired with preeclampsia or other hypertension disorders can affect your baby, and a quicker delivery can be advantageous.
- Premature rupture of the membranes (PROM): In most pregnancies, your water will break after contractions begin. However if your amniotic sac ruptures before, or early on in your contractions, you’re on the clock to deliver your baby within 24-48 hours to prevent infection (the exact timeframe depends on the situation and your provider’s protocols).
The American College of Obstetrics and Gynecology recommends delaying augmentation and labor interventions as long as it’s safe to do so. Your provider will keep a close eye on your and your baby’s vital signs, contraction patterns, and cervix before recommending labor augmentation.
How is Labor Augmentation Done?
Your care team might ask you to do a few things that can naturally help labor progress, such as taking a walk around the halls, or bouncing or rolling on a birth ball. They may even break your water (also known as rupturing the membranes) if the amniotic sac is still intact. However if these methods don’t help your labor speed up, oxytocin, commonly known as the brand name Pitocin, may be used. This synthetic hormone causes the uterus to contract, and will be given through your IV line.
Typically your medical team will start with a small dose of oxytocin, and gradually increase the dose until your contractions begin to get more efficient and intense. Every woman’s reaction to oxytocin is different, and your team will adjust the dose accordingly. The goal is to provide just enough oxytocin to cause about three to five contractions every 10 minutes. Having contractions too frequently (more than five in 10 minutes), or lasting longer than two minutes signals too much oxytocin, and the dose should be lowered.
Are There Any Risks of Labor Augmentation?
If the uterus is overstimulated it can stress your little one and potentially cause issues with baby’s heart rate. Your care team will carefully monitor baby’s vitals throughout the labor process, and adjust oxytocin accordingly. If baby is in distress, they can quickly lower the dose, stop oxytocin outright, or even give you a medicine to relax the uterus if necessary.
If your baby isn’t tolerating the stress of contractions well—whether during augmented or natural labor—your provider will likely recommend a C-section delivery to keep baby (and you!) as safe as possible.
We’re wishing you luck as you approach your due date, mama! Whether your labor progresses on its own or you need a little extra boost via labor augmentation, you’re in great hands.