A Tale of Two Options

A woman walks into the hospital, her water broken but no contractions yet. After one whole hour, the doctor tells her that she should start pitocin to get labor going. The woman says she would rather not, but the doctor says she should, because she “could be risking infection to the baby…”

Sure, it’s possible that there could be risk of infection to the baby- probably because of the frequent vaginal exams to check progress that the hospital likes to do. But what the doctor didn’t add is that by taking pitocin, she could also be risking fetal distress because of extra-strong and long contractions caused by the drug.

This mom had two options:

1) Get pitocin that would get her contractions cookin’ but make them unbearable to her and possibly to the baby. Mom might then require pain relief (and other possible following interventions) and baby would need to be monitored by EFM in case he/she went into distress from the overly strong contractions caused by pit. If fetal distress is indicated, instrumental delivery or a cesarean is often performed.

2) Ask the care providers to keep their hands out of her vagina (she will probably know when it’s time to push on her own, thank you very much) and walk a bit (or try other natural means) to get labor moving. Care providers can watch mom and listen to baby periodically to make sure everything is going well. If labor still doesn’t kick in after many more hours (especially more than just one), then she might consider a gradual increase of pit.

Which would you rather?


9 responses to this post.

  1. I take door number 2. I attended a birth as a doula where moms water broke and even though it was a hospital birth they didn’t even suggest a vaginal exam until after 24 hours. It was great. Mom did choose to start pitocin at that point. It was my longest birth ever.
    You can read it here – all 4 parts http://enjoybirth.com/blog/2011/01/05/looking-back-at-2010/


  2. I would go home! If she’s not in labor the best place for her to be (and the place that carries the least risk of infection) is in her own home. Assuming her baby is head down and low, the blocks are only going to stack up against her if she stays.


    • True, Erin! Sometimes, though, it seems that first-time moms and dads aren’t necessarily given all the information and don’t realize that staying home (even with clear broken membranes & no fever) is a safe and viable option. If they’re told to come straight in, they most likely will, if they don’t know there are other choices. Thankfully, this mom chose to wait it out and was able to have a pitocin free natural delivery- baby was born only about 14 hours from when her water broke.


  3. Totally. Once they’ve got you, you feel like you’re locked in. I’m so glad to hear this mama had a relatively quick birth, and pitocin free! Woo-hoo! That doesn’t happen every day!


  4. Posted by michelle on April 24, 2011 at 8:37 pm

    I hope people read this and realize that there are options when giving birth and you are not necessarily putting your baby at risk to delay interventions.


    • Yes! I’ve heard it’s always good to ask your doctor or midwife these questions before going ahead with an intervention:
      1- What are the benefits?
      2- What are the risks?
      3- What happens if we do nothing?


  5. Posted by Renee on May 23, 2011 at 11:38 pm

    Oh, this happened to me. I had never theoretically considered the predicament, so when i was told the OB’s recomendation to start Pit, I didn’t know any other recourse. The OB gave me a few hours but then she said she was tied to the hospital’s policy to get the baby out in 24 hours after my water broke. It was my first live birth, I didn’t know any better or the risks. I went into birth planning a natural one–no drugs. I never thought I was likely to be given Pit, and I’d not even researched it–I imagined the only scenerio i’d likely be offered it is if I went past 42 weeks, but I was delivering early, before I’d felt the need to research those measures! I didn’t even know how it worked the muscles in unnatural directions to mimic contractions and why all would be more painful. It was a very hard birth on many counts, compounded by flashbacks to a previous pregnancy loss labor. After the experience of Pit and all that came after, I went home and researched ways to have a baby outside the hospital; I knew i never wanted to do that again.


    • I’m sorry to hear that it was such a difficult experience, and I’m so sorry for your previous loss. It’s startling how quickly women receive pit now. I wish you all the best in finding a good caregiver and your best birth place for your future babies. It might be difficult to find the right match, but I think that the time and effort put into researching it is well worth it.


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