Should I refuse pitocin if it comes down to it? Please give me advice/support.

[HarperCait]

I'm kind of embarassed to talk about this, but I feel like I need support right now, so here goes:

I'm due on the 21st, and I have a doc appointment that day. At my appointment yesterday I was told that if I hadn't had the baby by then we'd have to "pick a date" to have her. She's fairly big, and I will not be given any time past 41 weeks.

Thing is, I have an overwhelming fear of pitocin. Not cause of pain concerns, though there is that, not cause of the cascade of interventions, though there is that, but for another- probably irrational, but still horrendously terrifying to me, reason:

I have worked with kids with autism for 5 years, and recently there have been a bunch of studies showing that there may be a link between pitocin & autism. It's generally agreed that autism has a genetic component, but that there is likely an environmental trigger as well. Also, certain people have characteristics that make them more likely to have a child with autism.

Obviously pit doesn't cause autism, or every pit enduced baby would have it. But I feel that maybe in cases where the child is more genetically predisposed, the pitocin is too much for that child's system, and could act as a trigger.

My husband and I have some of the characteristics and family history that leads us to believe our risk of autism is higher than most people. I am cripplingly terrified that accepting administration of pitocin into my body will affect my baby and possibly cause developmental problems, or further increase our risk of autism spectrum disorder.

I know this is probably all silly, and not proven, and irrational, but my fear is nonetheless crippling and overwhelming. The very idea that I would have to discuss this with my doctor had me in hysterical tears for hours yesterday. I'm afraid that I would be so incapacitated by my fear and stress that even if they insisted on inducing me with pit, it would be totally non-productive and end up in a c-section anyway. I would be terrified until my kid reached an age to prove one way or another that she was developmentally ok, and if she turned out not to be, I'd never EVER forgive myself for having taken the pit, no matter how unproven the link. And I'm afraid it would trigger severe post-partum distress or depression. I can barely think about it without heart palpitations.

Do I have a right to refuse pitocin entirely? Or is that a stupid idea, and I should just shut up and get over myself?

We want to request next week to use other induction methods only, with the understanding that this could mean direct c-section if those methods do not work.

What would you do? Do you think I'm being unreasonable? Does anyone have any advice for me??

[highlandmum]

Hi mama--ddc crashing here. I don't have any answers except my experience:: my MIL is one of the leading people in my state working w/ kids w/ autism. I've had 2 kids so far, both births had LOTS of pitocin (one had about 17hrs and one had about 24hrs...literally. My MIL knew all this, and knows that I am facing a possible induction here in a week and a half if I don't have the baby by then (that means more pit!). She has never once voiced a concern over it, other than being supportive and commiserating that it is not what I 'want'.

Also, neither of my heavily-pitocin birthed babies have anything on the Autism spectrum, and in fact, the one that had about 24hrs of pit is so far soooo ahead of the game as far as language, social skills, motor skills, etc.

I don't know if we have any of the 'traits' you are speaking of, but again, I just really think that if this were a BIG concern, my MIL would be all over it--she works w/ our federal and state reps about laws re: autism, she has started several autism schools in the state, I mean she is really on the front lines....

I'm definitely not undermining your worry -- because trust me, I worry all the time about stuff like this!!!! I'm just trying to make you feel better

Also, you still have a little while--start walking, having sex, epo, etc.....do what you can to get that baby out!

Good luck mama

[Youngfrankenstein]

Originally Posted by HarperCait

Do I have a right to refuse pitocin entirely? Or is that a stupid idea, and I should just shut up and get over myself?

We want to request next week to use other induction methods only, with the understanding that this could mean direct c-section if those methods do not work.

Absolutely! I would not be induced before 42 weeks without a MEDICAL reason. Not past dates, not big baby, etc.

There isn't the evidence to back up such things.

I would not be afraid of pitocin. I have no idea of it's long term uses and it really needs to be treated like a serious drug instead of "no big deal" but if natural induction methods don't work, I don't think it's the end of the world.

My first birth was with pitocin that was managed incredibly well by my CNM. When my labor kicked in, she turned off the pit and things went from there.

You can tell your HCP that if you agree to induction after 42 weeks, that you require her to be there in the room while you are laboring to monitor the pit herself...

[texmati]

s: I definitely don't think you need to shut up and get over yourself. It sounds like you are ok with the induction before 41 weeks. If you are, I would talk to your doctor about the other methods of labor induction.

I really belive that everyone should have the right to make informed, *educated* choices for their family when it comes to health care.

I would really, really, really research the risks of pit vs other methods of induction vs c-section. And then discuss with your doctor and hubby. After that don't at *all* be afraid of standing up for yourself, or worried that you shouldn't go against the doctor.

[cristeen]

Originally Posted by HarperCait

Do I have a right to refuse pitocin entirely? Or is that a stupid idea, and I should just shut up and get over myself?

You have every right to refuse it. But be aware that your fears in re: autism will likely be poo-pooed by the doctor. Rather than even going there, I'd just skip straight to "I do not consent to the use of pitocin at any stage of labor". But realize that it is commonly used in 3rd stage active management so even if another induction method works and the baby is born, they may still try to give you pit.

But I'm also with Youngfrankenstein. There is no medical reason to induce prior to 42 weeks. Induction for "big baby" is discouraged by ACOG, and the determination of "big baby" is entirely subjective. There is NO WAY for ANY doctor to know how big that baby is before he/she is born, period. None whatsoever. U/s estimations can be off by up to 2 pounds, and even palpation can be grossly inaccurate. You have every right to refuse an induction at 41 weeks - and according to HIIPA they can't fire you because they are required to give you 30 days notice in writing.

[lisa_nc]

Mama, it's your body and your baby! Of course you have a right to say no!! It's so hard to do it, but you CAN. Be prepared for scare tactics and the dead baby card (it seems to be a favorite of many OBs) but there's no reason to induce unless you're showing actual signs that the baby may be in distress. Say no!!

[2boyzmama]

Your fear is not irrational, I also have heard discussion of a possible trigger with pitocin and autism, I've also heard of a possible trigger between breech babies and autism (which is something in the back of my mind since my baby was transverse until 29 weeks, then breech until 35, then finally flipped). It's probably a chicken before the egg discussion in both...is it because the baby already HAS autism and the accompanying sensory issues that cause the baby to not communicate with the mother's body the right way to progress labor (thus leading to pit), the same with breech, is the baby not able to process its environment correctly and find its way to vertex??

So I'm not sure that one causes the other, or vice versa, but regardless, if you want to avoid pitocin, you CAN!!!

There are many other ways to induce a labor, some more natural, some more medical. I would definitely try things like a breast pump (5 mins every hour initially, then I think I've read 5 minutes on, 10 minutes off?? But you'd have to look it up). I'd also do membrane sweeps, a foley bulb, and possibly even consider AROM if baby is vertex and fully engaged (zero station). All of those are options you have available BEFORE resorting to pit.

Of course there's also sex, orgasm, blue/black cohosh, castor oil, accupressure, accupuncture, etc etc etc.

You should not feel backed into a corner here!!!

[tofutti]

hi---

i think more studies have shown heavy metals in the environment and in vaccines to have something to do with triggering autism than pitocin. i have some of those issues in my family too, and i had the pitocin, but then, no vaccines for DS. so thats a good compromise. (and DS is autism free, a voracious reader, early talker, etc etc) also if its a boy there is more need to be concerned as autism affects many more boys than girls.

i think you also have to look at whats the alternative to skipping pitocin (which does work when done right i think) -- a csection? more drugs in your system. a baby that goes way way past due? (way past 42) probably not advised either.

so in some cases pit might be the better alternative, know what i mean? might help to see it that way.

and then delay/skip some vaxes as insurance....esp. skip that hep b they try to lay on you in the first hour of life!!

hope this helps, thinking of you, and yes, go to 42 weeks and get monitored all the time if it makes your doc feel better. but go to 42 and fight for it, i did (had pit anyway, but still, i did all i could! and no csection)...i really stood up for myself and in the process realized - this was part of becoming a mom too, even before baby was here

[clemrose]

I agree with everyone else--you absolutely have the right to refuse. In fact, you should have the right to refuse induction altogether! A "big baby" diagnosis is no reason for induction. I personally think that it is criminal that doctors are giving women a 41 week deadline when the majority of first timers go past that point (if left alone).

[sugarpop]

Remember, It is your body, your baby and your decision. No doctor can make you do anything! They can advise you, they can suggest, they can push and they can bully you...but you can stand up to them and they can't make you.

I too am due 9/21, next week they informed me they would do a stress test. Monitor the baby. If I go another week past that there will be more tests. The stress test will monitor the babies heart beat. I have no other risk factors and well I am not due yet so no sense in getting flustered...although i am not a patient person and I want my BABY NOW! I have considered what I will do if I hit the 42 week mark, I am not sure and trying not to stress that yet. I believe that stress can really effect the body. My stress might inhibit labor, I don't have proof of this. But I have heard of fear stalling labor so why not keep it from coming altoghether?!

I would try some relaxation and release your fears. Try other methods of induction as PP have mentioned. At 40+ weeks I will consider accupuncture, accupressure, massage, chiro....whatever I need to do. I have also heard that licorice, which I love, may help. I don't know if I will refuse pitocin, but if I felt as strongly as you then I would refuse it.

Trust you instincts, trust your body, no need to shut up and get over it or yourself. I actually read that the average is over 41 weeks for first time moms...I am trying to find a source now.

s

Are you sure of your date of conception? I know when I conceived, so I know that I am due close to the 21st. The "big baby" theory is bogus, the measurements are + or - 20%! SO I was told by the US tech that I had a chubby baby. Oh so I could have an 8lb baby or a 10 lb baby or a 6 lb baby...yeah thanks for that very helpful info buddy! You can birth the baby, your body is designed to birth it!

[Mearaina]

Not from you ddc but saw your post...

Don't feel pressure for anything!! It is your body - listen too it. I will briefly outline my experiences to give you some food for thought. I will preface this by saying I have changed my views considerably since my first pregnancy.

dd1 - induced for "big baby". Awful experience, 2 days of labor and a baby who ("oh she isn't that big 7 13, and we think maybe the date was off she looks early...")couldn't nurse for over a week, we had to express milk and give it to her with a dropper/shot glass system (long story).

dd2 - induced becuse of non stop low grade contractions that went on for over 2 weeks. Great induction, everything was fine. However, she had horrible jaundice that took months to recover from because she wan't left to cook long enough.

dd3 - no induction, no nothing. Went into labor on my own 2 days before due date and, while having a difficult delivery, once she started to breathe she was fine. Minimal jaundice, great latch. A joy.

ds1 - went into labor on my own with help of acupressure. We didn't know his due date thanks to not knowing I was pregnant til the 2nd trimester, so I went with my gut. When he came out he had issues not related to his gestation, but as far as jaundice - he didn't have any. Once his tongue was fixed her nursed like a champ. Wonderful baby.

I guess what I'm saying is inducing can get the baby out but in my experience the baby just isn't quite done cooking (unless you guess exactly right) and that makes the first month or so very difficult. Also, my dd3 was done at 38 weeks 5 days and when my son was born he was evaluated at almost 42 weeks. So every baby needs a different amount of time to be ready, and you and your baby are the ones in the position to best decide that.

On the other hand, if you start to feel like something is wrong and the baby needs to come out, then you need to listen to that instinct, too. Basically, trust yourself, and good luck mama, with whatever you decide

[~Laura~]

I just want to echo that while you can certainly avoid pit, you can also avoid an early induction. We make babies we can birth - so even if the baby is big, you can handle it! And chances are the baby is a perfectly normal size.

But you aren't crazy to wonder about this stuff. I have two siblings and a parent with Asperger's Syndrome. I totally understand.

(FTR, my pit-induced son is just fine. )

Laura

[octobermoon]

i wish i had some advice, i'm a first timer too and headed for an induction so i just wanted to offer some s. i hope you find a decision you are at peace with regarding pitocin.

[OTMomma]

I would just refuse to be induced at this point. Inducing for a "big baby" at 41 weeks is a load of crap. Just tell your doctor you want to let your baby pick her/his birthday, and that's that. Or if they bully you into scheduling an induction- don't show up. Say you forgot- Mommy brain. lol

My bf was scheduled for an induction for her "big baby", the OB was sure they'd have to do a c-section anyway because the baby was So big. Baby was 8.5 lbs, and was born in about 5 pushes after a rather intense labor with pit. My friend said she's never be put through an induction again for such a stupid reason.

Seriously, you are deeply upset about this, and feel it may affect your ability to parent your child after the birth- that is a HUGE deal. It no longer matters how big a risk the pitocin itself is, what matters is the stress you will feel from it, and that the long term consequences to your relatiionship with your child are there.

[tofutti]

just got back from my 40 week midwife appt - she is very very natural minded and i very much trust her......but even she said going past 42 weeks is not a good idea. google the statistics. i think in the case of 42 + weeks vs pit, pit is the better choice.

she also said - pit is not evil, its actually very very helpful if used properly. the problem is its over used, and mis used.

she also said she would try castor oil at about 41.5 weeks ....

[Youngfrankenstein]

Originally Posted by tofutti

......but even she said going past 42 weeks is not a good idea. google the statistics. i think in the case of 42 + weeks vs pit, pit is the better choice.

....

Just remember, the OP isn't even 40 weeks yet. I think what "everyone" is saying that pit isn't the end of the world but there's no reason to do something that drastic at this point.

[hipmummy]

Originally Posted by cristeen

You have every right to refuse it. But be aware that your fears in re: autism will likely be poo-pooed by the doctor. Rather than even going there, I'd just skip straight to "I do not consent to the use of pitocin at any stage of labor". But realize that it is commonly used in 3rd stage active management so even if another induction method works and the baby is born, they may still try to give you pit.

But I'm also with Youngfrankenstein. There is no medical reason to induce prior to 42 weeks. Induction for "big baby" is discouraged by ACOG, and the determination of "big baby" is entirely subjective. There is NO WAY for ANY doctor to know how big that baby is before he/she is born, period. None whatsoever. U/s estimations can be off by up to 2 pounds, and even palpation can be grossly inaccurate. You have every right to refuse an induction at 41 weeks - and according to HIIPA they can't fire you because they are required to give you 30 days notice in writing.

:

[newmum35]

for what its worth my sister had a scheduled c section (so there was no pitocin Im assuming) probably because of diabetes (or gestational diabetes) - he is 7 yo now, autistic. I think theres probably lots other cases of autism where no pitocin. Another sister also has a boy with autism (mild case) - labor went too fast to even get an epidural! I believe the vaccine connection over all others.

[HarperCait]

Originally Posted by OTMomma

Inducing for a "big baby" at 41 weeks is a load of crap.

This is exactly how I feel. I think 41 weeks is early to be pushing me on this, but do recognise that at some point the risks to a post-term baby become much higher than the risks of intervention. Thus the reason I am ok with accepting certain forms of intervention at that point, and understand that without pitocin a c-section could be necessary.

...you are deeply upset about this, and feel it may affect your ability to parent your child after the birth- that is a HUGE deal. It no longer matters how big a risk the pitocin itself is, what matters is the stress you will feel from it, and that the long term consequences to your relatiionship with your child are there.

As I said, I KNOW the link is not proven. I know it is irrational for my fear to be this extreme. I know autism exists in pit babies and non-pit babies, I know all the other factors that are being investigated re: autism... in the end it's not the point...

My husband is very supportive, and will be coming with me on Monday to the appointment. We are both in agreement regarding the pitocin issue. It's not so much a matter of what it will and will not cause, but more a matter of my personal level of distress. I will be no use to anyone if I plunge into a deep post-partum depression over it, and I will be useless if I'm in hysterics during an induction.

That said, Thanks everyone. I think I'm starting to feel a little better, and more prepared to stick to my guns if it comes down to it.

I'm hopeful that my OBs will understand where I am coming from.

I'm even more hopeful that it won't come down to it in the end though!! I started EPO yesterday, and plan to walk lots today, have a date to eat some eggplant parmasan... Go mother nature!!