I'm posting this in the general birth forum (rather than doulas & midwives) b/c
it seems to get a lot more traffic.

One of my birth clients asked for an induction. She was past her edd, but the ob wasn't pushing it--mom just really wanted to have her baby in her arms, and no amount of information was going to change her mind (dad had a hand in it too :shrug )

So, she did the cervadil overnight, and it basically did nothing. No regular contraction pattern, no change in cervix. She started Pitocin the next afternoon, and eventually maxed out on it, and it also did nothing. I've seen pitocin induced contrax that were ineffective--but they always hurt. This lady has had no pain.

She has the option of going home and waiting another week, but she wants the c/s.

I've never seen this situation before (with max pit not producing painful contractions.) Has anyone had a similiar experience? Does anyone have any insights?

Well my understanding is that pitocin can also be used to stop contractions? I've known women who went into labor early, and pitocin was used to *stall* labor. Like a certain amount causes contractions but a different, higher dose, has the opposite effect. But then I'm certainly no expert.

Yep. I have friends and heard from my sis a former L&D nurse that some folks just do not respond at all. My neighbor had pit and was in no pain with it. None. Blew my mind. My sis told me several stories of women being at the Max on Pit and them asking her "When is it going to start?"

"Well my understanding is that pitocin can also be used to stop contractions? I've known women who went into labor early, and pitocin was used to *stall* labor. Like a certain amount causes contractions but a different, higher dose, has the opposite effect. But then I'm certainly no expert."

Not true. Pitocin is synthetic oxytocin, the hormone that triggers contractions in labor. No amount of it stops labor. It would never be given to a woman in preterm labor unless delivery was intended.

Anyway, to address the OP, I have seen this happen many times. No one knows all the exact hormonal steps that must be in place to trigger labor, but sometimes the uterus is not ready to respond to pitocin. I've seen numerous "failed inductions" because of this, and a number of them involved relatively painfree responses to pitocin. I've also seen it take 12-24 hours of pitocin before suddenly, the contractions start to be effective and dilate the cervix. Having no response like that does not mean that the mama will never labor on her own, or even that she wouldn't respond to pitocin a few days later.

Me. First hospital birth. I was on it for 2 hours on a low dose (does that count?) It didn't hurt at all. I was deeply relaxed thanks to HypnoBirthing.

After 18 hours in labor at the hospital (no pain thanks to HypnoBirthing) my body ran out of energy (I had not eaten during that time.) I was very hungry, but DH wanted to "follow the rules." :angry

So anyway, contractions just stop and my OB hinted I would end up with Csec if they didn't come back :scared so I requested the pit. :duh I completely forgot about natural nipple stim.

Well my understanding is that pitocin can also be used to stop contractions? I've known women who went into labor early, and pitocin was used to *stall* labor. Like a certain amount causes contractions but a different, higher dose, has the opposite effect. But then I'm certainly no expert.


I wonder if you are confusing demerol or stadol with pitocin. The two aforementioned drugs are narcotics; in early or "false" labor they can sometimes completely stop contractions (actually, they can really slow them down even in established labor). When I was in preterm labor, I had a particularaly bad night (an overagressive vag exam by a b*tch from hell nurse with inch long nails actually lacerated my cervix, causing bleeding and more contractions) and they gave me demerol to try to stop the contractions. Either my contractions were about to stop anyhow, or the demerol worked. But, they left me alone, and I did fall out of bed, the demerol made me so loopy.

And some people wonder why I don't work in the hospital....

Anyhow, hope that clears up the confusion!

Lori

Thanks for the response! I can understand (in a vague way) how pitocin might do very little, but I'd never heard of it actually happening.

This mama would prefer an elective c/s to waiting a few more days to see if the pitocin will work--or egads! to see if she's ready to labor on her own. She's a biologist. She understands the risks & benefits of all her options. It's her birth...all I can do at this point is support her choices.

there are tolerance issues too. One can build up ( and does build up) tolerance quickly, that is why during induction it is upped on cycles. Just as how some mothers continue to nurse while pregant- that nipple stim does not cause miscarriage or ctx because the mother has adjusted to that level of oxytocin.
I have been to inductions too where mother was maxed out. Another sign also that mom was not ready :)

With my ds I had a pit drip for 2 hours and it did nothing to help the weak contractions I was having. If they would have just listened to me they would have known that weak contractions are all I ever had with my dd also.

*

I was induced with my first baby with pitocin. I went in with no cervical softening and baby was not engaged, I was hooked up to the drip and to fetal monitoring intermittently, I spent the first hour walking around, I couldn't feel any contractions but when they strapped the monitor on it picked up fairly strong contractions, this went on all day, I couldn't tell when I was contracting but the monitor did, then my water broke and the nurse checked my dilation and I was at 10cm (this was a process that took 8 hours) then once my water broke I could feel intense contractions the whole time I was pushing. I have never been able to find an explanation as to why I had pain free contractions on the pit. For the record with my last two births I felt all the contractions, but there was not pitocin used during those births.
crystal

I was on pit for about 6 hours before they broke my water. I didn't feel the ctxs till then and they were in a regular pattern.

I had pitocin in my VBAC and boy, did the contractions hurt after they put me on it!

Both Cervidil and Pitocin were pure pain! She must have one strong cervix/uterus!

Thanks for the feedback, mamas. The common experience with pitocin is decidedly not painless, so it's nice to hear from the minority.

Well, the pitocin did nothing for her. She had contractions, but they were short and there was no pattern. There was no dilation, nothing. After an overnight w cervadil and 8hrs on pitocin, her cervix was still at 1cm & 60%, the same as two days before.

The doctor who did the cesarean told her that baby was so big (8lbs), that it had stretched her uterus "paper thin," leaving it unable to contract.

I've heard of several moms who have been given the "paper thin" diagnosis, only to have a vbac with a subsequent (and often bigger) baby.

Now I begin the delicate (and formidable) task of introducing vbac as a viable option next time :)