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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Dec 08
    2010

    Augmented Labors (Pitocin+Epidural)

    Archived User

    Hello Henci,

    I was wondering if you have ever come across any research in regards to the effects of pitocin incuced labors on subsequent labors? My question is this, can pitocin change a woman's body so that her own natural contractions will now mimic the augmented contractions of her previous labors?

    What are the other side effects for mother and baby of artificially induced labor? 

    I personally have experienced postpartum anxiety, and jaundice of infant.

    All thoughts are much appreciated.

    Henci Goer

    I have never seen any research on this topic, but I wouldn't think inducing labor could affect a subsequent labor. To begin with, Pitocin is oxytocin, the same substance the body produces naturally to cause contractions. For another, oxytocin is metabolized within minutes, and then it is gone. Women vary enormously in the intensity of their contractions. Contraction patterns can vary with different labors even for the same woman. The simplest explanation is that your natural contractions just happened to be similar to those you experienced in the induced labor.

    As for the other symptoms, a little jaundice is normal in newborns, and in healthy, full-term babies, never reaches levels that could do any harm. Jaundice occurs because the fetus has extra red blood cells. It needs them because the oxygen content in its mother's blood is much lower than in air. After birth, the baby needs to get rid of the extra supply while hanging onto the iron they contain for its reserves. (This is one reason why early cord clamping is a bad idea. It deprives the newborn of a substantial percentage of its blood volume.) The breakdown process produces a byproduct called "bilirubin," and it is this substance in the baby's bloodstream that tinges the skin yellow. 

    It isn't clear from your post whether you experienced anxiety after the induced labor or your natural labor or both. Postpartum anxiety may well be related to how the woman experiences her labor. It is one of the symptoms of posttraumatic stress disorder (PTSD). Classically, PTSD occurs during events where people feel that they or a loved one is endangered and they feel overwhelmed and powerless to do anything about it. Pain or injury is often a component as well. It makes sense, then, that one way the psyche reacts afterwards in an attempt to protect against a repeat experience is to amp up anxiety and vigilance. (Think about the war veteran who jumps and seeks cover when a car backfires.) Not surprisingly, studies of postpartum PTSD report associations with medical intervention such as unplanned cesarean surgery or induction of labor. 

    ~ Henci  

    Archived User

    Thanks Henci,

    Actually I don't know if my natural contractions were similar to the induced ones because I also had epidurals and other pain medication. So it was my first time to experience what natural contractions felt like for me.

    I have been reading many other posts here, which have been so very, very helpful. I guess I should have been more specific or more clear about my personal experiences.  My first two births were induced for no particular reason with epidurals and pain medication. I just thought that was how it was supposed to be done (hadn't educated myself yet) both pregnancies were very healthy and deliveries were good with minimal tearing no episiotomies (2nd baby just 1stitch) However, I wanted a different experience for my third pregnancy and labor. I thought if I had a midwife that I could avoid unecessary interventions.  I had hoped to have an empowering birth, but what I got was minimal feedback and support during that labor which left me with a third degree tear and the unanswered question WHY? (I NEVER thought that after two babies had already paved the way, my third one would have surprised me like that)  So I have been analyzing it left and right trying to make sense of it. Especially since I am awaiting #4 and want to avoid tearing with this one.   For me labor and pushing wasn't the worst thing about having a baby it was the healing and recovering that was the worst .So I started off  thinking I would try to birth my 3rd baby without an epidural. I knew that I did not want Pitocin and so when at 41wks my midwife advised me to come in for induction because of low amniotic fluid I was angry and determined to get labor started on my own. That very night my contractions started on their own.  I was quite pleased. Labor progressed well. I started out in the tub but when vomiting started they got me out.  I felt that I had been left alone and the water got too hot. So by the time I got into the bed I thought I might be in transition but after midwife checked me I was just dialated to 6cm. I was disappointed and asked for the epidural.  While waiting for 30 min to get IV fluids, before epidural could be given, my contractions were so strong, I had never felt such intense pain. I was literally seeing stars and flailing about.  The epidural wasn't sucessful on one side so I was given a second epidural. This is where the intervention became too much! I never felt the water break (probably wasn't much anyway) I never felt an urge to push. The midwife told me when it was time. I believe this is why I tore so badly.  I was pushing flat on my back until I became so aggrivated with this that I mustered up enough voice to say I needed to be on my side and then I curled myself like in a sit-up to push the baby out. He was covered in meconuim and immediately suctioned. I felt like I could not comfortably nurse him right away because the midwife was unable to repair my tear. So she held me together for 30 min while we waited for the on-call OB to wake up from sleeping!  I was given pitocin afterward to avoid hemmoraging.  I had been led to believe that Pitocin could be a cause for infant jaundice. Because my previous two had been severely jaundiced this was the reason I did not want pitocin. All in all my third baby was the least jaundiced. But I really don't know if less pitocin was the reason or if there were other factors that came into play.  My third birth experience left me doubting the decisions I had made.

    Thank you for having this post where women can process and vent their frustrations.  Being able to compare my own birth experiences and those of others is helpful. There is so much to learn about the birth process even after a 2nd or 3rd baby. I do know now (hopefully) what I want and do not want, but what will actually happen remains to be seen. This time I have hired a doula. I hope the midwives I have chosen this time will be more proactive.  I hope that I can birth my 4th baby without fear and uncertainty.  I hope other women will read this post and find something in it that will help them in their own journeys. 

    Lisa

    Henci Goer

    "There is so much to learn about the birth process even after a 2nd or 3rd baby. I do know now (hopefully) what I want and do not want, but what will actually happen remains to be seen."

    I think this quote from your post sums things up well. Here's what I think: You made the best decisions at the time based on what you knew and what you knew about what kind of birth experience you wanted. Now you have more information on which to base plans for this next baby.

    What I gleaned from your story about the birth of your third child is that you learned that choosing a midwife did not necessarily mean choosing someone with a particular practice style or philosophy. I recommend that if you want to verify that the midwives you have chosen this time are aligned with what you want, ask them specific questions about their practices. The Coalition for Improving Maternity Services has a downloadable brochure, "Having a Baby? Ten Questions to Ask,"  that can help you get started on deciding what you want to know. Likewise, The DONA website has suggested questions for interviewing a doula to determine if she is on the same page you are. Again, the DONA website questions can get you thinking about other, more specific questions on what is important to you. Beyond that, another thing that can be gleaned from your story is that while something can be generally true, it does not follow that it will be true in every case. This does not undercut the validity of the general truth. To pick an extreme example: "They say smoking is dangerous to your health, but my grandfather was a 2-pack-a-day man from his teens, and he lived to age 96." 

    I hope this next baby is happy and healthy and that this next birth experience is all you would wish it to be. I would be interested to hear how it goes.

    ~ Henci


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