Monday, August 13, 2012

A Detailed Look at the Side Effects of Pitocin I Experienced During Childbirth

This is not a post on the dangers of pitocin (synthetic oxytocin), or an outline of it's risks, or a debate on whether or not it should be used for labor induction.  I considered whether to bring up recent studies showing new dangers, or provide a complete list of risks other than the side effects I experienced, but I decided against it because that would be inserting my own opinion or me trying to manipulate.  This is about my personal experience, and my research will simply explain the events that unfolded in more detail. 

I posted my Son's 49hr Hospital Birth Story last week and shared it on a few different social media outlets.  Since my son was born with breathing problems, was sick with croup as a child, and later developed asthma, I've always blamed these problems on pitocin knowing the increased risk of fetal cardiac/respiratory issues associated with this drug.  I received a surprising number of comments challenging my beliefs, even in forums supposedly dedicated to natural unmedicated childbirth.  This prompted me to do a lot of research not just to defend myself, but with an open mind to know the truth since I'd never really researched it before.  One commenter even said her son was born with the exact same breathing difficulty at birth when pitocin wasn't used until postpartum.  Maybe I was wrong, perhaps pitocin wasn't to blame at all, and not nearly as risky as I thought.  But, what I found DOES indicate that pitocin was responsible for his breathing problems at birth, and may be responsible for his asthma as well though that is certainly up for debate.  What I found was so scary and shocking, I'm now facing my next birth with the knowledge that I'd rather have a c-section than risk pitocin again.  Knowing what I know now, I don't think there is a situation in which I'd agree to antepartum pitocin again.  I now realize my son or I could have died from the complications we suffered from this drug, and while I know many women have found success with it and believe they had no complications from it, this post is about what did happen to me and could happen to anyone. Get informed, get your doctors opinion, and then make your own decision.


Pitocin Indications and Usage
I didn't go far to find the information I needed.  The following information is included on the information insert that comes with the drug.  That info packet is provided online by the manufacturer, I invite you to read it yourself.  Every vaccine and drug, whether given at the hospital/doctors office, picked up at the pharmacy, or purchased over the counter comes with a package insert of information. You should read them!  It's not all medical jargon.  Due to lawsuits, most of them are very easy to read and understand.

Let's begin with a picture of me after about 36hrs of labor but before pitocin was started compared with a picture taken about 14hrs after pitocin was started.  I continued to receive pitcocin after the birth, so I'm not sure if I was still on it in the 2nd picture or not, but I believe I was.  This was almost exactly 6hrs after the birth.
Swell much?

Later when I saw these pictures I thought I was just blinking at the camera flash as I'm prone to doing, but there are 9 pictures and I look the same in all of them.  I'm swollen up to the size of the house. 

Instances when pitocin should not be used

I knew pitocin caused swelling for some users and didn't really think anything of it even in the years after the birth.  I knew I wanted to avoid pitocin for my next birth, if possible, because the swelling slowed my recovery, but I didn't think it was a life-threatening complication.  Had I received or asked for the package insert included with the drug, I would've learned that women have died from pitocin induced water intoxication (also known as hyponatremia) caused by the antidiuretic effect of the drug.  I was swelling because sodium levels outside my cells dropped, and so water was moving into my cells to correct the imbalance, causing them to be larger or engorged with water.  Had this continued, I would have experienced fatigue, and then a headache as my brain swelled and filled my skull.  I might have experienced alterations in personality, muscle spasms or weakness, before I dropped into a coma and died.(Source)  It would be overly dramatic to say the second photo is a picture of me getting closer to death, but it's indisputable that I was getting more unhealthy by the moment.  I think I'm an especially good example of this type of swelling because if I'd had a typical 8hr birth people might argue the swollen face/body was just from all the pushing and the exhaustion of labor.  In my case, the first picture was taken after 36hrs of hard labor, and the second more than 6hrs after the pushing was over.  It wasn't the labor or the pushing, it was the pitocin.

Listed under the overdose heading in the package insert is uterine hyperactivity "due to strong (hypertonic) or prolonged (tetanic) contractions," and it goes on to list the host of complications that this can cause, including fetal hypoxia.  During labor, the fetus gets oxygen by running blood through the umbilical cord to the placenta where it picks up oxygen from mom's blood (though their blood doesn't mix) and it goes back through the cord to the baby to it's heart and circulatory system (Source). During labor, a woman's body controls it's contractions so as not to exhaust the baby or the uterus.  Very long labors have periods where contractions space out to allow mother and baby to rest before starting up again.  Pitocin bypasses that natural control by keeping contractions 'regular', and the package insert says that in cases of overdose contractions can come more often and last longer.  Any fetus experiences a drop in blood flow during any contraction due to constriction, but longer, more intense contractions reduces the amount of blood flow even further, and with contractions right on top of each other the baby has no time to recover.  They can suffocate to the point of brain damage or death.  Both fetal brain damage and fetal death are listed under normal adverse reactions in the package insert.  Fetal hypoxia is listed in cases of overdose. 
12min after birth, before the nurses realized the was a problem

After 7hrs on pitocin, my baby was born with rapid breathing as if he was out of breath.  He had to go on the monitor for an hour, and the pediatrician was called at home.  If this happened after only 7hrs, what would have happened after a few more hours? or after only one more hour?  If I were to agree to pitocin during my next labor, would the baby experience the same reaction after the same amount of time? After less time?  What's the safe amount of time to have pitocin and still get a healthy baby?  The package insert indicates that overdose can't always be judged by a specific dosage, but should also be judged by the patients sensitivity to the drug.  Was I given an overdose?  There are no answers here, but my baby and I had a hard time with pitocin and I don't think our story is that unusual.  One might say they were minor issues, but I now realize they were the early stages of major complications.  I'm thankful they didn't progress further, and I think it's clear that I should avoid pitocin in the future.  This is the right choice for my family, but it doesn't mean it's the right choice for every woman.  I wouldn't presume to tell anyone whether they should use pitocin or not, and of course I'd never tell a woman to blindly follow a doctors advice, nor to ignore it.  Get informed, get your doctors opinion, and then make your own decision.

P.S. Always ask for and read the package insert for any injection, vaccine, pill, drug, or capsule of tylenol no matter if you receive it at your doctors office, hospital or at home!


I should have known this post would be trouble! Here's my reaction to the Pitocin Post Fallout.

4 comments:

  1. Thank you for sharing this. I too experienced severe swelling all over after my babys delivery, most apparent on my face. My feet were so swollen I could barely walk! The nurses told me it was from all the extra fluids I'd received via I.V. during 30 hrs of labour.
    I remained swollen for almost a week.
    My husband and I have decided on a home birth next. We never want to see a hospital again. My induction was totally unnecessary, we both realize that now. Thank God we have a beautiful healthy girl that survived it all with no signs of distress. Im happy I received the brunt of it all. I asked the midwives repeatedly if the Pittocin posed any danger to my baby and they said "no". Get informed women, we have choices.
    thank you jessica

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    1. Thanks! and yay for home births! I wrote this because I really wish I'd been better informed about the risks of pitocin before I agreed to it. Maybe I'd still have agreed, but now I'm looking back wishing I'd known better. While the hospital didn't pressure me into it at all, they also didn't give me any reason to delay (explain risks) or offer any alternatives (like breaking my water). I hope this prompts other women to just ask about other options, ask about risks, ask questions!

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  2. Thanks for writing this. I'm due for baby #2 on Dec 25th. For baby #1 I chose to go all natural, meaning I wanted no drugs. I had no idea what pitocin was or that they would insist that I needed it to avoid a section. My water broke at noon and I was in a hospital room by 1:30 or so. I wasn't dilated at all so they told me around 4 that since my water was broken and I wasn't dilating that I may need a section. Well that terrified me so I agreed to pitocin, not having any idea what it was or the risks of it. The contractions after being given pitocin were almost unbearable, it made me throw up about 3 times. I stuck it out without an epidural until I delivered at 1:03 am. Not to mention that my body was pushing the baby out for about an hour while nurses were telling me not to push until my doc got there, which was horrible. As soon as the doc walked in she told me to start pushing without even checking me cause I'm sure the nurses told her I've been ready. I thank God that my baby and I came away from this without complication. I now believe it was totally unnecessary for them to give me pitocin and that I would have had a much more pleasant birth without it. I'm def making it known to my doc this time around that I do NOT want pitocin or epidural.

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  3. you are my new bff i think!!! lol.

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