Inducing Labor with Pitocin: Making the Choice

Selective Inductions

Many induced deliveries are for personal reasons—often convenience—rather than medical ones. Some doctors offer inductions to their patients if the doctor may be unavailable when a patient goes into labor. "You have the right to decide how your baby is delivered," Dr. DiLeo says, "so long as it doesn't harm you or your baby." The American College of Obstetricians and Gynecologists sanctions the use of Pitocin to induce labor for convenience once a woman has reached her 39th week of pregnancy and her cervix is ripe, he adds. To determine whether or not a cervix is ripe, doctors check a woman's Bishop's Score, a numerical score based on dilatation, thinning (effacement) and head descent, explains Dr. Kritz.

Not all delivery practitioners and medical institutions agree with the American College of Obstetricians and Gynecologists' sanctions, however. Ratta explains that Massachusetts General's protocol states that inductions may not be done until the 41st week of pregnancy, if the cervix is ripe, and the patient desires. This time frame is based on research that indicates a baby may not remain healthy in the womb once week 42 has passed. After week 42, the baby can outgrow its supply of placenta, and the remaining amniotic fluid may not be sufficient to sustain the baby's metabolic needs, says Dr. Kritz.

The Risks

So, you've reached week 40 and you want your baby delivered—now. You may request an induction from your doctor, if your cervix is ripe. According to Dr. Kritz, Pitocin used to induce before the cervix has softened can cause serious complications including a risk of placental abruption or harm to your baby.

"If your body goes into labor, your body is saying, 'I'm ready to deliver.' If your labor is artificially induced, it likely won't work as well, and your body might stop midway," says Ratta. In other words, if your cervix isn't ripe, your body is not ready to deliver, and an induction will increase your risk of an emergency C-section.

Another risk is posed when "Pitocin is used incorrectly and causes hyper-stimulation, which brings on a 'mother' contraction, [which impacts the supply of blood and oxygen to the fetus] and affects the heart rate of the baby [fetal distress]," explains Dr. DiLeo. Sometimes, though, these mother contractions, called tetanic contractions, are simply fluke reactions to the drug. "In rare cases, [these strong contractions] can lead to tearing of the uterus," states the USP Drug Guide.