Pit to Distress – Wow

There has been a big rumbling going through the internet about this topic.  About doctors who encourage using pitocin until the baby is in distress.  Some feel it is a way for OBs to create a need for a cesarean.      Some feel it is a way to just get the babies out quicker so the OB can go home. 

I did have a friend who was getting induced with her 3rd baby.  She went in at 7 AM, her OB said, we are going to get this kid born by lunchtime.  Indeed he was.  She got her epidural and they cranked the pit and BAM he was born. 

I don’t really care what the reasoning behind “pitting to distress” is.  I just want moms to know that they have the right to say NO to upping the pit every 15 minutes!  I always tell my Hypnobabies moms, if you choose to be induced, be proactive!  Tell the OB you want the pitocin upped slowly.  Tell the nurse too.  THEN, Watch the nurse like a hawk, they will come in and turn it up without telling you what they are doing.    

It isn’t a race to get the baby out.  If it takes 12 hours or 24 hours, it doesn’t matter.  If baby and you are fine, then there is not a rush.  BUT if they crank up the pit, then baby AND you probably won’t be feeling fine, or looking good. 

If you communicate with your nurse and let her know you want it moved up slowly and to stop turning it up if you get a good pattern, you have a partner in avoiding “pitting to distress”  Your nurse can be on your side.  BUT you need to continue to be proactive in watching her and asking her questions and asking for what you want.

So far all the nurses I have doula’d with during inductions have been really helpful with this, which is great.   But I think of ALL the moms who go into an induction without a doula or without even knowing they have a choice in how fast they up the pitocin.  I am sure all get pit to distress or at least pit to the max, which they are just lucky enough it doesn’t cause distress.

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14 comments on this post.
  1. Jill--Unnecesarean :

    Hi. I’m glad to see someone weigh in on Pit to distress from a patient advocacy perspecitive.

    Really, it’s a shame that women would be expected to watch anyone like a hawk during labor, don’t you think? Hopefully their partner or doula would be able to be hypervigilant for them.

    [Reply]

    enjoybirth
    Twitter:
    Reply:

    It is a shame. But at least mom’s with a doula would have someone looking out for this exact thing!

    [Reply]

  2. brihoopes :

    I get SO MAD about this crap….

    [Reply]

    enjoybirth
    Twitter:
    Reply:

    Me too!

    [Reply]

  3. Taryn Goodwin :

    Thanks for posting! More moms need to know what is going on with Pit!

    [Reply]

  4. Joy :

    And this is why my birth plan states NO PITOCIN whatsoever! I’ve given birth twice without needing it but they GAVE IT TO ME ANYWAY, even after I said NO.

    This really, really peeves me.

    [Reply]

  5. Nicole :

    Great post on this topic. It is so important for women to really understand that it is their birth, their induction, their body, their labor room etc… It is sooooo reasonable to ask your nurse to take it slow on the Pitocin. It is not a race. Her shifts ends in 8 or 12 hours whether you have your baby or not. Take control of your birth and make it what you want it to be. I would also add that “a good pattern” is so relative. Let her know directly you are not interested in having contractions every 1-2 minutes. This is NOT necessary and this is when mothers and babies get into trouble. In fact having greater than 5 contractions in 10 minutes is considered “Tachysystole” and a reason to turn the Pitocin DOWN!! Yes…. down. And this this is my final point, just as easily as a nurse can INcrease pitocin, she can DEcrease it. Ask her to. Its your birth. Own it!!

    [Reply]

    enjoybirth
    Twitter:
    Reply:

    This is a good point! Indeed ask her to decrease it if you feel it is getting too intense.

    [Reply]

  6. Pit to Distress… my thoughts… « It’s Your Birth Right!! :

    [...] initially saw a post re: Pit to distress yesterday over at Enjoy Birth where she talked about helping her clients avoid this scenario.  I made a comment on her post that [...]

  7. Jenn :

    Unfortunately, having a doula is not a panecea. As a doula, I’ve been at births where Pitocin is abused–I blogged about it here: http://knittedinthewomb.com/wp/?p=470 . There is only so much that a doula can do. I notice what is going on, and I inform my client of her options…but she has to be able to fight.

    And quite frankly, that is often nearly impossible for a woman in labor. She should not have to be fighting, and one of the inherant properties of Oxytocin is that it causes us to trust the people around us–i.e. our care providers. So if the care provider is saying “your baby is in danger, we need to get this labor going so that we can get your baby out NOW,” well the natural instinct to protect our children coupled with the trust effect of the Oxytocin packs a double punch. So while the laboring woman may “know” in her head that something is wrong…in her heart she may have difficulty.

    This is why I tell my clients to negotiate how the Pitocin will be used BEFORE the IV is in place. You are more in a position of power then. Of course, saddly, doing that negotiation is not a guaruntee that the care provider will stick to the plan–but it really can help the doula to advocate for the client if the client already had an agreement with the OB in advance about how the Pit was going to be used.

    [Reply]

    enjoybirth
    Twitter:
    Reply:

    That is true, a doula can not prevent this from happening. Childbirth Education before and talking about it before and induction can help parents be more informed. I now suggest my expecting parents talk to their care providers about inductions way BEFORE 40 weeks, when do they typically induce, what drugs do they typically use, are they open to upping pitocin slowly… etc. This way if they get answers that are not good, they can change providers before an un-neccesary induction is pressed upon them.

    Then if we get to a point where they are going in for an induction, I remind them…. Pitocin SLOW. If I am their doula I am watching and alerting them and try to keep it slow, but they have to be outspoken about it too for it to work!

    I love your post and would love that word doc to know all the details about pitocin!

    [Reply]

  8. Questions to ask your Care Provider – NOW! « Enjoy Birth Blog :

    [...] who induce most of their moms are going to typically have more cesareans, maybe because of “pit to distress” [...]

  9. It’s Distressing « Woman to Woman Childbirth Education :

    [...] in with her tales of being a doula at some Pitocin-induced/augmented births, as does Sheridan at Enjoy Birth. One of the contributors to our Independent Childbirth educators blog posted [...]

  10. My Overall Hypnobabies Student’s Statistics « Enjoy Birth Blog :

    [...] turned the pitocin up.  Slower is better.  The nurses like to turn it up every 20 minutes.  This isn’t a race to see how quickly we can force the baby out. Possibly related posts: (automatically generated)2009 [...]

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