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There is a little-known law in New York— Public Health Law, Section 2503, passed in 1978—that requires all physicians and midwives to fully disclose and require informed consent from laboring women regarding the use of all drugs during labor and delivery. Unfortunately, many healthcare providers fail to tell their patients about the potential side effects and possible risks involved in administering one of the most common drugs used during labor: Pitocin.
Pitocin, a registered trademark of JHP Pharmaceuticals, is a synthetic form of oxytocin, the natural hormone that stimulates the onset of labor, promotes a sense of well-being, and enhances maternal bonding. Pitocin is given to women to induce or augment labor. It is manufactured from the pituitary extract of various animals, combined with acetic acid for pH adjustment and less than 1 percent chloretone as a preservative.
The routine use of Pitocin is not backed by any scientific data, and the side effects of its use during labor (and sometimes during the third stage of labor to assist the expulsion of the placenta) rarely are discussed with the laboring woman. Regardless of how many labors are induced with Pitocin, most of them are not medically necessary.
During the 1980s, Dr. Roberto Caldreyo-Barcia, former president of the International Federation of Obstetricians and Gynecologists and a renowned researcher into the effects of obstetrical interventions, declared that “Pitocin is the most abused drug in the world today.” He claimed its use was medically necessary in only about 3 percent of labors, yet estimates of its use range from 12 to 60 percent. Often, the drug is administered without the woman’s knowledge and she never is told of its potential harmful risk factors.
The Physician’s Desk Reference supports the use of Pitocin only when medically necessary, and advises to begin with a minimum dosage to see how the laboring mother tolerates it. The mother should receive oxygen and continuous electronic fetal monitoring, since fetal distress is more common with Pitocin use and needs to be carefully watched.
The natural rhythm of labor is supported by the release of oxytocin in bursts, as needed. Pitocin, in contrast, is administered as a constant IV drip that confines most women to bed. This decreases their ability to control the escalating pain caused by drug-induced uterine activity, and laboring women on Pitocin are more likely to require pain medication that slows labor. Think of the dichotomy: Pitocin is administered to speed up labor, but the increased level of pain requires medication that slows it down. In addition, Pitocin often has no effect on cervical dilation, even though the contractions it induces are much stronger.