"pit to distress"

Like RNBelle, my hospital (large one in Dallas) has physicians that do the same thing. One explained it to me as "declaring" the baby. If baby can not tolerate labor with pitocin, they can not tolerate labor period. They also use 3x3 as the dose. We would immediatly turn it off and take them to the back for a section.

We never purposely put our babies in distress. If pit causes distress, pit is slowed. Sometimes there is a fine line between upping it to get good contractions vs. lowering it to make baby happy.

I have noticed often with inductions, the body just isn't ready, and dilation slows or stops. We end up with a lot of C/S for "failure to progress." Also, in inductions they pop the water early in the labor to help it proceed. Then they have to deliver within 24 hours or it's a C/S for "failure to progress."

I don't like inductions. If they're needed d/t HTN, etc., that's one thing. But too often they are "social inductions" d/t convenience.

We just currently changed our pit orders. We have low dose and high dose pit. Low dose start at 1mu and increase by 1mu every 30-45min. up to 6mu. The high dose starts at 6mu and increase by 6mu every 15min until you reach 40mu. We had to do this because of the different thinking between all the docs and midwifes. I truly haven't seen a greater difference with high dose except certain practioners are hung up on the numbers.

We still have a small number of doc's who order high dose pit without it being a demise. Not many, but you see it sometimes. Typically, most of us nurses don't follow it though, lol. There are still a handful of old school nurses who will go up by 6 q15 but most of us don't. As for Pit to distress, I agree with others. It isn't an "order" and often it is more that the baby is going to tolerate labor or it isn't. If it isn't, you turn down/off the pit. You NEVER intentionally give ANY baby more contractions then any baby would tolerate though. At least, I have never seen it done.

Our pitocin protocol is start at 2mu and increase by 2 mu Q 15 min until ctx are adquate. To the max of 36mu. But I heard starting in Jan. the protocol is changing to start at 2mu and increase by 2mu Q 30 min untils ctx are adquate. To the max of 16 mu. Then we are to update the MD. And the MD will be required to come and evaluate the pt. in order to give us orders to cont' to increase to the max of 36mu.