Published Jun 27, 2000
Why is there so much pitocin being used for inductions? This makes a hard labor....
I agree, pit does make labor harder (speaking from both professional and personal experience )! A lot of the doc's I work with are starting to use Cytotec as the primary induction agent...which is a lot worse than pit!! At least with pit, you can turn it off! With the cytotec, once it's placed, that's it! We've had a high number of stat c/s for fetal distress from the Cytotec.
Most of our doc's will place an IUPC when using pit, which is a relief; you get a clear picture of what's going on.
Once thing's for sure; an induction isn't easy, but when you can help the pt through it, you have a great sense of pride and accomplishment as a nurse!
first baby, no drugs, 7 hours start to finish. second baby pitocin induction, no drugs 6 hours start to finish...lemme jsut say OUCH!!!! and how much worse it was the second time around!!!!!!!!!!!!!
Cytotec is probably not a good idea to use for routine inductions when pitocin can be used. They may be doing this because cytotec is very inexpensive. Not a good habit to get into!
Terbutaline also does not work well to stop it.
Yep Pitocin does what it is supposed to do.... make the uterus contract, increase the force of contractions and make them more frequent.
Although I have seen many occaisions when labor could have progressed normally.
My experience with inductions have been that the majority of them have been done due to social reasons: patient's wanting to be induced, etc. Pitocin/inductions etc have their place - I am not outright against it. Epidurals can slow labor down, causing the need for pit. What I am more so concerned about is the rise of epidural use.
As far as cytotec, I have seen good results with it. I haven't seen any more crash sections with cytotec than I have with pitocin. It is hard to reverse, yes, terb doesn't always do the trick, but the same holds true for prostin gel. It's very difficult to flush that out as well, especially with a tetanic uterus and pt in extreme pain.
if u can, check out this months issue of mothering magazine. there is a really scary article in there on cytotec inductions!!!
Back to the original question-
I guess if it wasn't used, it wouldn't be an induction. (or misoprostil or prostiglands would be used)
The Bishop score should always be used to evaluate the cervix. If it is not favorable usually Vitamin P is started or is started and ends up being stopped many hours later only giving discomfort to a fialed induction. Misoprostil can sometimes be favorable in this case if induction is absolutely necessary. Better yet give it a few more days, strip membranes etc.
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