Why is Pit started on spontaneous labor?

Patients who are sick of being pregnant begging to be induced, doctors who want a baby delivered on their schedule.... Am I close?

contraction stress test?

On 7/17/2013 at 2:46 AM, DalekRN said:

Patients who are sick of being pregnant begging to be induced, doctors who want a baby delivered on their schedule.... Am I close?

Yes, this. Some docs are impatient.

Let me just preface this by saying that I think Pit is WAY overused. However, I work at a busy teaching facility that does 300-400 births per month and boy do they love the Pit. We start it on freaking everybody and the only explanation I get is that we don't have the luxury of waiting for everyone to have a baby on their own time so we need to speed it along. They want everyone in an adequate contraction pattern. Never mind that plenty of women can make change despite having what looks like an inadequate contraction pattern on a TOCO. Doctors are seriously impatient.

FWIW, I work at a facility that does about 400 births/month and we don't overuse Pit. We do allow women to have their babies on their own time, as long as mom and baby are both doing okay. It's not uncommon for inductions to last 2-3 days. So it can be done.

I want to come work at your hospital then. I'm tired of trying to keep babies happy on pit!

It truly is a great place to work! The docs/residents truly seem to respect women and their birth choices. If a midwifery patient develops complications, such as pre-eclampsia, they allow the midwives to continue to manage the labor, while they just manage the pre-eclampsia.

I see a lot of unnecessary inductions as well just b/c they are 40weeks. I know when I was in clinicals, most of the hospitals DID use pit pretty much on everyone. I don't see the rush though at a teaching facility when docs are in the dept pretty much the whole day. I see the reverse as well with no pit being used, I don't want it to seem like it's used EVERY single time, but I do see it ALOT.

I think we have a Pit protocol, but many of the providers are pretty flexible. We have had the 3-4 day inductions as well, and if a woman truly wants to avoid the P, we do everything we can to facilitate that. True, some providers are itchy to start it, just as some providers have an itchy scalpel finger, but generally, unless the woman is not progressing, or progressing EXTREMELY slow, and her BOW is ruptured with mec and all that, then they will start talking Pit. I delivered at the hospital I work at, and with my son, the doc really REALLY wanted to get Pit going, but the nurses (I wasn't a nurse at the time) went to bat for me and it was a good 8 hours or so of walking, bouncing on the ball and the like before they went to Pitocin.

At my last hospital job, everyone got pitted. It was standard operating procedure. The docs were in a hurry, basically. Why wait till 2 am when I can pit the thing out by 8pm? seemed to be their thought process.

The only reason I think I got "pitted" was for the staff's sake, not me or my baby. There I am, laboring happily along with great contractions, no pre enclampsia, and all of a sudden a nurse rushes in and jabs pitocin into my IV. I am almost 6 months pregnant now, and I don't think I am going to let that happen this time around, unless it is absolutely necessary.

With my own children, I have noticed everytime I have received pictocin, or had to be induced (there were two times that the doctor was absolutely RIGHT to induce me) my children have developed serious jaundice. My second son was so jaundiced that the doctors were afraid that they would have to go beyond treating him with the bill-lights. The deliveries where there was no pitocin used, my babies were fine.

I agree it's overused. With my own children, it was needed for two of them (induction). However, with the one pregnancy I arrived at 6 cm after laboring at home. They put me on pit bc the one doctor's call was over at 8 am and wanted to see me out. I agreed on the pit only if I could have an epidural. Had both, and guess what, the baby was born on the other doctor's shift anyway (after 8 am). The epidural and my lying in bed is what probably slowed it down. I had been laboring at home okay walking around and should have just stuck with my own way.