Oxytocin is a hormone secreted by the mother's brain during pregnancy, necessary to trigger childbirth. Oxytocin comes from the Greek and means "quick labour". This hormone regulates the pace of the childbirth and facilitates the process of breastfeeding.
Before childbirth the levels of oxytocin increase in order to stimulate the contractions of the uterine muscle. Although synthetic oxytocin is regularly used in clinics in order to accelerate childbirth, its use is only indicated when there's not an adequate dilatation of the cervix and the labour needs to be induced.
Administration and characteristics
Oxytocin is administered as a serum, through a dropper, in a controlled way and with increasing doses. The speed of the administration increases until the appropriate contractions are achieved.
The obstetrician closely controls the uterine contractions, the blood pressure of the mother and the cardiac rhythm of the fetus.
Oxytocin is used to/as:
- Induce the labour when the risk of continuing the pregnancy is high.
- Stimulate the labour when uterine dynamics are insufficient for childbirth to occur within the time period that is considered safe for the mother and the fetus.
- An exam of the well being of the fetus, when there are doubts about the health of the child before childbirth.
- Oxytocin allows the intrauterine status of the fetus to be checked.
Many women wonder about the position on which oxytocin should be applied, if the contractions generated by the hormone are painful, if it increases the number of cesareans and the use of forceps and about the risks the hormone may have for the mother and the baby.
First, the position in which the hormone is applied does not matter. Plus, the administration of oxytocin, unlike epidural that limits the movement of the legs, allows for movement.
Second, synthetic oxytocin causes contractions that are very similar to the ones produced by the natural oxytocin. Given that the hormone is only administered when the uterine activity is insufficient, pain comes suddenly but it is the same pain a woman would feel if her answer to the natural oxytocin was adequate.
When it comes to the question of whether it increases the number of cesareans and labours with forceps the answer is no. In fact, there is a lower cesarean rate and a decreased need to resort to an instrumental delivery. The administration of this hormone also shortens the duration of excessively long labours.
In some cases there might be a slight antidiuretic effect (urinary retention) on the mother depending of the doses administered. In women who have had a cesarean there's a minimum risk of uterine rupture. In the fetus, the uterine stimulation might produce a transitory oxygen deficit that is easily solved when the administration of the hormone is interrupted.
This hormone should not be administered when there are evidences of fetal suffering and of placenta previa, when the position of the fetus is not normal and when there is a uterine prolapse. Oxytocin should be carefully used in cases of twin births and when the mother has a heart related disease. In cases of coronary or kidney insufficiency and of hypertension the dose administered should be low.
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