When is oxytocin necessary?

 During dilatation, substances are usually administered intravenously that reproduce the effect of the hormone that causes childbirth naturally: oxytocin.

This practice is not without controversy, as defenders of natural childbirth argue that it is not always used appropriately.

We resolve all doubts that may arise about the procedure.

In which cases is synthetic oxytocin applied?

What is really necessary for labor to occur is the endogenous production (by the body itself) of oxytocin, a hormone secreted by the mother's brain during pregnancy.

Before childbirth, levels increase to stimulate uterine muscle contractions. Although in most clinics and hospitals, synthetic oxytocin is routinely used to accelerate labor, its use is only indicated when contractions do not achieve adequate dilation of the cervix or if it is necessary to induce labor.

How is it administered?

Through a dropper (like a serum), in a controlled manner, and in increasing doses. The speed of the drip is gradually increased until the appropriate contractions are achieved.

The obstetrician keeps close monitoring of uterine contractions, the mother's blood pressure, and the heart rate of the fetus. This monitoring allows you to adapt the dose of the synthetic hormone to the characteristics of each parturient.

When and why did it start to be used?

It began to be used clinically in the 1960s, with the same intentions as today:

What position should the mother be in?

You can adopt any position. The drip does not have to prevent you from taking short walks around the room. It is epidural analgesia, and not the administration of oxytocin, that usually limits leg movement.

What type of contractions does it cause? Are they more painful?

Synthetic oxytocin causes contractions similar to those produced spontaneously by natural oxytocin. It is false that they are more painful. What happens is that, since it is administered when uterine activity is insufficient, the pain appears suddenly, but it is the same pain that the woman would notice if the response to endogenous oxytocin were adequate.

Synthetic oxytocin is also administered after delivery of the placenta  (even in cesarean sections ) to promote contraction of the uterus and reduce blood loss. This hormone also stimulates the release of milk.

Although it is not a common practice (and is generally discouraged), when breastfeeding cannot be initiated, oxytocin is sometimes administered nasally to improve the breast's ejection reflex (the appearance of milk gives confidence to the mother).

Is the number of cesarean sections and forceps deliveries increasing?

No. Being able to stimulate uterine dynamics when necessary has meant a lower rate of cesarean sections due to arrested labor and a lower need to resort to instrumental delivery (suction cup, forceps ) to alleviate prolonged expulsion.

In addition, it has contributed to improving the well-being of the newborn by shortening excessively long births.

What risks can it have for the mother and baby?

In the mother, there is a mild antidiuretic effect (urine retention). This effect, apart from not being serious, is exceptional if oxytocin is administered in adequate doses. In pregnant women who have had a cesarean section, there is a minimal risk (1%) of uterine rupture.

In the fetus,  uterine hyperstimulation can produce a temporary oxygen deficit, which is usually easily resolved by stopping the administration. Sometimes it is necessary to perform a cesarean section. This does not mean that the cause of this intervention is synthetic oxytocin, but rather that it is a fetus that does not tolerate the stress of uterine contractions well. Stimulation with oxytocin only highlights the baby's limited ability to withstand a long labor.