Will the REAL Oxytocin Please Stand Up
Labor induction is common. It's normal to schedule the day you'll go have your baby. Pitocin, the drug used to induce labor (Syntocinon or sythetic oxytocin are other names), is seen as a normal part of labor. Women's bodies just don't work without its help. Right?
The Two Uses for Pitocin
Pitocin is a sythetic substance created to mimic something your body already makes – oxytocin. Typically it's used for labor induction (to begin labor when it hasn't begun on its own) or to augment labor contractions (to make them “stronger” or “faster” or “more effective”).
It's also almost universally used in the 3rd stage of labor, when the placenta is being born. This is known as a “managed” 3rd stage and typically involves cord traction (continually pulling on the cord until the placenta pulls out) and Pitocin to encourage the uterus to clamp down (thus stopping bleeding). If you have Pitocin being delivered via IV, it's often turned “wide open” at this point (maximum amounts of the drug flow into your body), and if you haven't had any, you're given an injection.
If Pitocin is effective enough to do this, what's the problem? Aside from issues you don't hear about often (allergies, water retention, blood pressure complications), and those that you do (harsh, ceaseless contractions that stress uterus and baby), Pitocin is a replacement for a natural substance called Oxytocin.
Oxytocin does a lot more than Pitocin.
And Pitocin overrides oxytocin, leaving mother and baby compromised and without the protective effects oxytocin is supposed to have during birth, breastfeeding, and postpartum.
Oxytocin – Your Body's Own Miracle Drug
Oxytocin is a natural hormone your body produces in the hypothalamus. It's sent directly to the central nervous system and is also stored in the pituitary gland (where it can be released as needed) 1. This release is just one of the differences between oxytocin and Pitocin. Oxytocin is released in pulses, as it's needed (see diagram below). Pitocin comes in a continuous stream, which is why the contractions it creates are relentless.
Calm and Connection
You've probably heard of “the love hormone” – that's oxytocin. It helps us relax and desire to be social with other people. It also drives trust in social situations, and most especially in situations where you're bonding with someone else (friend, lover, parent, child). Oxytocin fuels the “Calm and Connection” system, which is the opposite of the “Fight or Flight” system. It hasn't gotten as much study as the fight or flight response, but it's just as important to day-to-day well-being. 2,3
Research shows the calm and connection reaction lowers blood pressure and heart rate. It also boosts blood circulation and lowers the levels of stress hormones. It positively impacts appetite, nutrient storage, and can help you sleep better, too! 4
This system is important throughout your life, but begins to take a staring role during pregnancy – and oxytocin is at center stage.
Oxytocin actually builds through pregnancy. In fact, researchers have tracked the oxytocin levels of women during pregnancy. The levels of oxytocin in your body influence how you and your baby bond.
Interestingly, researchers discovered that it was not the women who had the most oxytocin, but those whose oxytocin levels increased the most during pregnancy, who had the strongest bonds with their babies. 5
This is powerful information for you because you can actively foster the relaxation and connection system during pregnancy, increasing your own oxytocin levels dramatically.
High oxytocin levels do help labor begin (which is why Pitocin is used as a substitute), but a mother who has been building up oxytocin naturally throughout her pregnancy is primed and ready to begin labor at the perfect time. Pitocin just doesn't have these calming, bonding effects (I'll discuss exactly why shortly). You can't take it throughout pregnancy hoping for an artificial oxytocin high.
That's okay – nature has given you everything you need, no drug required. Simply taking time to relax every day boosts oxytocin. Sit back with music you love. Fold baby clothes. Have a favorite meal. Daydream about your perfect birth. Imagine blissfully breastfeeding your new baby. Pet your dog or cat. Make love to your spouse. Cuddle on the couch with your older kids. All of these things boost oxytocin levels and your baby feels those effects.
High levels of oxytocin during pregnancy help you bond with baby even in the womb. Many “bonding” activities such as talking to your baby, rubbing your belly, folding baby clothes or diapers, etc. boost oxytocin. So you boost oxytocin and your bond with your baby, which motivates you to do more to bond with baby which boosts oxytocin… and on and on 🙂 Listen to my podcast episode on your baby's experience during pregnancy to get more information about how stress and relaxation impact baby and practical tips on keeping oxytocin flowing even when life is stressful (opens in a new window for you).
Some moms also feel they have calmer, more connected babies after focusing on keeping oxytocin levels high throughout pregnancy.
Oxytocin Doesn't Stop When Labor Begins
The effects of natural oxytocin in labor have been studied, because that's how researchers and doctors figured out something like Pitocin would work. Unfortunately the focus on oxytocin seems to have stopped after Pitocin and its equivalents were developed. Now that the “new and better” synthetic is on the scene, the “natural remedy” is all but forgotten – or worse, seen as inferior.
There is no trust that a woman will go into labor when she and her baby are ready. It's my belief that high levels of oxytocin in pregnancy contribute to labor starting and moving along smoothly (I'm not aware that research has been done on this because there's only a small amount of research that acknowledges oxytocin's importance during pregnancy – and as I noted above, that's focused on the important yet different topic of mother/baby bonding).
But even with high oxytocin levels, a mother and baby must be ready for labor to begin. When they are, high oxytocin levels kick in in marvelous ways.
You may have heard of prostaglandins, which are hormones that help to ripen the cervix (make it soft and ready to open). Higher oxytocin levels result in higher prostaglandin levels, which boost oxytocin levels, which boost prostaglandin levels, and so forth. This is another positive feedback loop oxytocin participates in, and the first that has a direct influence on labor.
Pitocin does not have this effect (in fact, synthetic prostaglandins are often used in conjunction with Pitocin to try and make labor induction work better).
Another feedback loop is called the “Ferguson Reflex” and happens in the second stage of labor (when you're pushing your baby out). When your baby's head stimulate receptors in the birth canal, the brain gets the signal to increase oxytocin levels even more, which causes the uterus to push down on baby. That stimulates the receptors again, which causes another burst of oxytocin and another effective pushing contraction from the uterus. 6
These feedback loops function throughout labor to keep labor moving smoothly. Your baby is also moving and working through labor – your body's efforts are to support your baby's – sometimes things slow down as baby adjusts into a proper position. So if labor “stalls” the answer may not be Pitocin, which doesn't help your baby rotate and stresses both of you.
And Pitocin actually overwhelms your body's oxytocin receptors. In effect, it relentlessly floods them, deadening them to further stimulation. This makes your body's own feedback loops stop working. Pitocin drips must be turned up higher – and when that stops working the answer is usually a cesarean.
Flooding the body's oxytocin receptors can also have deadly effects – after baby is born the uterus must clamp down to stop bleeding. A uterus that no longer responds to oxytocin or Pitocin can result in postpartum hemorrhage (“uterine atony” is the technical term for when the uterus will not contract). Oxytocin prevents postpartum hemorrhage. Pitocin makes it more likely. 7
Help for You and Baby
Natural oxytocin brings pain relieving effects to you during labor. Labor creates an extensive “cocktail” of hormones that work at certain times and in certain ways to help you through labor, naturally. Introducing synthetic hormones like Pitocin circumvents the body's natural system and, as I've already shown, disturbs feedback loops.
Beta Endorphin is another hormone that rises during labor. It creates that “Labor Land” feeling that you may have experienced or read about in birth stories. It creates a place where time doesn't matter so much, and a mother feels a certain level of transcendence. This is natural and part of the oxytocin-and-baby-induced natural labor processes. 8
Oyxtocin also appears to cross the fetal blood-brain barrier. It in effect puts baby's systems to sleep during labor, which is a protective mechanism that lowers baby's oxygen needs as contractions compress the cord periodically. 9, 10 Pitocin just can't cross the blood-brain barrier the way oxytocin does.
Safety in the 3rd Stage
Perhaps one of the greatest tragedies of widespread Pitocin use – widespread destruction of the natural oxytocin system – is the increasingly dangerous third stage of labor.
Rachel Reed, an experienced midwife and researcher, argues that a managed birth may be safe for most women simply because the natural design for the 3rd stage has been destroyed by interventions. However, at the end of her article, Reed outlines how to make the 3rd stage safe again – and it doesn't involve more Pitocin. Instead she argues for letting natural oxytocin and the birth process do their jobs. 11
I've already covered the problem with relying on Pitocin to make the uterus clamp down – eventually the body gets overwhelmed. It doesn't happen in every case, but it happens often enough that stronger drugs are often brought in, and hysterectomy and maternal deaths are unfortunately not unheard of.
When Pitocin has not overwhelmed the body, natural oxytocin levels peak as the baby is born and remain very high for about an hour after birth. The levels are so high, in fact, that everyone in the room can feel the effects of mama's oxytocin – everyone experiences the “birth high.”
Oxytocin floods your system, signaling your uterus to contract, shear off the placenta, and shrink down. This effectively closes off the blood flow in your uterus, leaving you with only normal postpartum lochia flow within a short time.
Being with your baby boosts oxytocin further. Smell, sight, touch, and pheromones all appear to act together during this time period. You gaze at your baby, touch him or her, feel his/her movements at your breast (not necessarily nursing yet). All of this continues to raise your oxytocin levels, and interrupting it is dangerous to you and your baby because interruptions stop the oxytocin flow. Looking at, touching, and smelling your baby causes an oxytocin peak. Baby's movements and massaging of your breasts causes another. And baby latching on causes yet another. All of this is well-designed, and all of it depends on letting birth happen naturally – letting the oxytocin flow. 12
As you know, oxytocin is important throughout a person's lifetime, so the effects don't stop after it helps you birth your baby. But it does have special effects that continue as you mother your baby.
Oxytocin has a protective effect (beginning with labor and the immediate postpartum) against postpartum depression. It promotes a strong bond and a good breastfeeding relationship with your baby. This in turn boosts your confidence in yourself as a mother and as a woman.
These bonding effects extend out from the mother-baby pair (though it's okay if you only have eyes for baby for awhile!). You're able to bond better with other people, enjoying the boosted effects from your maternal hormones. And the “calm and connection” habits you built throughout pregnancy continue to handle the inevitable stresses of life – for the rest of your life. Oxytocin is a natural gift that just keeps on giving.
Maybe we need to let the REAL Oxytocin step back up
An Oxytocin-Filled Birth
Sometimes having the information you need is enough. Knowing that oxytocin plays a powerful role through pregnancy, birth, and beyond is enough to help you say “I want that” for your labor and birth. Sometimes you want more information. Sometimes you want practical ways to work with your body, with hormones like oxytocin, and with your baby to have the natural birth you want.
That's where my online natural childbirth class – MamaBaby Birthing – can really help you. It's focused on giving you both the knowledge you need and the practical tips and techniques to work with your baby for a beautiful birth. Plus you have access to a live, weekly Q&A session with me to get answers to any questions you have about your unique pregnancy and birth. Click to get more information on MamaBaby Birthing Classes
1 Chemistry of Connection page 10
2 The Oxytocin Factor page x
3 The Chemistry of Connection p 21
4 The Chemistry of Connection p 23
6 “Liquid Love – Oxytocin,” lecture by Sarah Buckley at the 2012 Trust Birth Conference
8 Gentle Birth, Gentle Mothering by Sarah Buckley, Chapter 6
9 “Liquid Love – Oxytocin,” lecture by Sarah Buckley at the 2012 Trust Birth Conference
10 UK Resuscitation Counsel neonatal resuscitation guidelines
12 “Liquid Love – Oxytocin,” lecture by Sarah Buckley at the 2012 Trust Birth Conference