There has been a great kerfuffle in the blogosphere recently about Pitocin, as a recent study (cited below) indicates a correlation between induction and augmentation of labor (both done with Pitocin) and autism.  Note that this is a CORRELATION, meaning that it appears that when one incidence goes up (use of Pitocin for induction or augmentation), so does the other (autism).  That does not mean that we have any certainty that one CAUSES the other.  Lot’s of things that have nothing to do with one another can be statistically correlated, such as climate change and women’s rights or availability of high-quality chocolate and the rise in U.S. wage gaps.

Let’s be clear at the outset: administration of synthetic Oxytocin (Pitocin) to a pregnant woman can be a wonderful thing.  It can improve health outcomes for a woman and for her baby.  It can prevent a woman from hemorrhaging.  It can potentially prevent stillbirth for babies who show no signs of being born even though the uterine environment is deteriorating.  It can help a woman to have a vaginal birth when it is necessary for a baby to be born earlier than planned, as when a woman has pre-eclampsia.

However, as with most drugs, it is best not to take Pitocin if it isn’t needed.  Some say that oxytocin is naturally produced by the body, so it’s fine to give it to pregnant/laboring women.  But lots of hormones and other substances are naturally produced by the body–estrogen, testosterone, red blood cells–and having too much of any of these in one’s system is harmful.  That’s why we don’t generally take hormones or get blood transfusions unless there is a specific medical indication that they are needed.

The FDA has a black box warning on Pitocin.   Pitocin is a high alert medication.  Pitocin is specifically NOT indicated for elective induction of labor.  Guidelines for augmentation of labor are not clear–though the Friedman curve has been widely discredited in the contemporary obstetric environment, it is often still used to determine an appropriate speed of labor.  Obstetric articles regarding augmentation often tout faster labor time as a benefit, without assessing whether that is what the woman prefers–her pain level, her satisfaction with her ability/inability to move around, her overall experience of labor an birth–or whether faster labor produces better outcomes.

The issue around autism and Pitocin is less whether Pitocin use and autism have a causal relationship than the question of why women are being given Pitocin in the first place.  If there is any potential for harm, and the drug is not needed, why is it being administered at all?

A woman is not a scientific experiment, nor is her laboring body obligated to conform to s schedule that does not increase benefits to her health or those of her infant.

JAMA Pediatrics research article on Pitocin and Autism

Overview of Pitocin

Institute for Safe Medication Practices list of high alert medications

Evidence Based Birth on Pitocin augmentation

Also on this blog: Elective Inductions: Be Thankful not to Have One and Public Service Post: The Bishop Score

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