Pitocin was designed to simulate the body's natural oxytocin, which is released in bursts, however Pitocin is administered through an IV in a continuous stream, and because of this the pressure surges are unnaturally strong, peak longer and may result in decreased uterine blood flow which can cause harm to the baby, and tetanic pressure surges, which can cause uterine rupture.
Benefits: Pitocin inductions only work when your body is ready for birth; you may want to check your score on the Bishops Chart to gage the likeliness of a Pitocin induction being successful.
Risks: Pitocin can start the domino effect - IV, Pitocin, external fetal monitoring, lack of mobility, diminished ability to deal with pressure surges, pain medication, weaker surges due to narcotics, then more Pitocin, fetal distress, etc. Cons for the birthing mother include much more discomfort and prolonged difficult pressure surges, which may cause premature separation of the placenta, rupture of the uterus, laceration of the cervix or postpartum hemorrhage. Cons for the baby include fetal asphyxia and neonatal hypoxia from too frequent and prolonged uterine pressure surges, physical injury and prematurity if the due date is not accurate.
Alternatives: It depends on what your care provider wants to accomplish with Pitocin. If they suggested Pitocin to speed birthing surges up or get a stalled birthing time going again you can try walking, changing positions, nipple stimulation and of course make sure you are well hydrated and nourished. If they suggested using Pitocin to induce, you can try walking, nipple stimulation, intercourse (if your waters are intact) and many other natural induction techniques. If none of those work it is likely a Pitocin induction would also be unsuccessful. Read more about pitocin".
An Episiotomy is a surgical incision in the perineum (the area of skin between the vagina and the anus). It is the equivalent to a 2nd degree tear. There is no reason to have one done in a normal vaginal birth (by that I mean non-operative).
Benefits: Episiotomies are said to speed up the birth by 5-10 minutes, prevent tearing, protect against incontinence, and are said to heal easier than a tear. There is no scientific evidence to back these theories up.
Risks: Infection, increased pain, increase in 3rd and 4th degree vaginal lacerations (extensions into the rectum), significantly longer healing time and when sexual intercourse is resumed, there is increased discomfort.
Alternatives: Don't get an Episiotomy. When you talk with your care provider ahead of time about your birth plan be sure to include what you would like your care provider to do regarding this issue (you can specify that you would rather tear naturally if it came down to that). Ahead of time you can do Kegels, you can request warm compresses on your perineum while your baby's head is crowning, and push slowly all of these will lessen your chances of tearing. (Ed.: At crowning you can ease the baby's head out in between surges! -- more on this later) More Episiotomy Resources.
**(What is a true indication for an episiotomy? A tear that is starting to go up into the peri-urethral area, or fetal distress.)
This method provides beat to beat view of the baby's heart tones, in relationship to mother's pressure surges on a continuous basis. This is a benefit for the high risk mother, but of questionable benefit to the low risk mother.
Benefits: There is NO proven benefit to continuous EFM over periodic checks of Fetal Heart Tones -- birth outcomes have been shown to be the same whether EFM is used, a hand-held Doppler or a non-electronic fetoscope; Intermittent Fetal Monitoring can be safely used during the birthing time.
Risks: This method does use ultrasound; leaves room for mechanical error, which may cause incorrect interpretation, unnecessary interventions etc.; loss of maternal mobility (when in use), and/or trouble with the baby descending properly, which is often aided by movement, which may slow your birthing waves; and may switch attention from the mother to the machine.