How Can I Avoid Pitocin if My Waters Break Early?

QUESTION

Dear Midwife,
I am pregnant with my second child. During my first delivery, my midwife insisted that I receive Pitocin about five hours after my water had broken due to my labor not "progressing." I do not want this to happen with this birth.

When do you suggest Pitocin and is it really safe? I've been reading about the problems it sometimes causes. Is there anyway to prevent this from happening again?

Thank you.

ANSWER

You need to choose a provider who understands your desire not to have pitocin. They can't give it to you without your permission, but they can choose not to treat you if you don't do it their way. Pitocin itself is very close chemically to natural oxytocin, but women who have had it say it is not used the same way, so it doesn't feel the same way as oxytocin. Pitocin is relatively safe if used carefully.

I don't know how long ago you had your first baby, but until August 2002, the Centers for Disease Control advised antibiotic prophyllaxis if the membranes were ruptured more than 18 hours, so many providers tried to get the baby born before then. Now, the CDC says if you are tested for Group Beta Strep between 35-37 weeks (and they recommend that you do get tested), and you turn out to be negative, there is no need for antibiotics with a term baby unless you develop a fever. That takes the rush-rush pressure off the provider, but many are still worried about infection, and try to hurry the process.

One thing you can do to prevent all this is to build a really strong bag of waters so it doesn't break. Eat a pristine pregnancy diet with plenty of protein, and maybe you won't even have to "go there." Good luck!

-- Cynthia, CNM

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.