At some point in everyone woman’s pregnancy, she will be introduced to the drug called oxytocin or its brand name Pitocin® because it’s used to start contractions during labor and after the placenta is delivered to help stop bleeding.
Many lawsuits occur as a result of the improper use of oxytocin because it can harm both the unborn baby and mother. Oxytocin is given during a labor induction when the mother is not having contractions which are necessary to cause the cervix to dilate or open. It is usually given through the vein (also known as intravenously) and it must be given at a slow rate, notice I emphasize the word “slow.” The medicine is given slowly so that the uterus will not contract too fast or too strong and potentially harm the baby. If not, a process called hyperstimulation will occur which means the contractions are occurring every minute. This can cut off the oxygen supply to the baby and can potentially make the muscles in the uterus rip apart or rupture. How do you prevent this from occurring? By following these rules:
- It should be started at the lowest value and only given if the fetal tracing is normal, meaning the baby’s heart beat is not too fast or too slow
- Once the contractions occur every 2 minutes, it does not need to be increased any more
- If the contractions occur every 2 minutes and the patient is not making progress, it should not be increased any further until a special catheter called an intrauterine pressure catheter (IUPC) is inserted to measure the pressure in the contractions. If this is not done or can’t be done, oxytocin should be discontinued because a proper assessment has not been done and the patient and her baby are at risk for potential complications.
- A midwife or physician should periodically watch the tracing when a patient is receiving oxytocin. The nurse should not have the responsibility of managing the patient alone. Most lawsuits occur because the healthcare provider was not properly managing the patient and fetal distress occurred.
I strongly encourage all pregnant women to ask whether your hospital has a oxytocin or Pitocin protocol as a patient safety measure. Remember, a healthy pregnancy doesn’t just happen. It takes a smart mom who knows what to do.