Pitocin changes things.

Of course it does.

That's why it gets talked about so much.

Any intervention and interruption in labor changes things.

Our job is to understand how it might change things and then decide how we can show up in the midst of those changes.

Are Pitocin contractions more painful?

I want you to leave this episode with a lot more hope than most Pitocin conversations leave you.

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Mama of four littles, former labor and postpartum RN, CLC, and your new best friend in the messy middle space of all the choices you are making in pregnancy, birth, and motherhood.

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We are diving into one of maybe my favorite questions or conversations that I've had on social media over the last few years, and that is the question, are Pitocin contractions more painful than, I'm air quoting here, but normal ones or spontaneous labor ones?

Are Pitocin contractions more painful?

Now, I will tell you, as you'll probably expect, that every time I open up this conversation or make some sort of post about it, I get all kinds of perspectives, all kinds of experiences, all kinds of opinions, and we are gonna get into it.

I wanted to bring that convo here and flesh it out a little bit more because I think it will help you understand Pitocin more, and that is definitely the goal for me.

I think it will help you understand why people have such big feelings about Pitocin, and it is going to help you approach Pitocin when or if you need it in your own birth with way more information to support yourself.

Now, this is kind of a part two to episode 68, the one just before this one.

So if you have not listened to episode 68, I would encourage you to actually pause here, go listen to that, and then come back.

68 lays out what Pitocin is, six, seven, eight things that I think you should know about Pitocin.

So it just gives you this incredible foundational understanding of Pitocin, how it's used, how we use it in the hospital, what that process looks like, and you're gonna hear little tidbits within this conversation that will be more fully explained inside of that one.

So again, pause here, listen to 68, and then come back here.

We do talk about this idea of, are Pitocin contractions more painful, in 68, but it's brief, and I basically say, "Hang on. Get into episode 69, and I'm gonna fill you in." So here in 69, we're gonna deep dive that topic.

So before we can really get into the question, are Pitocin contractions more painful, we do have to know the differences between Pitocin and oxytocin.

If they were the same, this would not be a question that anyone is hashing out on social media or inside a birth course, right?

Because if they were the same, they would mostly do the same things.

We wouldn't have anything to compare.

So I think naturally we can say, okay, we know Pitocin and oxytocin aren't the same.

Again, episode 68 fills all of this in really great.

But essentially what I want you to hear, and we'll break this down really quickly in this episode as well, is they do many of the same things, Pitocin and oxytocin, but they do not do everything the same.

And what they do do that is the same, they do it in a different way.

So big ways that they're the same.

Pitocin and oxytocin act on receptors on your uterus and they cause and/or strengthen the contractions that are already present.

What that means is that Pitocin can be used in induction or in an augmentation.

And if those terms are unfamiliar, episode 59 totally breaks those down for you so you understand that.

It's kind of like the root of the root of induction conversations in episode 59.

So you can jump back there and you can listen to that as well.

But Pitocin is used to induce, which means to start contractions when there are none, or augment, which means to strengthen the existing kind of process that is going on.

Both oxytocin and Pitocin also act on the utereth- uterus in the third stage of labor, so that is after the baby has been born, and they help the uterus contract back down.

This is called involution.

This is what we want happening after your baby is born.

That involution, that contraction, that strong getting smaller uterus, that supports and helps prevent postpartum hemorrhage, which is obviously the goal after your baby is born as well.

So both Pitocin and oxytocin really do a lot of work on the uterus.

That's the whole point, and that's the goal, especially for that Pitocin.

So they're the same, right?

In that regard, they do so many of the same things, and those are good things, and we need those things, and we want those things.

Two big things to understand that might help answer that primary question that we're here for, though Pitocin labors flow differently than spontaneous labors.

So, you know, I just said they do many of the same things, but they do it in a different way, right?

So they don't flow the same way, and then pitocin does not cross the blood-brain barrier.

So what's going on inside the body is also not the same.

So let's break that down a little bit further for you 'cause it really helps us get at the root of this question that we're trying to answer.

Spontaneous labor, so that's labor that's being powered by your body's own oxytocin, is very pulsatile.

So it ebbs and flows in a very, Most people are gonna call it a natural rhythm, that spontaneous has a more natural rhythm, and often has breaks or gaps, and they're just kind of built in.

It's like your body says, "Hey, you need a break.

I'm gonna give you one." It recognizes things that are going on, and so the system is not really, really rhythmic and really, really controlled, okay?

It has these ebbs and flows.

In my third birth, I often assume this was kind of evidence of that oxytocin just flowing and uninterrupted.

Right before my son was born, my water broke, which means my babies are coming out immediately, which you know if you've listened to my birth stories, right?

And so my water broke, and it was like, okay, this baby's coming, and we're kind of all getting prepared.

We're about to meet this child, right?

And then I just got this long break, and it was like my body said, "Pause. Stillness." It was actually really interesting to have such stillness in the moments before that final contraction on, in which he delivered.

Now, I cannot promise you that if I had been on Pitocin at that point, if I would've experienced this differently, but part of me does think I probably would've had a contraction every two to three minutes in that moment.

There would've been nothing wrong with that.

But I wouldn't have had that long break for whatever reason, you know, that four-minute gap between my final two contractions.

I don't know why my body gave me that.

It was kind of lovely, but it's a cool example of just this inherent break that was built in based on whatever my oxytocin in my body wanted to do for me So Pitocin is intended to be a lot more regular than that, right?

We've been indicating that or hinting at that.

It is supposed to get you rhythmically contracting every two to three minutes.

That's usually the goal, and no more than that, which we discuss in the prior episode, right?

But every couple of minutes, and often you don't get quite as much of a break in between, or it's possible the uterus doesn't fully relax in between.

This can happen as well.

Can lead to other things.

That's other conversation.

But you do have this rhythmic frequency of contractions.

There are no longer breaks or stalls.

Pitocin often ramps up really quickly, too, so you'll hear that in a lot of people's kind of the storytelling that they're giving you after their birth, where they say, "Man, I went from zero to 100 the second they started Pitocin."

So you might hear that combo as well.

Again, interjecting with my own personal experience, and I know some of you will share this as well, I have had spontaneous labors go from zero to 100 as well.

So it's not like that doesn't ever happen in spontaneous labor.

But it can be a specific feature of Pitocin that is not as common as it would be if you were laboring entirely spontaneously just with your own oxytocin at work.

Okay, so the second one, oxytocin in the bloodstream crosses the blood-brain barrier.

Pitocin does not.

So when oxytocin crosses your blood-brain barrier, gets to your pituitary, pituitary releases endorphins.

You have something called the endorphin effect, which essentially is this flood of feel-good hormones, and this continuously happens, and these feel-good hormones help you manage your own labor.

So it's your body's just cool kind of analgesic effect that it has to help you handle what's going on in your body.

This is really cool, too, because it's specific to labor pain, so this doesn't necessarily happen when you stub your toe, break your arm, recovering from hernia surgery, right?

But labor, this whole process, this is how the body kind of supports itself inside of it You also get a surge of oxytocin right before your delivery, like the actual moments of delivery.

That oxytocin can trigger the fetal ejection reflex that can help just support delivery, and it can cause a surge of en- surge of endorphins again at that moment in time.

Obviously, Pitocin is not going to surge and do some of those things, so there's some differences there as well.

You do still have oxytocin in your own body when Pitocin is being utilized, and I do want you to hear that 'cause this can sound like great, like I don't get any of that stuff.

That's not what's going on here, but the Pitocin that pit, it can alter your body's production of it, right?

And so these benefits of oxytocin crossing the blood-brain barrier, they might not be completely lost.

I am not saying that at all.

Plenty of people still have a surge of endorphins and feel-good hormones when that baby hits their chest, right?

But these can be diminished, right, when we have Pitocin going on and/or you could say but Pitocin doesn't give you the same benefit.

So that brings us back to that initial question, are Pitocin contractions more painful?

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Okay, let's get you back to the episode

And you may think what I just told you means absolutely yes, and I think you'll find that that is public opinion in a lot of places, or maybe you've already heard that and that's why you're here wondering what I think about it.

You will probably hear Pitocin contractions are worse than spontaneous ones.

They move in a different way.

My body isn't helping me.

Obviously, that means they hurt more.

I want to share two quotes with you from one of the social media posts that I referenced when we were starting that kind of speak to more of the nuance here.

So the first quote says this: " I was induced with my first two babies, and those contractions came on hard and fast and felt like I couldn't get on top of them.

They def had me asking for an epidural.

My second two were unmedicated in a birth center, then at home, and I felt much more in control my whole labor.

I could feel each contraction start to build, and I could mentally and physically breathe through it much easier." Sounds like what you would expect, right?

Very valid experience that makes sense with all the stuff we just laid out.

The second quote: " My first labor was more painful than my second.

My first labor was without any Pitocin.

In the second labor, I was induced with Pitocin.

My coping skills and perspective were better the second time around, and I attribute a lot of the pain control to that.

My contractions still came on gradually, peaking and then decreasing until I hit late transition, at which point it just became intense all around.

That happened the first non-induced labor too, though." like I said, I will be honest with you and I will tell you that many providers and people who have experienced Pitocin contractions, particularly if they've experienced both types, will tell you that the Pitocin is worse.

I think what we've just laid out also shows you how that can be true and I would never discredit a single experience that says, "Oh yeah, my Pitocin labor was way worse than my spontaneous labor."

But those two quotes I just read, which are basically direct opposites, right?

I think they show a level of nuance here that is valuable and it is important and encouraging for you, too.

I will not in this podcast say, "Yep, this is why they hurt more," because there is so much more and you need more than that before you are going to walk into your birth and potentially be or need utilizing Pitocin, okay?

When it comes to Pitocin or induction or levels of intensity, there are more questions to ask and I want you to stop, pause, and be listening really well right now because you need these questions.

What do you believe about Pitocin before you've even begun?

I hope we are going to kind of change that right now if you've come in with more of that foreboding, oh no idea about Pitocin, okay?

Which baby is this for you?

Has your first experience or your first couple of experience, have those changed you already or made you more aware of or able to handle birth because there's less unknown?

Are you gonna handle this differently simply because you've done it before?

What about your cervix?

Is it ready?

Is it ripe?

Is this an early medical induction that you would prefer not to be having right now?

Is this an elective induction alternatively that you are wanting and you cannot wait to start this process and get into it?

Are you somewhere, are you in an environment that's gonna allow you to move, to get in the water, have wireless monitoring, labor the way you want to and the way that you need to despite the fact that you might have some Pitocin running?

Does your environment and your team, do they make you feel safe?

Do they help support your own oxytocin production in the way they love you, hear you, see you, and really keep you covered inside of your environment?

What about the hospital itself?

What are the protocols for turning the Pitocin up?

Is the RN following them?

Do they have independence with them?

Are you and the RN able to collaborate together?

Are you able to chime in and say, " Hey, can we slow it down a little bit?

Can we wait and not turn it up?

I'm feeling XYZ type of way." Do you guys have that relationship?

Is that available to you?

Is that something that the RN can do?

And of course, I talked about this more in episode 68, more of these protocols and things that I'm kind of mentioning, so you'll get that there as well.

And then lastly, is the care team willing to go low and slow or consider turning your Pitocin down or off and let your own body's oxytocin kick in or take over once you're in a good place?

Now, that is not an all-inclusive list of great questions to ask, but these are the types of things I want you asking and thinking about before any sort of induction, the things that I think you can be considering as you consider the answer to this question, particularly before you've been through experiences that allow you to answer it from a place of actual experience.

for induction isn't always managed the same ways, nor do we go into our labors with the same mindset, education, or prior experiences.

That is true for all of us.

So we cannot say, I will not say, that something is or isn't worse because you and your scenario will not look like mine.

The answers to all of those questions I just laid out will not be the same.

So we are not apples to apples comparing situations here So the big takeaway, because I get it, I am not answering this question in a yes or no for you, but did you really think that I would?

Of course not.

The big takeaway is I want you to understand the basics of pitocin.

That's why I keep saying listen to 68 and good job.

We have listened to this one as well.

I also don't want you to let the individual experiences of others people color your own expectations and almost make you feel like you're doomed before you even started.

Pitocin changes things.

Of course it does.

That's why it gets talked about so much.

Any intervention and interruption in labor changes things.

Our job is to understand how it might change things and then decide how we can show up in the midst of those changes, right?

So that's why you're here.

I would be asking the questions that we just laid out.

You know, tap back two minutes and listen back through that list of questions again and let the answers to those questions or considering asking those questions at your next appointment, let those flip the way you're moving towards your birth and any possibility of induction, whether that's known or just knowing it could be a conversation that any of us are going to have in our future birth, right?

The answers to those questions, basically, they're gonna turn into your roadmap for walking through any pitocin experience you may have with a bunch of knowledge, with strength, right?

Not just physically, but like strength of mind as well, and then genuine empowerment about what the experience may entail.

Just think all of this information that you're carrying into it now, and also knowing how to move through it.

That was the goal of this episode.

Are pitocin contractions more painful?

I will not be the one to answer that for you.

But I want you to leave this episode with a lot more hope than most pitocin conversations leave you.

There is a lot that goes into the way you experience your labor induction, which means there are a lot of ways that you can lean in and learn before and change the way it plays out for you