Pitocin®, a synthetic form of oxytocin, is routinely given to women before, during and immediately following birth to induce and augment labor and to also prevent and treat postpartum hemorrhage. Much to the surprise of the medical community, a recent study showed that Pitocin® is linked to postpartum depression and anxiety.
The mothers aren’t surprised.
Surprise! Pitocin Is Linked to Postpartum Depression
For women with a history of depression or anxiety prior to pregnancy, receiving Pitocin® increased the risk of postpartum depression or anxiety by 36%.
For women with no prior history of depression or anxiety, receiving Pitocin® increased their risk of postpartum depression or anxiety by 32%.
Let that sink in for a moment.
I Bet the Numbers Are Even Higher
While I pondered these incredibly high numbers, it occurred to me that the numbers may actually be higher.
The information used in the research study came from women that received a diagnosis and/or a psychotropic medication. What about those that didn’t seek help?
In my experience, for whatever reason, many women do not seek professional help when experiencing postpartum anxiety and/or depression.
How many anxious or depressed mothers never confide to their care providers about what they’re feeling? Or even worse, were dismissed and told “everything will be fine”.
It’s Not Just in Our Heads
Even if the numbers may be higher, the research as is, is incredibly validating. Ladies, what you are feeling is not “just in your head”. It’s real, and it’s a big problem (that society has no idea how to handle).
*For a list of symptoms of postpartum mood disorders please visit Postpartum Progress. (Postpartum Progress is a non-profit that aims to raise awareness, fight stigma and provide peer support and programming to women with maternal mental illness.)
Pitocin Is Not the Same as Oxytocin
The strangest thing about the research study was that the hypothesis was the opposite of what made sense to me as a mother and childbirth educator. The hypothesis suggested that synthetic oxytocin, Pitocin, would in fact lower postpartum depression and anxiety.
The underlying assumption I am gathering is that, despite the evidence, medical professionals believe that Pitocin® is the same as oxytocin.
A few years ago I was attending a Pitocin® induction at my local hospital. My doula client was struggling BIG TIME with the sudden wave after wave of strong, painful contractions. Her nurse, not knowing what else to do, told her, “this is just labor, honey”. As if what she was experiencing were normal labor sensations. How sad.
Believe me, Pitocin® does not feel warm and fuzzy, and isn’t “just like labor”. My pitocin augmentation birth was much harder than my first two births. For me, Pitocin® made my active labor phase feel like the transition phase, and lasted far longer than the transition phases I had experienced in my non-Pitocin® births.
Oxytocin is Needed to Mother Well
Oxytocin, on the other hand, is helpful for coping with stress, supporting emotional and mental well-being and also helps with bonding – which are absolutely necessary for a successful transition to motherhood. (source)
Another study showed that women given Pitocin in labor had low oxytocin levels during breastfeeding. This revealed that the exposure to Pitocin® has consequences that last on into mothering. (source)
What About the Baby?
If oxytocin is an important hormone for becoming a mother and synthetic oxytocin is linked to postpartum depression, anxiety and low oxytocin during breastfeeding. I can’t help but wonder – what about the baby?
If oxytocin effects how women transform into mothers, how is this synthetic hormone affecting the baby?
How is the baby affected by synthetic oxytocin before, during and after labor?
Frighteningly, we have no idea.
Re-Examine Routine Procedures
If Pitocin® is linked to postpartum depression and causes a lack of oxytocin during the postpartum period, maybe it’s time to re-evlatulate the use of Pitocin® as it pertains to each woman. (Never mind the baby…)
According to the CDC, induction has more than doubled from 1990 (10%) to 2010 (23%). (source) However, just because a procedure is routine does not mean that it’s a good enough reason to do it.
We Need More Research
I’m not suggesting to eliminate Pitocin®, as it is an important life saving tool in modern obstetrics. (Shoot, I’ve even experienced it first hand!) However, because the consequences of routine childbirth interventions such as Pitocin® on human maternal behavior have been understudied, it would be wise to limit the use of Pitocin® until further research is completed.
And if Pitocin® is deemed necessary, it would be wise and compassionate to provide quality postpartum care, especially to those with high risk factors for postpartum depression.
What if care providers were required to pay for 40 hours of postpartum doula services to women that received Pitocin®? I bet we’d quickly see the true motivations behind the choices made in the care of new mothers.
Oxytocin is essential for our species to thrive as mothers. Our current methods meddle with the mental health of these new mothers – the backbone of society.
Is the crumbling mental health of new mothers important enough for us to take action?
Leave a Comment
Thank you so much for reading! Please leave a comment and let me know your thoughts.
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LurA says
I just want to say I’ve read tons of articles on your blog and most of the books you’ve suggested. Thank you for being a great source of information on unmedicated and natural childbirth.
This article is a perfect example of information expectant couples should know before they give birth!
Sarah M Jarvis says
I was forced to have petocin and have horrible post pardum depression 🙁
Jessica Trotter says
I had pitocin with my first and suprise got baby blues. Second baby no pitocin no problems. Now I am pregnant with #3 and wonder what alternative there is?
Monica says
Pitocin is used to firm up the uterus by uterine contractions to help things progress and further dilate the cervix. My L&D nursing instructor said aloe vera juice works just the same. That’s also why one should avoid that juice during pregnancy to avoid miscarriage or preterm labor.
Lisa Chin says
Clary sage essential oil is really great to help the laboring process. I’d look into different positions. And sometimes time is all we need. From reading various texts, the 40 week pregnancy is an arbitrary time and is not applicable to everybody. Plus if you don’t chart your cycle, you actually don’t know when you conceived which can throw off your due date as much as a week or two. Hold your ground if you don’t feel like your body is ready and trust it. Good luck!
pam says
Avoiding all intervention and awaitingspontaneous natural birth 🙂
Susan says
Thank you so much for this information! I wanted to point out that the actual numbers of women who have increased risk would be very low, less than 1%. An increased risk of 36% would equate to an actual increase of maybe 1/1000 women. It does not mean 36% more women experienced this side effect. It’s good to get this interesting info out there, but it is equally important to understand the data you are reporting on.
Dara says
Hi Susan,
Can you explain further? I read the PubMed article and am by no means an expert on interpreting research findings! Are you referring to the Relative Risk (RR) of 1.36? Thank you!
Dara
Jennifer says
It’s not quite as low as 1/1000 women, but 36% of women are not getting postpartum depression as a result of Pitocin, its more like 2%. Interpreting relative risk ratios can be deceiving.
From the paper (table 4), 4.9% of women without a previous depression/anxiety symptoms had postpartum depression after a birth with NO pitocin (1,701 women out of 34,240) and 7% of women who gave birth WITH pitocin had postpartum depression (621 out of 8,883 women).
So its a difference from about 5% to 7% of women getting postpartum depression attributed to pitocin (that 2% difference). Another way to put it is: its a difference of 70/1000 women instead of 50/1000 women getting postpartum depression as a result of receiving pitocin.
MareWartin says
That’s a pretty low number. Pitocin isn’t always bad–I knew a gal who was pregnant w twins. She didn’t go into labor because the uterus was over-stretched, and refused intervention. She delivered two perfect babies–both dead. So sad and so avoidable. A total shame. Tragic ignorance.
Kate says
My daughter lost her life because of pitocin and there are many law suits against it as well, but it’s only the clearly obvious ones. Our attorney told us that for every ten cases he saw, only one made it to court. He also said that he would love to take a class action law suit against pitocin, but can not because pitocin is NOT FDA approved for use during labor. It is an off label use and it’s done this way to protect the manufacturers of the drug. Personally I hate the drug for obvious reasons, but it is over used in unnecessary situations and causing more harm that it’s avtually helping.
KIm says
Wow this makes so much sense! I have 5 children and two were natural unmedicated. My induced picotin Labour with my daughter was by far the worst. The pain was like fire. I had extreme anxiety and postpartum for a year at least after. I couldn’t even leave my house it was awful. My daughter is by far the most anxious child out of the 5 and suffers with extreme anxiety (I’m sure some of it was learned but it makes me wonder the affects it had on her)
Megan says
I think your comment “just because it’s routine doesn’t mean it’s safe” is exactly the direction we should be heading. I’ve seen awful things happen with pitocin. I also, had an uncomplicated birth augmented with pitocin… so it’s not every case. But everycade should be evaluated individually. It would be nice to move away from inductions unless they are medically necessary. PPD is real and serious. We need to do a better job walking our mothers through the transition of pregnancy to Motherhood.
So many well thought out points in the article.
Thanks
Elisabeth says
Having this information is such a relief to me! I had pitocin after my first two were born and suffered with severe postpartum depression, the first was blown off so I didn’t mention it with my second. If pitocin was really the cause it makes those feelings of “what’s wrong with me” fade away a little bit!
Beth says
Does this research point to the effects of pitocin used only as a labor inducer, or also administered in the third stage of labor to prevent maternal hemorrhaging?
Lindsey Morrow says
Both.
Sherrita Michele Brummitt-Scott says
What I have noticed is that there are a lot less studies done pertaining to women’s health. Breast cancer studies have just came to the forefront because we demanded it. We need to demand women’s studies on this and on ALL things in healthcare because they are not taking care of us.
Cheryl cherry says
Could you cite the research paper for this study. I’m interested in reading it. Many thanks.
Lindsey Morrow says
The sources are linked throughout the post.
Barbara Gonzalez says
I had Pitocin with my second child. I had severe PPD after his birth and have had anxiety issues ever since. I am 59 now and finally gave in to see a therapist to deal with anxiety issues.
Karissa Etheridge says
Hey Barbara,
You should try collagen. I had anxiety for almost a year after a miscarriage in which they gave me Misoprostol which is similar to the Pitocin. I started taking collagen over a week ago and my anxiety completely disappeared. It’s good for gut health…which could be why it’s working…I’m not sure. Very interested in getting to the bottom of this. Blessings to you and hugs.
Michelle says
I have had 8 kids, only one without pitocin. I didn’t really notice a difference in my pain levels, the alertness or health of the baby, or my bodies ability to cope. But I also fail to go into and progress in labor a lot. So I think it depends on the situation. Sometimes it is really needed. I do believe though that if the body can do it on its own it should be allowed to. I do know of hospitals that just automatically give it, and don’t wait at all. I think this practice is a little much. But I also think we shouldn’t just do away with it or quit using it all together. Some people really need it. So I would say put your foot down on automatic use but don’t be so scared of it that you will not use it at all. I have never had postpartum depression, even when using it.
ruw says
Beautifully said. I definitely agree.
Phyllis K. Stein, PhD, SEP says
While this is really disturbing information, it is also junk science because association is NOT causation. I suspect there are huge physiologic issues with induced labor per se, so that comparison group would be women who were induced without pitocin (which would likely be the small group who were so close to labor that rupture of the membranes was enough). Another comparison group could be women who received pitocin only after delivery, which probably did not do anything. The fact that their bodies were not ready, combined with the creating of contractions that are way too intense and painful for the stage of labor that the mother is in, the whole loss of control and efficacy associated with induction might account for a lot of the effects attributed to pitocin per se. So these data are suggestive but a lot more needs to be done with them to declare them scientifically valid.
ruw says
I agree 100%. The data is taken from depressed patients and not where it should be done- which is assessing all patients that have received pitocin. If the study was done this way the results would have been startlingly different.
ruw says
I personally think that the criteria for the Research based article’ is incorrect. How many patients were included in this study?
This was done on patients that were in postnatal depression. To assess The effects of pitocin would be best seen on a random patient study cross etnicity and include all parity’s that have received pitocin then see how many patients have experienced postnatal depression.
This article also discussed pitocin used mainly for induction. Is the statitucs the same for pitocin used for an induction which I can understand causes an increased height in contractions and for this reason can not be given to previous caeser mums. The induction could be hours of receiving artificial oxytocin which Yes,could exacerbate depression. Does this have the same effect if given postnatally?
In my practice i very rarely use pitocin foe an Induction…if not ever. I use syntocinon according to regulation postnatally.
In Over 1000 births I can say that I have have minimal depression. Postnatal depression In Cases where it had occurred were related to patients mainly with tape A personalities and/or lack of support. Another HUGE Reason where minimal research was done was actually patients that had low Hb’s.
I think much further needs to be included as mulipara patients read just the beginning and refuse pitocinon postnatally.and ave an increased risk of post partum haeortage,morbidity and mortality.
ruw says
I’ve re-read reply..please excuse grammar and typos.
CHRIS says
So what can my 34 year old niece do to get done to her if she is suicidal and in a care hospital. She had twins 3 years ago and the Pitocin injections. Is there a medical therapy that reverses the Pitocin effects? Other treatments haven’t worked.
keely says
get her on CBD OIL now. look up thoughtcloud.com
Geraldine Schlichter says
Hello Lindsey Morrow: Thank you for your article, very informative.
25 years ago, I gave birth to my daughter. I insisted on no pan relief during labour. I’d read that my body would produce it’s own Oxytocin if I let it do it naturally. I also went through almost the entire labour staying upright, & the birthing was done with the bed back raised to facilitate gravity. For about 1/2 hour during the hard labour, my coach insisted that I lay down. I did it for her sake, she was tired of holding me up during contractions. During that short time of laying down, the pain was excruciating. When I got back up, there was almost no pain. Not much more than a mild toothache. I did not bleed after birthing, so I did not receive Pitocin. Do you have any theories on why staying upright during labour is helpful? Do you have any theories on why natural body Oxytocin might alleviate postpartum anxiety & depression?
wendy says
Thanks for posting this. I agree that we should not use Pitocin for the convenience of moms and doctors. I’m so glad there’s good research now to back it! I hope you keep advocating for postpartum maternal mental health care. 🙂
Rich winkel says
Obstetrical abuse is real and imprinting on both mother and baby. See: http://members.tranquility.net/~rwinkel/MGM/birthUSA3.html
Becky says
Thank you for this article.
I think this is the drug I was given to help speed up the final stages of my labour. Honestly it was horrific – I can’t bear to think about those last few hours. I think I suffered from Post Natal Anxiety.
I’m now pregnant with my second baby and am nervous about the PNA returning. I will definitely try to avoid the drug this time round if I can.
The trouble is once you are in hospital I found that nothing is offered to you in terms of choices. The doctors and nurses never remind you everything is a choice. I blindly went along with everything they told me I should do or have. And the result I feel was a terrifying experience with no friendly face or kind words. I spent the first few hours after the birth sobbing my heart out in a room in my own.
Thankfully with the help of wonderful online communities like this I have armed myself with hopefully extra self confidence and awareness – hopefully this time round it will be a different story x
Amanda says
I was also given Pitocin just like many others who have commented here since my water had broken and I wasn’t having enough contractions to get labor going. Then, my baby’s heart rate was having a lot of decelerations and they told me I would have to have a C-section to get him out safely. And *then* they told me that my baby had pneumothorax at birth and would need to be in the NICU for three weeks. After he came home I started experiencing really intense postpartum depression and I really wish I knew about this beforehand. Thank you for educating all of us!
Steph says
It’s so important that subjects like this are discussed and that awareness is increased. There are so many unknowns within the birthing arena and I’m glad there is at least scientific research being done in this area. We need more research. Procedures have been brought in – Not sufficiently researched first – Have then become the norm – Then clean, double-blind trials become unethical. Ultrasound, strep B & vitamin k are just a few areas with such issues…but the list goes on…it makes our right to informed choice incredibly challenging
Lindsey Morrow says
Thank you! I agree… we need more research!
Sue says
I had my son a year an a half ago. I did not have any complications during pregnancy or labor and my goal was to have a natural child birth. My doctor came in at the very end when my nurse said I was ready to push. The doctor rushed in, told me how long this would take all depended on me. Told me to stop making so much noise and start pushing. My body did not feel like it was time but at the doctors orders I pushed as hard as I could for 20 minutes. My son was born healthy. My placenta and umbilical chord were still connected and the doctor didn’t want to wait for it to come out on it’s own. She gave me Petocin to get the placenta to come out quicker. This could have been avoided if the doctor was patient. I don’t know if it’s related or not, but I had a terrible post partum experience. I had pretty bad depression that lasted nearly a year.
Lindsey Morrow says
I’m so sorry you were rushed during your birth. And I’m so sorry you struggled postpartum. I hope you find healing. ❤
EDith Augusta says
Frankly, I’m a little disappointed in some of the above replies from medical professionals. Sure, faults can be found in virtually any study, depending on the research, how it is conducted, and the side for which you’re advocating. The initial hypothesis of the study was to investigate the role pitocin plays in reducing PPD. However, the data collected, as biased as it is, seems to be the opposite. Because the study was conducted to produce a different result, of course there are going to be flaws in it due to the way they selected the “control” group. But, just because the numbers aren’t completely accurate for pitocin hypothetically contributing to PPD doesn’t mean that the whole thing is invalid. This blogger clearly states that this is not hard evidence of an issue, but rather there is absolutely a cause for concern with the use/overuse of pitocin as it relates to PPD, the stigma associated with PPD that is often why women don’t seek treatment for, the lack of knowledge and research there is on the matter, and the need for more information, research, education, and understanding that both doctors and patients not only require, but deserve in order to make truly informed healthcare decisions.
Rayna says
My baby was growing rapidy inside of me. I was given a choice of inducing 2 weeks early for natural child birth,, a scheduled c-section a few days before due date, or let baby decide but if she comes in between it would be a difficult natural birth and possibly lead to emergency C section. The doctors never told me about the risks of Lito in and I am suffering from post partum OCD/anxiety.
Given the risks that come with C-section, and the risks with pitocin for induced labor- which is the larger evil? Is it better to be induced to avoid csection or better to wait and see with a high risk of emergency c-section?
I wish I was given more facts before making the choice.
Lindsey Morrow says
Check out this article: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/ Unfortunately the evidence doesn’t necessarily backup induction or scheduled c-section for suspected big baby. How big was your baby anyways?
chris says
Does Pitocin cause postpartum depression? If you believe headlines like these (“Pitocin Use May Increase Risk of Postpartum Depression”), you might think so. But a closer look at the study reveals the headlines are not always what they seem.
The study appeared in the journal Depression and Anxiety and noted an association between synthetic oxytocin (US brand name: Pitocin) and postpartum mood disorders. Let’s review the actual numbers.
This is a retrospective study, meaning it looks at events that have already happened. Charts were reviewed for one medical system between 2005 and 2014. 46,732 women were identified who had one or more deliveries in the time frame. Of these, 9,684 had pitocin within 2 weeks of delivery and 37,048 did not. The pitocin may have been for induction, a contraction stress test (stimulating contractions while monitoring the baby to make sure the baby can tolerate labor), or postpartum hemorrhage.
Among women who had pitocin, there was a 32% increase in postpartum mood disorder (36% increase if mom had a history of a postpartum mood disorder). This increase held true whether the birth was the first or second, whether it was term or preterm and whether it was vaginal or cesarean delivery.
So, if there is an increase in postpartum mood disorders, doesn’t that mean that pitocin causes depression? Not necessarily. Just because two things are linked does not mean one is causing the other. The classic example is ice cream sales and shark attacks. When ice cream sales go up, so do shark attacks. Obviously, the ice cream sales are not the cause of the shark attacks, merely an indicator of summertime, when folks hit the beach and are therefore more likely to encounter a shark. In that case, the headline shouldn’t read, “Eating Ice Cream May Increase Risk of Shark Attack” because that’s not true.
This study is an example of a correlation. Pitocin use in women is correlated with postpartum depression, but that doesn’t necessarily mean that it causes depression. In fact, there are a number of reasons why the correlation may exist.
Oxytocin, sometimes called the “love hormone” is responsible for those loving feelings mommas get when they see their babies. Oxytocin levels in women with postpartum depression have been found to be lower than levels in women without postpartum depression. This “love hormone” is also responsible for uterine contractions. Postdate, or overdue, pregnancies and “failed inductions” have been shown to have decreased levels of oxytocin receptors. Perhaps these low oxytocin levels and decreased receptors are the reason why the patient needed pitocin for induction or augmentation of labor in the first place. Obstetric complications in general increase the risk of postpartum depression. Many of those complications involve treatment with pitocin.
Just like the ice cream in the shark attack example, the need for synthetic oxytocin use may simply be a marker for those with already low levels or low levels of receptors.
A more helpful study would randomize women to elective induction or spontaneous labor and then compare subsequent postpartum mood disorders. That might help tease out some of the questions about whether the pitocin is causing the depression or merely being used in women who have decreased oxytocin levels or receptors to help with labor progress, who also happen to be at risk for depression.
Still, this study is important, even if it isn’t quite what the headlines made it out to be. While all postpartum women need to be screened for depression, knowing which mommas needed pitocin for an obstetric complication will help healthcare providers identify women who may be at increased risk for postpartum depression.
If you are having symptoms of postpartum depression, whether you had pitocin or not, see your healthcare provider right away. You are not alone, mommas.
Lindsey Morrow says
Thank you for such a detailed and well thought out comment. I love it.
Carol says
My son was born in 1990, before postpartum depression or pitocin were talked about much, and long before blogging had hit its stride, so I could do no real pre-labor research.. I had been in labor for 12 hours when I went to the hospital, and the pain was fairly tolerable. They set up an IV of pitocin (they didn’t tell me what it was, they just did it, so I thought it was water). The pain became incredibly bad, I was begging them to rip the kid out of me, kill me, just stop the pain. They also didn’t do epidurals at that hospital.
I had never been prone to depression before the birth. Well, after I had him, I suffered from postpartum depression for over a year, and he suffered from colic for months, then night terrors–he didn’t sleep through the night for two years. I didn’t know what caused any of it, only that I wanted to hurt myself, I felt like a terrible mother. I even called a hotline once because I felt like I was going crazy –and hubby had called my mother to tell her to come and stay with me because I’d gone nuts. So no sympathy, no understanding, just a ton of pain and suffering. Thank you pitocin, and the nurses who administered it without a thought of the patient.
Claire Winstone, Ph.D. says
Not true that we know nothing about the effects of Pitocin on babies. My doctoral research, completed in 2008, looked at the use of Pitocin in birth (not post-partum) and the psychosocial functioning of 3-year-olds and found some interesting effects: on interpersonal relationships, among other things. https://www.amazon.com/gp/aw/d/B016OBFQK2/ref=mp_s_a_1_1?ie=UTF8&qid=1507958180&sr=1-1&pi=AC_SX236_SY340_FMwebp_QL65&keywords=Claire+Winstone&dpPl=1&dpID=51pm3awTrVL&ref=plSrch
Lisa says
I would like to see where those numbers came from. How many of the 32-36% were single moms, Or didn’t have support at home, Or had other children?? By associating pitocin with PPD you are going to encourage moms to refuse it. This is a dangerous road you are steering these moms down.
Sheri says
I had pitocin in my first labor and it was aweful. I had postpartum depression that was undiagnosed because we were spending so much time dealing with our infant with full blown colic! (He’s now 17, and a wonderful young man!). I have talked to SO many other Moms that had babies with colic, and they ALL were born with pitocin! This really needs further research!
Incidentally, my second labor proceeded naturally and it was COMPLETELY different! Painful, yes, but in a tolerable, rhythmic way that was very manageable. My second baby was also fairly calm and could be soothed when upset. It wasn’t until she was born that I realized how much I internalized my previous struggles, and believed I was a “bad” mother. If I could go back, I would have refused the pitocin.
Jessixa says
I’m curious what are better options to combat the “risk of hemorrhaging” postpartum other than Pitocin, there has to be something!
Verna says
Hi I am in Australia and here we use Syntocinon. Just wondering is it the same as Pitocin or different drug?
Lindsey says
Same drug! Different name.
Verna says
Thanks!