Ever wondered about medications used in labor?
To begin this journey, Let's meet Mr. Pitocin/Oxytocin aka known by every mispronunciation in the book.
This is probably the most used labor medication in Labor and Delivery. If you go into labor and home and come to the hospital early on. Guess what? We are going to start Pitocin. If you are in the hospital and your labor stalls, yep, Pitocin. If you have a snappy Doctor who would like to go to bed…yep.
Why I am here and who I am:
Hey mama, I am Trish— AKA Labor Nurse Mama, a labor and delivery nurse with over 15 years of high-risk OB experience. I am also a mama to 7 kids and have given birth to 6 and have labored thousands of mamas and delivered many, many babies. I am the online birth class educator for Calm Labor Confident Birth and The VBAC Lab birth classes. and the mama expert inside our Calm Mama Society Mama Membership Community! You can find me over on IG teaching over 240k mamas daily.
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To begin this journey, Let's meet Mr. Pitocin/Oxytocin aka known by every mispronunciation in the book.
This is probably the most used labor medication in Labor and Delivery. If you go into labor and home and come to the hospital early on. Guess what? We are going to start Pitocin. If you are in the hospital and your labor stalls, yep, Pitocin. If you have a snappy Doctor who would like to go to bed…yep.
It is used to induce labor if your cervix is favorable. Girl, if you go into the hospital for induction and you are closed, thick, and high, DO NOT LET THEM START PITOCIN. You will get a cesarean. TRUST ME. There are parameters to using medications in labor and delivery and using it when your cervix isn't ready is outside of them ALL!
Pitocin is also used after delivery to decrease the chances of hemorrhaging. This med is most often delivered through an IV but it can also be given through an IM injection.
Tip: If you are being induced by this med and you start to get into a good labor pattern and your cervix is changing. Ask your OB to cut back or stop increasing the Pitocin. Studies have shown this is the best way.
Medications used in labor and delivery #2: Cytotec
Your cervix has to be soft to dilate. I often draw a picture of an empty balloon for my patients. Picture the balloon with its tail. The tail is the part you put your mouth on to blow it up. Its long and its thick. When you start blowing it up it gets shorter and thinner. This is the process we need for your cervix to take. For a first time momma, this needs to happen before you can begin to dilate. For someone like me, I might be thin just sitting here….not pregnant.
USE: Cytotec is a medication we use to soften your cervix.
Cytotec is a tiny pill that we cut into fourths and 1/4 is placed into the vaginal cavity close to the cervix. Cytotec can be given a variety of ways including orally, sublingually, rectally, and buccally. We usually save the rectal route for post delivery in the case of hemorrhages.
Usually, the OB/Provider will do 1-3 doses (max 6 doses but this is never good) every 3-4 hours. If the cervix is favorable it is followed by Pitocin.
Cytotec cannot be reversed. Once given that's it. It's worth noting that Cytotec used in pregnancy is an off-label use.
Medications used in labor and delivery #3: Cervidil
This is another drug used for labor induction. It is used to ripen the cervix. Cervidil looks like a flat 1-2 inch tampon, is inserted as close to the cervix as possible, and it has a string attached for easy removal. This is important because unlike Cytotec, it can be removed for adverse side effects. You will remain in bed for the first 2 hours following insertion. Not to be used if vaginal bleeding is present. Usually, this stays in for 12 hours. If the cervix is favorable it is followed by Pitocin.
Read this post written by a doula: All about Cervidil!
Note: this is an expensive drug so not all hospitals offer it.
Medications used in labor and delivery #4: Antibiotics
You may be given IV antibiotics for several reasons in Labor and Delivery.
Group B Streptococcus
It's a type of bacterial infection that is in your vagina or rectum. Normal healthy women have this in there so don't worry. However, Women who are GBS positive are said to be colonized. Read more here if you want more info on this topic. If you are GBS positive you will get antibiotics every 4 hours once labor has begun (what classifies labor, READ this post) or in some cases at the start of induction.
Antibiotics are also used to treat possible infections which may present themselves through labor; manifested in mother as an increasing fever and in the baby as increasing heart rate.
Medications used in labor and delivery #5: IV Pain Medications
Several options are available for pain relief during labor, however not all hospitals or physicians offer them all.
Examples of a few IV Pain meds:
- Fentanyl
- Stadol
- Nubain
Side effects are the same as taken outside pregnancy for the momma. You may feel loopy and a little disoriented. The fetus may show a period of minimal heart rate pattern on the monitor. (Have your nurse explain this)
If your baby is already nonreassuring on the heart monitor we most likely will not use IV pain medications.
TIP: The first dose usually helps but subsequent doses aren't as effective.
WARNING: If these drugs are given too close to delivery, the newborn may have respiratory distress and need medicine to revert the drugs.
Medications used in labor and delivery #6: Nitrous Oxide
More and more hospitals are using “laughing gas” for pain relief during labor.
Unlike narcotics, this med does not affect:
- fetal alertness,
- breastfeeding
- bonding.
This med is self-administered through a mask, during the contraction.
Medications used in labor and delivery #7: Epidural
For a majority of women, this is the one thing they most care about in labor. However, there are rare birds like me who never even considered one. Well, I did once but that was a long story involving my now thirteen-year-old, who decided to come out facing the sky and not the ground. But lucky for me, she was number 5 and my path had been paved by her big brothers.
In simple terms, an anesthesiologist or CRNA (at most hospitals the nurse anesthetics put in way more epidurals) comes into your labor room and places a small catheter (tube) into your back. Next, they connect the tube to a pump, just like your IV, and pump pain medication into your epidural space, delivering the medication until someone manually turns the pump off. During a normal vaginal delivery, your nurse will turn it off after delivery. Therefore, you should be up and walking within 1-2 hours.
Check out my Instagram post on a successful delivery WITH an epidural!
Related post: If you want a natural birth and none of the above interventions!!
You should educate yourself on all things about birth. Seriously, People learn more about dog breeds than childbirth. LET'S CHANGE THE STATS! Finally, I recommend you head over and check out this customizable birth plan by Heather over at A Life of Labor!
