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Induction via synthetic oxytocin – not for everyone

”I got induced by oxytocin with my first baby. It was like riding a really wild horse. I got totally confused. Never again.”

Helen, mother of two

Your delivery has started. You feel the contractions coming faster and faster, with higher intensity. This might go on for hours-and then your labour might suddenly be arrested. Or maybe your contractions are intense and painful, but the cervix is not opening. This tough situation faces around 20% of all women giving birth, and 40% of all women giving birth the first time.

Your midwife and obstetricians will follow your labour with a multitude of tools and technologies. In a partogram, they will track your uterus opening and how the baby’s head is progressing downwards the birthing canal.

It is a well-established fact that women give birth in many different ways. Some women and babies need longer time than others, without anything really being “wrong” or problematic. But a too long delivery can cause concern.

A very long delivery exhausts the woman and her baby, which will be under great duress during a long labour. Maternity wards can also be pressed for resources, when many births occur simultaneously. There are many reasons for speeding up prolonged, arrested or stalled labour.

The most common medical procedure used at this point is to use synthetic oxytocin. It is given intravenously, most often through a needle in the hand or arm. This has the same effect on the uterus as your own oxytocin, and will in an ideal case stimulate the contractions of the uterus, and make them more forceful and frequent. Synthetic oxytocin is today standard practise for all women with prolonged labour, but recently there has been much debate about to which extent all women with dystocia should be treated the same way.

For some women, the synthetic oxytocin treatment is spot on. The delivery will gain new momentum, mother and baby will be spared a long and towering labour.

For some women however the treatment creates a too forceful experience, an overactive labour which can increase the risk of oxygen deprivation for the baby. Yet another group of women will have limited response to the synthetic oxytocin, as the uterus seems exhausted and cannot be sparked into action again, or will start and then stall, or deliver irregular and unsynchronised contractions.

The effect is like forcing someone who has just finished a gruelling marathon to rerun the whole race-it becomes impossible, the muscles just cannot be sparked into any further actions. In this case the muscle is the uterus, which instead needs rest, before sometimes resuming labour at a later point. Sometimes however this situation can lead to acute caesareans, and in worse cases very tough delivery experiences.

As women respond so differently to synthetic oxytocin, it is vital for health care professionals to understand when and how to administer this drug, and when the treatment will have no effect.

The most efficient way to understand which route to choose for a women, is to measure her levels of lactate in the amniotic fluid. A higher level of lactate indicates a tired uterus, a lower level indicates a uterus that can be stimulated into further action. Thereby you can tailor the support for the women giving birth. The AFL-method is the first method in the world to provide this support.

Through such a tailor-made support you can diminish the risks for oxygen depletion for the baby, for tearing and ruptures of perineum of the mother and create a safer and more individualised delivery for the mother.

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