Labor Inducing Medications During Pregnancy
During childbirth, a woman’s uterus contracts at regular intervals to transition the baby from womb to world. But contractions sometimes are weak, erratic, or fail even to begin. Doctors might use medication to induce labor or improve its efficiency if this happens.
Two of these drugs – Pitocin & Cytotec – have the potential to cause catastrophic injury to a mother in labor, as well as to her baby if improperly used or not correctly monitored during use.
When misused, Pitocin and Cytotec can cause complications that jeopardize the baby’s oxygen and blood supply. Reduced oxygen (hypoxia) and reduced blood supply to the brain (ischemia) can cause hypoxic-ischemic encephalopathy (HIE), which is severe and permanent brain damage. Many babies suffering from HIE at birth or shortly after can develop cerebral palsy, seizure disorders, learning disabilities, and developmental delays.
In many cases, these complications occur because doctors, nurses, and other medical professionals failed to use Pitocin and Cytotec correctly. When this occurs and causes either birth injury or birth trauma, this constitutes medical malpractice.
What are Pitocin and Cytotec?
Pitocin is the synthesized version of a naturally-occurring hormone called oxytocin. A woman’s body makes oxytocin throughout her lifetime, with increased production during pregnancy.
Doctors typically give Pitocin intravenously when inducing a woman whose labor has not started. Pitocin is also given to women in labor whose contractions need to be strengthened for their labor to progress.
Cytotec is a brand name for the drug Misoprostol. It is also used during labor but for a different purpose than Pitocin. This drug is administered vaginally to efface or thin out a woman’s cervix so that birth can occur.
PITOCIN
- Brand name for naturally occurring Oxytocin.
- Used to induce or strengthen labor.
- Administered intravenously.
CYTOTEC
- Brand name for Misoprostol.
- Used to help the cervix efface during labor.
- Inserted vaginally.
Although these drugs can be beneficial when medically necessary, doctors and nurses must understand how to use them – and when not to use them.
In fact, Pitocin is the labor-related medication most often linked to preventable adverse effects during labor. Sometimes this is because doctors, nurses, and other medical staff committed negligence or medical malpractice by misusing Pitocin and Cytotec.
When should doctors use Pitocin or Cytotec?
Pitocin and Cytotec should only be administered when medical intervention is needed to start or strengthen contractions. Some maternal medical conditions might delay the start of labor or make vaginal birth harmful or unlikely, including:
- Preeclampsia, especially if the mother is at or near her term,
- Diabetes,
- Rh and ABO incompatibility issues,
- Uterine inertia, and
- Prolonged or arrested labor.
It’s crucial for doctors, nurses, midwives, and other caretakers to understand when Pitocin & Cytotec use is appropriate.
Drugs to induce labor or strengthen contractions should only be given when doing so is in the best interests of the baby and mother. Failure to properly use drugs like Pitocin and Cytotec could cause serious injury that constitutes medical malpractice.
Are there any signs that Pitocin and Cytotec should not be given to a woman in labor?
During a woman’s pregnancy, her doctors and other medical professionals should understand whether she is a good candidate for Pitocin/Cytotec use. There are concerns about giving women Pitocin or Cytotec under certain circumstances, including:
- Cephalopelvic disproportion: This means the baby is too large to pass safely through the mother’s pelvis.
- Abnormal or difficult fetal position: Induction may put the mother and baby in danger when the baby is breech or lying sideways in the uterus.
- Fetal Distress: Pitocin or Cytotec use when a baby is in distress and delivery is not near puts the baby in grave danger. Doctors must respond immediately at the first sign of fetal distress when using Pitocin during labor. If necessary, they must stop administering the drug altogether. Suppose the fetal distress is not corrected or shows immediate dangerous signs of hypoxia or anoxia. In that case, the baby should be delivered by emergency C-section to minimize or eliminate the danger of brain damage or death.
- Allergy or Hypersensitivity: Doctors should not give Pitocin or Cytotec to mothers with a history of sensitivity or allergy to the drugs.
- Previous Uterine Surgery: Because of the potential for uterine rupture – which is catastrophic for the mother and baby – Pitocin and Cytotec should not be used.
- Vaginal Delivery Contraindicated: Induction should never be tried if vaginal birth is considered too risky. For example, a woman with placenta previa or a prolapsed umbilical cord is not a candidate for Pitocin or Cytotec use.
It is the doctor’s responsibility to understand an expectant mother’s risk factors for the use of Pitocin or Cytotec. Pre-existing conditions and events that occur during labor jeopardize both mothers and their babies when Pitocin or Cytotec are used.
What Labor Complications Make Labor Inducing Medications Dangerous?
Labor and delivery is a complex process.
Enormous stress is placed on the fetus, but body systems can usually cope with the stress of an average delivery. Unfortunately, Pitocin and Cytotec can cause extreme uterine contractions (uterine tachysystole or hyperstimulation) that increase risk instead of reducing it.
- During labor, the mother’s uterus contracts and rests.
- As the mother’s uterus contracts, the baby’s oxygen supply temporarily decreases.
- During the time between contractions – the rest time – the placenta recovers and resumes sending blood and oxygen to the baby.
Pitocin and Cytotec can cause a mother’s contractions to be too strong, too long, or too close together. The resulting reduction in rest time between contractions can cause birth asphyxia as blood and oxygen are restricted. And birth asphyxia often causes severe brain damage called hypoxic-ischemic encephalopathy (HIE), a leading cause of cerebral palsy, cognitive disabilities, and seizure disorders.
When administering labor inducing medications, the mother and baby must be monitored using electronic fetal monitoring equipment. If the fetal monitoring strips show signs of fetal distress, these drugs must be stopped immediately.
In addition, the baby’s skull reacts to its mother’s contractions. Increased intracranial pressure because of extreme contractions can change the cranial bones (molding).
Head molding can change the shape of the baby’s skull and cause a reduction in blood flow to the brain.
Babies with excessive molding due to extreme contractions brought on by misuse of Pitocin can have brain hemorrhages. Hypoxic-ischemic encephalopathy (HIE) can result. Even with treatment, babies with HIE often develop cerebral palsy, cognitive disabilities, developmental delays, and seizure disorders.
Complications from Pitocin or Cytotec During Labor and Delivery
Inappropriate use or excessive dosage of Pitocin can cause labor complications for the mother, including:
- Uterine tachysystole or hyperstimulation (five or more contractions over a 10-minute period),
- Hypertension,
- Allergic reactions
- Dehydration,
- Uterine rupture,
- Extreme pain,
- Cervical or vaginal lacerations,
- Excessive blood loss,
- Emergency cesarean delivery,
- Hysterectomy (removal of the uterus), and
- Death
When mothers suffer complications, babies are also susceptible to injuries and birth trauma, like:
- Excessive head molding,
- Fetal distress, evidenced by abnormal heartbeats on fetal monitoring strips,
- Hypoxic-ischemic encephalopathy (HIE),
- Perinatal strokes, and
- Death
Obstetricians, OB nurses, and other healthcare providers must care for at least two patients during labor and delivery – the mother and at least one baby. Misusing medications like Pitocin and Cytotec on the mother also harms her unborn child.
Some labor complications can be anticipated. Doctors and nurses must consider a mother’s risk factors associated with the use of drugs like Pitocin or Cytotec. Failing to treat the mother endangers both mother and baby.
Where Medical Professionals Can Go Wrong
Doctors and nurses should only use Pitocin or Cytotec when there is a “medical necessity.” In fact, Pitocin has been linked to preventable adverse outcomes in childbirth. Yet medical providers make mistakes that cause maternal complications and fetal injuries, including:
- Weighing Risk vs. Benefit: Doctors must consider the benefits versus the risks of using Pitocin or Cytotec. Will using these drugs help the mother or put her in danger? Are conditions favorable for the baby to be born vaginally or not?
- Failing to get Informed Consent: Before administering Pitocin, doctors must discuss the risks and benefits with the mother. Failing to get informed consent is medical malpractice.
- Inadequate Supervision: This potentially dangerous drug, which is given through an IV, should only be administered in a hospital. Its use must be supervised by trained personnel who understand the signs and symptoms of complications and how to intervene. To get an accurate reading of uterine pressure during contractions, doctors should use intrauterine pressure monitoring and electronic fetal monitoring to look for signs of fetal distress.
- Improper Dosing: Doctors should use the lowest dose necessary to get the appropriate uterine activity and only increase it using acceptable standards and protocols. Increasing the dose in the light of uterine hyperstimulation or fetal distress is negligence and medical malpractice.
- Failing to Intervene: Using Pitocin and Cytotec requires close monitoring of both mother and baby. Ignoring signs of hyperstimulation or fetal distress or failing to intervene can cause serious complications to both mother and baby. If a mother is showing acceptable uterine activity but labor doesn’t progress, a C-section should be done. An emergency C-section is necessary when signs of fetal distress are also present.
It's possible that your doctor misused Pitocin or Cytotec during labor and delivery. Contact experienced birth injury lawyers to determine if you have a claim against them for medical negligence & medical malpractice.
Is Your Child’s Birth Injury the Result of Pitocin or Cytotec Misuse?
The parents of children who suffered birth injuries often want answers. They want to know what happened to harm their child’s brain—was there birth injury or birth trauma that was preventable? Were there signs of fetal distress that the doctors and nurses failed to recognize and/or failed to respond to in a timely manner? Did doctors and nurses misuse Pitocin or Cytotec by giving too much, improperly increasing the dose, or failing to properly monitor using state-of-the-art technology during the administration of these drugs?
Our dedicated birth injury lawyers want to help you find those answers.
We diligently investigate the facts, including a detailed examination of the fetal heart rate monitoring strips and labor and delivery records. If this review shows the medical providers did not diagnose or respond to fetal distress, we hold responsible parties accountable by pursuing medical malpractice claims against them.
The compensation our clients receive helps them pay for their child’s current and future medical treatment, assistive technology and equipment, attendant care, and the other expenses associated with caring for a child with brain injuries, seizure disorders, and cerebral palsy.
Sometimes families are afraid to talk to lawyers about their child’s case because they worry there is a fee. There is never a fee unless and until we make money recovery for our clients.
Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod?
The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injury.
At Miller Weisbrod, a team of committed professionals uses our detailed case review process to assess your potential claim. They start by learning more about you and your child. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.
If we feel medical malpractice was present, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors.
At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.