The Health Sciences Institute is intended to provide cutting-edge health information.
Nothing on this site should be interpreted as personal medical advice. Always consult with your doctor before changing anything related to your healthcare.

"Pit to distress" – you just might be livid when you find out what that phrase means

Like Candy From a Baby

Despicable is a harsh word, but it may not be harsh enough to describe a hospital practice known as “Pit to distress.”

Get ready to hit the forward button to send this e-Alert to every woman you know – especially those of childbearing age.

A visit to OB world

My jaw just about hit the keyboard when a friend sent me an e-mail titled “Pit to distress.” His note: “This is crazy”

Crazy only begins to describe it.

Oxytocin is a hormone that naturally prompts contractions of the uterus during labor. Pitocin is a synthetic pharmaceutical version of oxytocin, frequently used to induce labor or speed up a labor that’s not progressing well.

How common is Pitocin use? As one medical center professional told the Wall St. Journal in 2006, “Pitocin is used like candy in the OB world.”

But “candy” for whom?

It’s not candy for the mother. While under the influence of Pitocin, her uterus may become over stimulated and even tear if contractions become too strong or start occurring too rapidly.

And it’s certainly not candy for the fetus. Over stimulation of the uterus impedes blood and oxygen flow, prompting fetal distress.

Can you tell where this is going now?

Forcing nature’s course

Apparently Pitocin is candy for certain obstetricians who prefer to manipulate births around their personal schedules.

Using Pitocin to induce labor is one way to schedule a birth. And to be fair, this is sometimes necessary for women with preeclampsia and other pregnancy problems. But doctors who prefer to move labor along quickly sometimes call for the highest dose of Pitocin, knowing the fetus will become distressed. The unwitting parents are informed that their baby is in danger, and everyone hurries to an operating room for an emergency cesarean section.

Pit to distress. It’s just so much more convenient than waiting for nature to run its course.

This outrageous practice may be new to you and me, but for OB personnel it’s not a secret at all. In fact, in the 2008 textbook “Labor and Delivery Nursing,” authors Murray and Huelsmann note that it’s a nurse’s duty to protect the fetus against unsafe protocols. And the book states, straight out: “‘Pit to distress’ is not an acceptable order.”

This is a wake up call for pregnant couples: Never assume. Always create a detailed birth plan with specific instructions and fallback options. If you wish to avoid a C-section unless it’s absolutely necessary, ask your doctor for his ratio of vaginal-to-cesarean deliveries. If the cesarean percentage is high, that’s a red flag. And if the number is unusually high, ask if he’s ever employed “Pit to distress.”

He’ll probably be flabbergasted that you even know what that means.

“‘Pit to Distress’: Your Ticket to an ‘Emergency’ Cesarean?” Unnecesarean, 7/6//09,
“New Practices Reduce Childbirth Risks” Laura Landro, Wall St. Journal, 7/12/06,