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Could your symptoms of anxiety and postpartum depression be related to your Pitocin induction?

First off what let’s explore what oxytocin and synthetic pitocin is and why should you care about it.

What is Oxytocin

In the medical community oxytocin is best known for causing uterine contractions during the labor process. It is often referred to as the “hormone of love,” as it plays an important role in maternal behavior, lactation, building relationships, and sexual pleasure. During labor oxytocin levels peak around the time of the delivery and remain high after delivery, specifically increasing in response to physical contact like skin to skin with the baby.

Oxytocin has calming and pain-relieving effects, it helps mothers cope with the stress of labor, mental well-being and also helps with bonding. It works as a buffer to counter the negative experiences of labor pains and anxiety. By increasing endorphins in the brain, it helps mothers to cope with stress and even decrease their pain responses. After birth, mothers with higher oxytocin are more likely to engage in affectionate parenting behaviors, including: frequent checking in on baby, affectionate touch, speaking and singing to the baby.

Oxytocin:

Makes us feel affectionate

Helps with social bonding and building relationships

Boosts our ability to cope with stressful situations

Induces labor

Supports breastfeeding and mother baby bonding

What is Pitocin

Pitocin on the other hand is a synthetic version of naturally occurring oxytocin, it has the same molecular structure but they are not the same. Pitocin does not cross into the brain to help counter increased stresses and pains of labor therefore; mothers are less able cope with the intensity of labor contractions and can be more stressed and worried about the labor process. The more synthetic Pitocin in the blood stream the less of the natural occurring oxytocin is released. That might explain why mothers who received Pitocin during labor may be more at risk for postpartum depression.

Another problem with synthetic administered Pitocin is the fact that it flows continuously without a natural rhythm. This can lead to less effective contractions, uterine overstimulation, excessive bleeding, a cascade of birth interventions. Consequently, it leads to higher numbers of births including forceps deliveries and cesarean sections. This added stress can be associated with increased depressive, anxiety, and PTSD symptoms.

Oxytocin on the other hand is released as a positive feedback loop. It is release only if the cervix is ready, and it increases gradually as the body responds to it until the baby is born. Having experienced both unmediated and induced labor I can attest to the fact that natural labor feels much gentler on the body and it is much easier to cope with.

Pitocin:

Produces strong uterine contractions

Doesn’t cross blood brain barrier unless in very high doses

Often leads to a cascade of birth interventions.

Increased risk of cesarean delivery

Increased risk of neonatal stress

How does synthetic Pitocin increase postpartum depression risk?

According to one study for women with a history of depression or anxiety prior to pregnancy, receiving Pitocin® increased their 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%.

We need more data than this one study to really understand the effect of Pitocin on mental health and oxytocin levels post birth. It would be unreasonable for anyone to advice that Pitocin use should stop based on these findings but each person should consider their own risk for postpartum depression and made best decisions for themselves. We need to reevaluate the reasons for Pitocin use as the rate of induction of labor more than doubled from 1990 through 2010, from 9.6% to 23.8%. As a maternity nurse I’ve seen Pitocin being used routinely without clear indications and considerations of it’s risks.

What can be done to increase Oxytocin levels?

Skin to skin contact and breastfeeding are shown to have a positive effect on oxytocin levels. Skin to skin and breastfeeding help to decrease cortisol (stress hormone) and lower the risk of postpartum depression. There’s nothing like the power of physical touch, cuddling, gazing in the eyes of a baby, but also staying connected to a partner, a family member or a friend.

If you have been told your Oxytocin levels are low please talk to your endocrinologist or breastfeeding medicine doctor if you’re breastfeeding.

If you are experiencing symptoms of depression don’t be afraid to reach out for help. A little help will really go a long way.

Resources:

  1. Guilarte-Walker Y, Moore Simas TA, Deligiannidis KM. Association of peripartum synthetic oxytocin administration and depressive and anxiety disorders within the first postpartum year. Depress Anxiety. 2017 Feb;34(2):137-146. doi: 10.1002/da.22599. PMID: 28133901; PMCID: PMC5310833.
  2. Robinson C, Schumann R, Zhang P, Young RC. Oxytocin-induced desensitization of the oxytocin receptor. Am J Obstet Gynecol. 2003 Feb;188(2):497-502. doi: 10.1067/mob.2003.22. PMID: 12592262.
  3. Zelkowitz P, Gold I, Feeley N, Hayton B, Carter CS, Tulandi T, Abenhaim HA, Levin P. Psychosocial stress moderates the relationships between oxytocin, perinatal depression, and maternal behavior. Horm Behav. 2014 Jul;66(2):351-60. doi: 10.1016/j.yhbeh.2014.06.014. Epub 2014 Jun 20. PMID: 24956026.
  4. Bell AF, Erickson EN, Carter CS. Beyond labor: the role of natural and synthetic oxytocin in the transition to motherhood. J Midwifery Womens Health. 2014 Jan-Feb;59(1):35-42: quiz 108. doi: 10.1111/jmwh.12101. Epub 2014 Jan 28. PMID: 24472136; PMCID: PMC3947469

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