Surprise! Pitocin Is Linked to Postpartum Depression | Mother Rising

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Pitocin®, a synthetic form of oxytocin, is routinely given to women before, during and immediately following birth to induce and augment labor and to also prevent and treat postpartum hemorrhage.  Much to the surprise of the medical community, a recent study showed that Pitocin® is linked to postpartum depression and anxiety.

The mothers aren’t surprised.

For women with a history of depression or anxiety prior to pregnancy, receiving Pitocin® increased the 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%.

Let that sink in for a moment.

I Bet the Numbers Are Even Higher

While I pondered these incredibly high numbers, it occurred to me that the numbers may actually be higher.

The information used in the research study came from women that received a diagnosis and/or a psychotropic medication.  What about those that didn’t seek help?

In my experience, for whatever reason, many women do not seek professional help when experiencing postpartum anxiety and/or depression.

How many anxious or depressed mothers never confide to their care providers about what they’re feeling?  Or even worse, were dismissed and told “everything will be fine”.

It’s Not Just in Our Heads

Even if the numbers may be higher, the research as is, is incredibly validating.  Ladies, what you are feeling is not “just in your head”.  It’s real, and it’s a big problem (that society has no idea how to handle).

*For a list of symptoms of postpartum mood disorders please visit Postpartum Progress.  (Postpartum Progress is a non-profit that aims to raise awareness, fight stigma and provide peer support and programming to women with maternal mental illness.)

Pitocin Is Not the Same as Oxytocin

The strangest thing about the research study was that the hypothesis was the opposite of what made sense to me as a mother and childbirth educator.  The hypothesis suggested that synthetic oxytocin, Pitocin, would in fact lower postpartum depression and anxiety.

The underlying assumption I am gathering is that, despite the evidence, medical professionals believe that Pitocin® is the same as oxytocin.

A few years ago I was attending a Pitocin® induction at my local hospital.  My doula client was struggling BIG TIME with the sudden wave after wave of strong, painful contractions.  Her nurse, not knowing what else to do, told her, “this is just labor, honey”.  As if what she was experiencing were normal labor sensations.  How sad.

Believe me, Pitocin® does not feel warm and fuzzy, and isn’t “just like labor”.  My pitocin augmentation birth was much harder than my first two births.  For me, Pitocin® made my active labor phase feel like the transition phase, and lasted far longer than the transition phases I had experienced in my non-Pitocin® births.

Oxytocin is Needed to Mother Well

Oxytocin, on the other hand, is helpful for coping with stress, supporting emotional and mental well-being and also helps with bonding – which are absolutely necessary for a successful transition to motherhood. (source)

Another study showed that women given Pitocin in labor had low oxytocin levels during breastfeeding.  This revealed that the exposure to Pitocin® has consequences that last on into mothering. (source)

What About the Baby?

If oxytocin is an important hormone for becoming a mother and synthetic oxytocin is linked to postpartum depression, anxiety and low oxytocin during breastfeeding.  I can’t help but wonder – what about the baby?

If oxytocin effects how women transform into mothers, how is this synthetic hormone affecting the baby?

How is the baby affected by synthetic oxytocin before, during and after labor?

Frighteningly, we have no idea.

Re-Examine Routine Procedures

If Pitocin® is linked to postpartum depression and causes a lack of oxytocin during the postpartum period, maybe it’s time to re-evlatulate the use of Pitocin® as it pertains to each woman.  (Never mind the baby…)

According to the CDC, induction has more than doubled from 1990 (10%) to 2010 (23%). (source)  However, just because a procedure is routine does not mean that it’s a good enough reason to do it.

 

We Need More Research

I’m not suggesting to eliminate Pitocin®, as it is an important life saving tool in modern obstetrics.  (Shoot, I’ve even experienced it first hand!)  However, because the consequences of routine childbirth interventions such as Pitocin® on human maternal behavior have been understudied, it would be wise to limit the use of Pitocin® until further research is completed.

And if Pitocin® is deemed necessary, it would be wise and compassionate to provide quality postpartum care, especially to those with high risk factors for postpartum depression.

What if care providers were required to pay for 40 hours of postpartum doula services to women that received Pitocin®?  I bet we’d quickly see the true motivations behind the choices made in the care of new mothers.

Oxytocin is essential for our species to thrive as mothers.  Our current methods meddle with the mental health of these new mothers – the backbone of society.

Is the crumbling mental health of new mothers important enough for us to take action?

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New York City Launches Initiative to Eliminate Racial Disparities in Maternal Death

A Central Brooklyn hospital featured in ProPublica and NPR’s “Lost Mothers” series for its high hemorrhage rate will serve as a pilot for quality reforms.

In response to alarming racial disparities, New York City announced a new initiative last week to reduce maternal deaths and complications among women of color. Under the new plan, the city will improve the data collection on maternal deaths and complications, fund implicit bias training for medical staff at private and public hospitals, and launch a public awareness campaign.

Over the next three years, the city will spend $12.8 million on the initiative, with the goal of eliminating the black-white racial disparity in deaths related to pregnancy and childbirth and cutting the number of complications in half within five years.

“We recognize these are ambitious goals, but they are not unrealistic,” said Dr. Herminia Palacio, New York City’s deputy mayor for health and human services. “It’s an explicit recognition of the urgency of this issue and puts the goal posts in front of us.”

The city’s health department is targeting nearly two dozen public and private hospitals over four years, focusing on neighborhoods with the highest complication rates, including the South Bronx, North and Central Brooklyn, and East and Central Harlem. Hospital officials will study data from cases that led to bad outcomes, and staff will participate in drills aimed at helping them recognize and treat those complications.

Health department officials approached SUNY Downstate Medical Center in May to serve as a pilot site for many of the new measures.

 

The Central Brooklyn hospital was featured in the “Lost Mothers” series published by ProPublica and NPR last year as one of the starkest examples of racial disparities among hospitals in three states, according to our analysis of over 1 million births in Florida, Illinois and New York. In the second half of last year, two women, both black, died shortly after delivering at SUNY Downstate from causes that experts have said are preventable. The public, state-run hospital has one of the highest complication rates for hemorrhage in the city.

“We look forward to working with all of our partners to provide quality maternal health care for expectant mothers,” said hospital spokesperson Dawn Skeete-Walker.

“SUNY Downstate serves a unique and diverse population in Brooklyn where many of our expectant mothers are from a variety of different backgrounds, beliefs, and cultures.”

The city will also specifically target its own public hospitals, which are run by NYC Health + Hospitals, training staff on how to better identify and treat hemorrhage and blood clots, two leading causes of maternal death.

The initiative is “aimed at using an approach that encourages folks to have a sense of accountability without finger pointing or blame, and that encourages hospitals to be active participants to identify practices that would benefit from improvement,” said Palacio.

In addition to training, the city’s public hospitals will hire maternal care coordinators who will assist high-risk pregnant women with their appointments, prescriptions and public health benefits. Public hospitals will also work to strengthen prenatal and postpartum care, including conducting hemorrhage assessments, establishing care plans, and providing contraceptive counselling, breastfeeding support and screening for maternal depression.

Starting in 2019, the health department plans to launch a maternal safety public awareness campaign in partnership with grassroots organizations.

“This is a positive first step in really being able to address the concerns of women of color and pregnant women,” said Chanel Porchia-Albert, founder and executive director of Ancient Song Doula Services, which is based in New York City. “There need to be accountability measures that are put in place that stress the community as an active participant and stakeholder.”

The city’s initiative is the latest in a wave of maternal health reforms following the “Lost Mothers” series. Over the past few months, the U.S. Senate has proposed $50 million in funding to reduce maternal deaths, and several states have launched review committees to examine birth outcomes.

As ProPublica and NPR reported, between 700 and 900 women die from causes related to pregnancy and childbirth in the United States every year, and tens of thousands more experience severe complications. The rate of maternal death is substantially higher in the United States than in other affluent nations, and has climbed over the past decade, mostly driven by the outcomes of women of color.

While poverty and inadequate access to health care explain part of the racial disparity in maternal deaths, research has shown that the quality of care at hospitals where black women deliver plays a significant role as well. ProPublica added to research that has found that women who deliver at disproportionately “black-serving” hospitals are more likely to experience serious complications — from emergency hysterectomies to birth-related blood clots — than mothers who deliver at institutions that serve fewer black women.

 

In New York City, the racial disparity in maternal outcomes is among the largest in the nation, and it’s growing. According to a recent report from New York City’s Department of Health and Mental Hygiene, even as the overall maternal mortality rate across the city has decreased, the gap between black and white mothers has widened.

Regardless of their education, obesity or poverty level, black mothers in New York City are at a higher risk of harm than their white counterparts. Black mothers with a college education fare worse than women of all other races who dropped out of high school. Black women of normal weight have higher rates of harm than obese women of all other races. And black women who reside in the wealthiest neighborhoods have worse outcomes than white, Asian and Hispanic mothers in the poorest ones.

“If you are a poor black woman, you don’t have access to quality OBGYN care, and if you are a wealthy black women, like Serena Williams, you get providers who don’t listen to you when you say you can’t breathe,” said Patricia Loftman, a member of the American College of Nurse Midwives Board of Directors who worked for 30 years as a certified nurse-midwife in Harlem. “The components of this initiative are very aggressive and laudable to the extent that they are forcing hospital departments to talk about implicit bias.”