By Doula Delight  From Bahama Islands Info

Naturally occurring oxytocin is produced by the brain (in the hypothalamus and secreted from the posterior pituitary gland) in increasing amounts as a pregnancy approaches term (39 weeks 0 days to 40 weeks, 6 days). The muscle layer of the uterus (myometrium) has specific receptor sites (oxytocin friendly and welcoming) programed for the uptake of oxytocin. The number of these receptor sites reaches a maximum in early labor at term.1 Released in pulses, naturally occurring oxytocin is responsible for generating spontaneous uterine contractions that increase in frequency (how often they happen), length (how long they last) and strength (how strong they are) as labor progresses. One could say that “oxytocin is the maker of mothers.”

Syntocinon (Syntocin) is the drug most commonly used agent for labor induction/augmentation world-wide.2 Syntocin (Pitocin… used interchangeably in this article) is a synthetic oxytocin that is used to stimulate contractions to begin labor or to intensify the strength of weak and ineffective uterine contractions (augmentation) as well as to combat post-partum hemorrhage.2 Augmentation of labor is done to “pick-up,” as in to intensify, a labor that has begun but is slow to progress or perhaps that has stalled. In contrast, the induction of labor is the forcing of labor to begin.

Today augmentation and induction of labor are kindred interventions because many of the augmentations today are, in fact, inductions. Current research suggests that active labor does not begin until five centimeters of dilation (for some it is even more).6 Therefore, if labor isn’t active until five centimeters of dilation, then those given Syntocin at two or three centimeters of dilation (a common practice), are more inductions than they are labors that have been augmented. Consequently, augmentation and induction are interventions that can no longer be addressed independently of one another.

In 1996, the induction of labor was the exception rather than the rule. Today, nearly half-of all labors are induced.3 In the USA, some would say that almost 80% of all births take place under conditions of an oxytocin-stimulated labor4 (much like it is here in the Bahamas). The induction and/or augmentation of labor has become a most common and routine obstetrical intervention. Indeed, it is often used when a mother could and would labor independently and successfully without the use of this potent and high-risk medication.5

The World Health organization (WHO) has stated that induction and/or augmentation (pitocin-driven labors) rates higher than 10 % are unacceptable.7 But, because induction or augmentation (stimulation) of labor has become a routine elective intervention today (increased 125% between 1989 and 2001; the rate is even higher in 2014),8 it is not surprising that this high-alert medication is “one of the leading causes of obstetrical liability.” (p.15).13

Adverse outcomes are associated with electively augmented/ induced labors because the onset of labor is being forced before the fetus is ready to initiate his own birth. Consequently, it is often the baby who must be rescued from an environment that has become hostile 10, 11 subsequent to uterine over-stimulation (too many, too strong contractions occurring too fast giving the baby too little time to re-oxygenate in the too short rest periods between the contractions).2,3,5,12 The consequences of this hyperstimulation (uterine overstimulation), if not addressed appropriately, are uterine rupture, fetal distress (especially if used in gestations less than 39 weeks of age)5, 13 and possible cervical injury.14

Failure to follow the drug manufacturers’ recommendations for the administration of Syntocin “has been the basis of much litigation (obstetrical) in the United States and around the world.”3,12 “Approximately, one half of paid claims involve allegations of pitocin misuse.”9 This reality is why Syntocin was added to the list of high-alert medications in 2007 by the Institute for Safe Medication Practices.2,13 High-alert medications are those with the potential to cause harm to a patient if not administered with caution and according to established protocol. Pitocin is one of only twelve medications labeled as high-alert.9

But… there is more to consider about the adverse outcomes of the “overuse”13 of this “high alert” medication. That is the recent and accumulating research information that suggests there is an association between the rising incidence of Autism Spectrum Disorders (ASD) that parallels the increase of Syntocin-driven labors. “The CDC believes that there might be an association between autism and Pitocin while the WHO says there is.”(p.14)15 Current research findings don’t prove that the use of Syntocin for labor induction or augmentation is the cause for autism but they do suggest an association between the two.15,16,17,18,19, 20

“Autism has a large genetic predisposition”4,21 and it is likely that the genetic predisposition for autism is sown prenatally in the womb subsequent to external environmental stimuli.4,17 In the US, Autism Spectrum Disorder (ASD) is the number one childhood disorder and is more prevalent than Down Syndrome, diabetes and cancer combined.15,17 Dr. Lawrence Levine, an neurologist, “cites a personal clinical analysis that found Pitocin was used in 60 percent of the births of autistic children”. (p. 15)15 In 1980, one in 5,000 children was diagnosed with autism; in 1990 1 in 1,000 children were so diagnosed. In 2000, it was 1 in 500 children; in 2004, it was 1 in 166 children; in 2007 it was 1 in 150 children, in 2010 it was 1 in 110 children15,14 and today (2013) one in 8815,16,18,20 children are diagnosed with ASD, the preponderance of whom are boys (1 in 70).15,16,20 This is a ten-fold increase in the diagnosed incidence of autism in the United States since the 1980s.(p. 6)19 While males, exposed to oxytocin therapy (OT) during labor, seem to be particularly at an increased risk for developing autism, female fetuses, who experience OT during labor and birth, appear to develop Attention Deficit and Hyperactive Disorder (ADHD) more frequently than do females whose labors were neither induced nor augmented by Pitocin.19

Researchers are unsure of the link between OT in labor and the post-birth development of ASD and ADHD. The research data suggests that bombardment of the fetus’ immature oxytocin receptors with a continuous (rather than an intermittent [pulsed] release), high-dose artificial oxytocin (made from the pituitary glands of cattle) destroys the sensitive oxytocin receptors of the baby,17,23 thereby causing a “dramatic reorganization of central oxytocin binding receptors.”17 This artificially-induced reorganization appears to dull the baby’s oxytocin receptor’s uptake of this essential “feel-good, love” hormone. The consequence of this artificial hormonal overstimulation of the fetal brain alters the oxytocin system4 (responsible for regulating the psyche, sexuality, and the human ability to bond4) of the newborn. This adversely affects the internal emotional regulation and critical social behavior19 of the baby and the mother-child attachment4 because of the syntocin-induced oxytocin deficiency in the baby and subsequently in the child.15

While the need for more definitive research exists,4,20 experts suggest that “finding people [today] who have not been exposed to Pitocin [for clinical trials] is difficult,”17 because it [syntocin] is given so frequently.17 However, the consensus of respected health care agencies, National Insititutes of Health (NIH), World Health Organization (WHO), the Milbank Memorial Fund, the Institute for Healthcare Improvement IHI), the American College of Obstetricians and Gynecologists (ACOG), The American College of Nurse-Midwives and so many more urge caution in inducing or augmenting labors with syntocin when there is no medical indication for the induction or augmentation of a labor because of the association between autism and intrapartum administration of Pitocin. What most mothers don’t know is that the routine use of syntocin has the potential to harm their offspring both in the short term (labor) and long-term (ASD). Physicians are not going to inform them of the association between labor induction, augmentation and ASDs, especially for male fetuses. Mothers, beware! What you don’t know can hurt your fetus, baby and child!

For references in this story go to: http://www.bahamaislandsinfo.com/~bahamais/images/stories/2014/wk-04-03-14/REFERENCES040114.pdf

For more on this story go to: http://www.bahamaislandsinfo.com/~bahamais/index.php?option=com_content&view=article&id=17565:doula-delight-the-association-between-the-syntocinon-use-and-autism&catid=117:doula-delight&Itemid=232