"If we hope to create a non-violent world where respect and kindness replace fear and hatred, we must begin with how we treat each other at the begining of life. For that is where our deepest patterns are set. From these roots grow fear and alienation or love and trust."
Suzanne Arms

Tuesday, August 4, 2009

"Pit to Distress" . . . reason number 101 to stay out of the hospital

OK what do y’all think of when you hear that . . . Pit to Distress?

I am sure a few things could come to mind (maybe related to peaches . . . or Brad ;0). Though if you frequent birth related blogs, chances are you have heard it already as it has gone viral.

When I was browsing a message board a few weeks ago and first read the words ‘Pit to Distress’ I unfortunately knew exactly what it meant, despite never having heard it before. And how on earth can I not have heard of this? . . . in all my 10 yrs of researching childbirth?. “Pit” is short for Pitocin (a drug used to induce/augment labor) and Distress is . . . you guessed it. It refers to the baby showing signs of distress during labor. It basically means cranking up the pitocin till the baby shows signs of distress so that an ‘emergency’ c-section can be performed!!! No, I kid you not, you don't need to clean your glasses, Yes, you read that right!

Now I love learning new things about labor and birth and childbirth practices, but this . . . well I don’t have to tell you that it is extremely disturbing. But the sad thing is, when my cynical self was made aware of this practice I was not the least bit surprised. Though I was outraged along with everyone else and the blogosphere has been a buzz about it since Jill of Keyboard Revolutionary blogged about it back in July (check out her blog, having had a c/s with her first, she has a unique perspective . . . though probably not as unique as it should be, considering 31.8% of births in the US end in c/s).

Of course most logical minded people would think that there is no way this could be true, there is no way Dr’s would endanger the life of a baby and ultimately the mother, by cranking up the pit in order to do a c/s!!! I hate to break it to ya, but I have read enough supporting evidence in the last week to be able to say with confidence that it DOES happen! Now I am not saying that all Dr’s or hospitals practice this. I know there are some decent dr’s out there. But seeing as how the practice is mentioned in books and newspapers, and is a fairly widely known term . . . I don’t think it can be easily refuted. Jill at www.theunnecesarian.com has blogged about it and has some pretty compelling quotes to back up it up. In an effort to save space (because I am sure to be long winded) I will just link to her post rather than quoting all her research (she even references a Wall Street Journal article and a nursing textbook) HERE is the first post, and the follow up.

I am sure many dr’s won’t use that actual term, and heck, I will even go far enough as to say that some who do it probably don’t even realize what they are doing or maybe they don’t do it intentionally. They are just SO used to cranking up the pit for a ‘dysfunctional’ labor that they don’t think twice about the consequences or the fact that they are the ones causing all these babies to go into distress, the reason for the 'emergency' c/s (though I certainly believe some are callous enough to prescribe ‘pit to distress’ intentionally and have such a huge God like ego that they don’t really even care). For an example, please check out the Nursing Birth blog post about Pit to Distress and the comments from other nurses that follow (heck, check out the whole blog, it is wonderful and as an L&D nurse she has a unique perspective). She describes a scenario where an OB demanded she turn up the pit to ‘hyper stimulate’ the moms uterus . . . the way he went about it, was very nonchalant, like, what is the big deal? it is just what they do. He probably didn’t even think twice about it . . . and that my friends, is the most disturbing aspect of all of this, that it can be done without even considering the consequences. She lists several other examples that she personally has dealt with as an L&D nurse. It is eye opening!!

These are peoples lives they are playing with!! We are talking about childbirth here, it is a NATURAL process. Why are we letting ourselves be managed by people who obviously do not respect us our our bodies or the beautiful process of giving birth? It doesn’t need to be rushed, or managed, or augmented or put under a microscope . . . it needs to be left to progress at it’s own pace, the way it was designed be. We need to be left the heck alone!!!

The fact is that the use of pitocin to augment labor is staggering. It will vary by dr and hospital, but I have read about numbers as high as 60% of all women giving birth having labor either induced or augmented with pitocin. On Rixa's blog, she talks about a medical article and study in which a hospital was lowering it's pit rates and getting better outcomes, I am with her when she states . . .

I had to blink a few times when I read that the hospital's rate of Pitocin usage began at 93.3% and declined to only 78.9%. Seriously? Less than 7% of all laboring women did NOT have Pitocin? I cannot imagine any reasonable justification for Pitting 78% of all laboring women, let alone 93%.
Read more at her blog HERE

Lets go over the list of complications from Pitocin usage shall we . . . from the Internet Drug Index

Anaphylactic reaction

Postpartum hemorrhage

Cardiac arrhythmia

Fatal afibrinogenemia

Hypertensive episodes



Premature ventricular contractions

Pelvic hematoma

Subarachnoid hemorrhage

Hypertensive episodes

Rupture of the uterus

Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus.

The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug.

Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported.

The following adverse reactions have been reported in the fetus or neonate:

Due to induced uterine motility:


Premature ventricular contractions and other arrhythmias

Permanent CNS or brain damage

Fetal death

Neonatal seizures have been reported with the use of Pitocin.

Due to use of oxytocin in the mother:

Low Apgar scores at five minutes

Neonatal jaundice

Neonatal retinal hemorrhage

Wow! Sounds like something I wouldn't want routinely used on me and my baby . . . how about you? Not to mention that the wide spread use of this drug undermines us as birthing women. Our bodies are not flawed and WILL give birth in their own time . . . just as God designed them to do (He didn't make a mistake when He designed us to give birth). I guess according to the Dr's 3 of my 5 kids wouldn't have been born because my labor was dysfunctional (contractions 10-20 min apart the whole time) . . . oh wait . . . they WERE born, and they were fine and healthy and born in their own time!! Wow what a concept!!

And to support the fact that maybe some Dr's use pitocin because they are impatient and don't want to wait for our slow butts to give birth . . . there has been at least one study done (that I know of) that supports the fact that the some c-sections are done for Dr’s convenience. Quoted from Wikipedia

” Research into reasons for emergency cesareans found that 66% occur between the 25% of day shift hours of 8 AM and 3 PM, and the least between 5 AM and 6 AM leading the authors to conclude that physician convenience is a leading cause of "emergency cesareans." (Goldstick O, Weissman A, Drugan A.The circadian rhythm of "urgent" operative deliveries.Isr Med Assoc J. 2003 Aug;5(8):564-6.)”

Aw, well aren’t us birthing moms and babies nice to wait for ‘working hours’ to have all of our 'emergencies' that require a section! Don’t want to inconvenience the good Dr now do we?

I know I am being sarcastic, but this is really a very serious matter. C-sections are the most common surgery among women in the US. And the list of possible complications is not to be overlooked . . . infection, bleeding, atony, lacerations, hysterectomy, placenta accreta, blood clots, nerve injury, wound breakdown, uterine rupture, bladder injury, adhesions, UTI, delayed bowl function, fetal injury. For babies born by c/s, they are more likely to have respiratory problems and more likely to spend time in the NICU.

Yes, some of these things occur after vaginal births too, but a vaginal birth is normal and natural, if a complication occurs it is an exception to the rule. Where as with an unnecessary or 'pushed' c/s you are taking steps to intervene in the natural process, and from there complications become . . . well . . . manmade.

C-sections have become so commonplace in our society that no one even bats an eye about it anymore!! Heaven forbid a mother feel bad about having one!! In truth there are very few reasons why a c/s should be needed (placenta previa, cord prolapse, placenta abruption and a few other rare complications of pregnancy). The WHO states that it should be around 15% for all countries world wide (remember, in the US it is 31.8). I know that many homebirth midwives have a rate of 1-3% and IMO that is really what it should be for low risk healthy women.

Look I am not anti c/s. I think it can be a life saving procedure and I am grateful to live in a time where it is a possibility and would be so grateful for the ability to have one if really needed (though I would still mourn the loss of a gentle natural birth for myself and my child). But it is being abused . . . women are being abused by placing their lives in the hands of providers who are so ingrained in the medical model that they can’t see anything else. They are placing (intentionally or unintentionally) their wishes over ours . . . and for those Dr’s who do this, those Dr’s who are playing God with our lives and our babies lives, it is wrong!!!

What can we do about this? How can we stop this? We have to change our mindset. Dr's do this because they can. Because we let them. Because for some reason they have this power over us that whatever they say we blindly follow . . . and because we love our babies and want the best for them, and when a Dr throws the 'dead baby' card at us, in our lack of knowledge, we crumble. We need be strong, to stand up and remember that the Dr works for us, that we can refuse things, that we can do our own research and come to our own conclusions. The Dr doesn't "allow" us to do anything, we call the shots!! We need to remember that the Dr is not God, he is only human just like we are. That our births belong to us . . . they are our responsibility regardless what we choose, and the health and well being of our children and family is in our hands. And we need to be proactive and surround ourselves with positive supportive people so that the chances of being faced with these interventions is reduced.

The choices we make regarding who will give us care, provide us with information, share in our experiences and whom we will TRUST is very personal and it is a huge responsibility and decision . . . make it an educated, informed and empowered one!!


  1. With both of my children's births, I had a brush with c/s. With my daughter, I had PUPPS rash, and it was making me nuts. My OB nonchalantly said "Well, we can schedule you for a C-section." I blinked. "For a rash? For some itching?" I declined, and had an 11 hour labor and delivery (8 hour labor, 3 hour pushing). Perfect baby. Happy me.

    With my son, now 6 months, it was a little more serious. He was sideways breech. I tried yoga, swimming, even a special chiropractor to turn him, and he turned, but always floated back to his sideways position.

    In desperation, hoping to avoid a C/S, I opted for a version. 3 times in 1 day. No go. The following week, at 34 weeks, they "allowed" me to try one more version. If it hadn't taken, I would have been scheduled for a c/s at 36 weeks, because my OB didn't want to risk me going into labor with a sidelying baby. Fortunately, that version took. And of course, since you have someone smashing your uterus, you contract.

    The doctors all assumed I'd deliver later that day. Well... no. My doula's opinion was, they're not letting you eat and barely drink for 18 hours, of course your labor stalls! What energy have you got to run it? Since I was ready to kill for a cheeseburger, I was inclined to agree.

    At shift change, new doctors file into the tiny closet they have me in (the midwife unit was closed due to lack of midwives, same as when I had my daughter 5 years before). They all assure me they'll take the best care of me, and one of them says she'll be back to talk to me in a minute. This doctor, a lady, later came in and told me if I was her patient, I'd be on Pit already, but as she'd just come on, she'd give me another hour to see if I could establish a regular labor pattern on my own before she started doing things her way. Excuse me? I suggested that the baby just wasn't ready to come out yet. Well, maybe, but they didn't want to take the chance of him going breech again. After the most brutal pelvic exam, bar none, I have ever experienced, she concluded my labor had stalled. I had two choices. Pit (to her mind the responsible choice) or leave and see what happened (and be a contrary and irresponsible mother). Well, what's a responsible mother who is very concerned about her baby and his welfare supposed to do?

    Yeah. I went home with my husband. But not before we got a cheeseburger.

    For the record, my son was born perfectly normally, after a 6 hour Hypnobirthing labor.

  2. As a doula I have witnessed the "pit to distress" technique. It was completely unnecessary but the doctor was in a big hurry to leave since my client was his only patient. So he jacked the pit up above safe levels and pulled out the forceps after 10 minutes of very effective pushing. The baby was healthy, but the mother required reconstructive surgery. But at least the "doctor" was able to get home for dinner...

  3. AMEN!!!! I found out about your site from my mother-in-law, Carolyn Goss - I know your dad and my in-laws are great friends!
    I've enjoyed reading your blogs! If you were here in Nashville we would so be buddies! I had an amazing natural birth in July - 10lbs10oz! It was so easy - no pain at all during pushing! I used Hypnobabies and it was wonderful! My birth story is the first post in my little guys blog - babychristiangoss.blogspot.com.

  4. I get really sad when I realize that I let the doctor make a decision for a plan that has it's own natural clock. The nurses would come in every hour or so and pump up the Pitocin like on a schedule and after 8hrs or so they said the baby is in distress and a C-section is recommended. They kept telling me that the baby is in distress and after many tears from me and my husband, their fear tactic of risking the baby's health worked. It eats at me regularly.

    Now we are expecting baby #2, 13 months apart from baby #1 and they keep telling me that the best (only) option is C-section since I’ve had one already.

    I don’t know what to do or how I would even handle declining a cesarean after just having one.



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