Many pregnant women are given oxytocin to stimulate a labour that has been slow to start or has come to a halt for a few hours. However new research indicates that it is fine to leave first time mothers-to-be for a further three hours before administering the drug.
Oxytocin is a hormone made by the body during labour. It can also be made synthetically and given to a woman via an intravenous drip. This helps to stimulate uterine contractions and get labour moving again. However, overstimulation with oxytocin risks restricting the supply of oxygen to the unborn child.
Swedish researchers looked at healthy, first time mothers with normal pregnancies and a spontaneous start to labour over a five-year period. The women were monitored throughout their deliveries and were followed up one month later.
Those with a slow or arrested first stage labour were randomly allocated to receive early oxytocin treatment, or were left for a further three hours. All of the women were given the same access to pain relief and staff support.
The results showed that there were no differences between the groups in terms of the number of Caesareans, ventouse deliveries, major haemorrhages, significant tears, or newborns needing neonatal care.
In the group that was left waiting, treatment with an oxytocin drip was avoided in 13% of women and, as expected, the deliveries took slightly longer.
A month after delivery both groups of women were equally positive or negative about their birth experience.
"A reasonable interpretation of these results is that it is safe to hold off with the oxytocin when the delivery process has been slow for two to three hours, and that this approach could help to bypass the unnecessary use of oxytocin in otherwise normal deliveries, which would also help to avoid unnecessary risks to the unborn child," said researcher, Anna Dencker, of the University of Gothenburg.
She believes that these findings will give midwives and obstetricians a scientific basis for taking a health-promotion approach to deliveries, particularly when healthy women are having their first child. She said it is essential to offer women and their families a good delivery environment, good delivery preparation and personal support with ongoing information on progress throughout the process.
"A normal first delivery and positive birth experience are extremely important and impact on future pregnancies and deliveries. However, more research is needed to identify the factors that contribute to negative experiences," Ms Dencker added.
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