Book Review: Cervical Ripening and Induction and Augmentation of Labor

Did you know that during an induction with Pitocin that continued increases in the rate over a prolonged period can result in desensitization of the oxytocin receptors, actually making the artificial oxytocin LESS effective in producing normal uterine contractions? Learn about this and much more in Kathleen Rice Simpson’s new 37 page (+ references and Appendix) monograph, Cervical Ripening and Induction and Augmentation of Labor, available from AWHONN. Intended for labor and birth nurses, I have only two little quibbles with this excellent, well-researched pamphlet.

The first is that she states that the FDA removed the contraindication for the use of misoprostol (Cytotec) for women during pregnancy in 2002, but she doesn’t include the information that use of misoprostol for softening the cervix or labor induction is still NOT approved by the FDA. The second is that she states that synthetic oxytocin is chemically and physiologically identical to endogenous oxytocin. Some researchers have raised concerns about possible effects of altering the intricate orchestration of natural hormones.

For instance, a small study back in 1985 showed that women receiving artificial oxytocin did NOT have the same increases in endorphin levels that women who had spontaneous labors did. (The endorphin levels in the women with artificial oxytocin stayed the same.) What you will get in Dr. Rice’s monograph is the latest research about why recent increases in the number of inductions may not be such a good idea for mothers and babies and powerful research about why low-dose STANDARDIZED protocols should be adopted in all birth locations where Pitocin is given.

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