I also wanted to mention something I learned about Pitocin from Pushed. Pit is the synthetic, pharmaceutically developed drug that mimics oxytocin, a natural hormone produced in humans. Pitocin is used to begin labour (induction: usually used in combination with a cervix softening drug that is placed on the cervix), or to augment labour that is slow or stalled. There are medical indications for induction and augmentation, but Pitocin is overused, especially in some hospitals. I personally know of no one who had a augmented labour, though I know several people who have been induced. I think augmented and managed labour is more prevalent/popular in America (though I can't speak for Canada beyond BC, and I have heard that the further West you go in Canada, the more physiological/natural birth tens to be), but it was interesting to read about Pitocin labours. Pit mimics oxytocin in stimulating the uterus to contract, but this stimulation tends to be on the strong side. Pitocin labours are reported to be much more painful than natural ones, and contractions stimulated by Pit are measured to be longer and stronger than your average natural contraction. Contractions that continue at that intensity are often hard for the baby to handle, too, because of the stress of being compressed, and because oxygenation of the placenta is reduced during contractions, so the baby has less oxygen in a Pit contraction than during an average natural one. Some babies get so deprived that they go into distress; hence, the higher need for cesareans with induced/augmented Pit labours.
But another interesting fact is that oxytocin crosses the blood-brain barrier, but Pitocin does not. Oxytocin crossing the blood-brain barrier causes endorphin release (pain relief!) AND stimulation of prolactin, which is the bonding and breastfeeding hormone. Pitocin not only doesn't stimulate endorphins and prolactin, it supresses the body's natural oxytocin, REDUCING the amount of oxytocin available to stimulate endorphin and prolactin release. SOOOO interesting! And so many implications!!
The pain of labour often stimulates fear, which also reduces oxytocin levels and increases pain perception. If women are well supported during labour and understand the fear-tension-pain cycle, they are generally better able to cope with the intensity of contractions. Pushed indicates that it is possible that pain in labour acts much like other pain, in that it gets you to move. If you burn your finger, moving it away from the source of pain is pretty important: if you sprain your ankle, moving it around helps you identify what feels best and what feels worst, and how to protect it. Same with labour. Movement in labour actually shortens the duration of labour because it wiggles the baby down through its tight squeeze journey from uterus to the outside world, so anything that stimulates that movement would be a good thing.
I've often felt that the pain of labour is meant to capture and focus a woman's attention. The pain says, "This is a really important event! You need to find a safe, private place to give birth! You need to pay attention! You need to focus on this important physiological process!" Without which, birth would be less safe.
So, between natural pain relief through endorphin release, natural bonding and breastfeeding physiology, and encouragement of movement and capturing the labouring woman's focus, natural oxytocin is superior to pharmaceutical pitocin.
I'm continually surprised by the amount of things there are to learn....