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Monday
Jul062009

"Pit to Distress": Your Ticket to an "Emergency" Cesarean?

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Jill from Keyboard Revolutionary wrote about a new term that she recently came across— “Pit to distress.”

“Pit to distress.” How have I not heard about this? Apparently it’s quite en vogue in many hospitals these days. Googling the term brings up a number of pages discussing the practice, which entails administering the highest possible dosage of Pitocin in order to deliberately distress the fetus, so a C-section can be performed.

 

Yes folks, you read that right. All that Pit is not to coerce mom’s body into birthing ASAP so they can turn that moneymaking bed over, but to purposefully squeeze all the oxygen out of her baby so they can put on a concerned face and say, “Oh dear, looks like we’re heading to the OR!”

 

The term is found in this 2006 article in this Wall Street Journal article:

 

Oxytocin is a hormone released during labor that causes contractions of the uterus. The most common brand name is Pitocin, which is a synthetic version. It’s often used to speed or jump-start labor, but if the contractions become too strong and frequent, the uterus becomes “hyperstimulated,” which may cause tearing and slow the supply of blood and oxygen to the fetus. Though there are no precise statistics on its use, IHI says reviews of medical-malpractice claims show oxytocin is involved in more than 50 percent of situations leading to birth trauma.

 

“Pitocin is used like candy in the OB world, and that’s one of the reasons for medical and legal risk,” says Carla Provost, assistant vice president at Baystate, who notes that in many hospitals it is common practice to “pit to distress” — or use the maximum dose of Pitocin to stimulate contractions.

 

 

It’s also used on this AllNurses forum:

I agree, and call aggressive pit protocols the “pit to distress, then cut” routine. Docs who have high c/s rates and like doing them, are the same ones that like the rapid fire knock em down/drag em out pit routines.

 

 

“Pit to distress” appears on page 182 of the textbook Labor and Delivery Nursing by Michelle Murray and Gayle Huelsmann. In this example, the onus is on the nurse to defend the patient from the doctor if he or she sees the order “pit to distress” by immediately notifying the supervisor or charge nurse.

 

 

 

 

Jill asks the questions, “OBs, do you still think women are choosing not to birth at your hospitals because Ricki Lake said homebirths are cool? Do you still think we are only out for a “good experience?”

 

I imagine that all of us who have openly questioned the practices of obstetricians in the U.S. have been hit with the same backlash. We must be selfish, irrational and motivated by our own personal satisfaction. We’ve been indoctrinated into a subculture of natural birth zealots and want to force pain on other women or just feel mighty and superior. We fetishize vaginal birth and attach magical powers to a so-called natural entrance to the world.

 

Nah. It’s stuff like “pit to distress” that made me run for the nearest freestanding birth center. If I had to do it all over again, I’d stay home.

 

 

 

Have you heard this term before? What is your experience with “Pit to distress?”

 

 

 

 

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Reader Comments (80)

That is truly disgusting. And then when the woman balks, they berate her for "putting her baby in danger"

July 6, 2009 | Unregistered Commenterlorien

Wow, I can't believe I have never heard of this before. It just makes me so mad. Purposely putting your baby in distress so they can wisk you off for a cesarean. This is not right!

Yet another example of how evidence based medicine is not practiced in obstetrics.

July 6, 2009 | Unregistered CommenterKayce

Remembering George W. Bush and the Love of OB-GYNs
Posted By Christine C. On January 19, 2009 (11:23 am) In Politics

On the final day of George W. Bush's presidency, we bid farewell not only to eight years of failed policies but to gaffes like this gem:

At a rally of cheering supporters in Poplar Bluff, Missouri, Bush made his usual pitch for limiting "frivolous lawsuits" that he said drive up the cost of health care and run doctors out of business.

But then he added, "We've got an issue in America. Too many good docs are getting out of business. Too many OB-GYNs aren't able to practice their love with women all across this country."

What's your favorite Bushism?

Article taken from Our Bodies Our Blog - http://www.ourbodiesourblog.org
URL to article: http://www.ourbodiesourblog.org/blog/2009/01/remembering-george-w-bush

No offense intended to any GB fans out there.

July 6, 2009 | Unregistered CommenterAnon

I am so glad I have a bit of a choice as to where I'm going to have my baby - I plan to have her at a local birth center staffed by midwives. They will whisk me off for a c-section if the baby is breech, but so far, at 37 weeks, she's still head down... Fingers crossed!

July 7, 2009 | Unregistered CommenterCaroLyn

I am so appalled by this that I cannot even gather my thoughts enough to express how I really feel. I am a doula and soon to be childbirth educator and my husband is a bit of a birth junkie himself. When I told him about 'pit to distress' his response was 'what do they think pregnant women are?'

i am with you, I would do it at home. I unfortunately had an inverted t incision c section (for a face first presentation) and don't know if VBACing at home is the wisest choice for me but I can guarantee you this, I will NOT be having any unnecessary interventions and I am educated enough to know when it's necessary or not.

July 7, 2009 | Unregistered CommenterAmy

Lorien, I agree. Try speaking up and you'll hear why you should leave your and your baby's health decisions to the doctor.

July 7, 2009 | Registered CommenterJill

CaroLyn, I didn't know you were so far along! Congrats and fingers crossed for heads down. :)

July 7, 2009 | Registered CommenterJill

Wow - crazy stuff! Thanks for letting us know!!

July 7, 2009 | Unregistered CommenterDiana

Amy, I am really appalled, too. I guess we all knew it happened but I never knew it had a name, indicating that it's totally deliberate.

Anon, I love that Bushism. It's so funny, yet it shows how clueless people (or at least Bush) are about the reasons for litigation. Is the above VBAC case frivolous? Hardly. That's malpractice.

July 7, 2009 | Registered CommenterJill

Oh. My. Lord.

*vomits*

Jill replied: Bonnie, I'll hold your hair back.

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