Pitocin Shortage: Burden or Blessing?

Is the national Pitocin shortage a burden or blessing? Due to the recent Pitocin shortage, hospitals and Ob/Gyn doctors are strategizing plans for how to optimize the use of this medically necessary drug.

It has become common practice to use Pitocin in the birthing process. Pregnant women are wondering what their options are if they were to need pharmacological aid to induce labor or prevent postpartum hemorrhage while Pitocin is in short supply.

What does Pitocin do?

Since Pitocin increases intracellular calcium ions, it is often used to induce labor and prevent excessive postpartum bleeding. According to the National Institutes of Health (NIH), uterine mobility and contraction are dependent on the presence and influence of calcium ions.

Therefore, Pitocin is a top choice for many Ob/Gyn doctors whose patients need to go ahead and give birth or who are experiencing excessive postpartum bleeding.

It has also become common practice to use Pitocin after delivery to prevent hemorrhaging. Pitocin is not recommended for elective inductions, defined as the initiation of labor without medical indications of need. Though Pitocin is indicated for non-elective inductions only, there is a wide range of symptoms that merit the use of this medication.

What caused the shortage?

The Pitocin shortage began on September 23 when Fresenius Kabi, one of the top two Pitocin suppliers, reported manufacturing delays. When only two major manufacturers, along with some small compounding pharmacies, supply this synthetic hormone, the ripple effects are surely felt when one of the manufacturers is having production problems.

I’m expecting. What are my options?

Women delivering before the New Year may be concerned about the decreased availability of this medication. However, this supply-demand causes us to evaluate processes and consider the current use. Evaluating the common use of synthetic hormones is always a good idea.

Though this drug is medically necessary, is it medically necessary for everyone? Many hospitals have already instituted an action plan to minimize risk for pregnant women. Some hospitals have developed a hierarchy that helps medical professionals evaluate the necessity of Pitocin use and have defined specific parameters in which to administer the drug.

Though some practices rely solely on Pitocin, other induction methods are available for pregnant women if Pitocin is in short supply in their local hospital. Historically, artificial rupture of membranes (AROM), commonly known as “breaking the water,” was and continues to be performed to decrease delivery time and hemorrhage risk.

Cervical ripening techniques, such as a small balloon and Misoprostol, have been effective in dilating the cervix and decreasing delivery time. According to the American College of Obstetricians and Gynecologists (ACOG), simple planning is essential.

Hospitals and staff should follow guidelines for Pitocin use.

Pitocin should not be used for convenience but only when medically indicated.

Medical professionals should consider other methods and medications that could be used in conjunction with Pitocin, therefore, elongating the supply.

Pregnant women should clearly communicate expectations and concerns with Ob/Gyn.

Pregnant women should establish a birthing plan that is clear and flexible.

Does the shortage increase risk?

Pregnant women may wonder if this manufacturing delay will put them at risk for pregnancy-related complications. Since alternative medications are available, these women should not be worried.

Many medical practices have been required to re-evaluate policies when it comes to the common practice of Pitocin administration. Some may see this as a burden or inconvenience. However, the low supply has been a valuable push for medical practices to evaluate the automatic administration of these synthetic hormones.

What’s next?

According to ASHP Foundation, an organization that represents patient care pharmacists, resupply of Pitocin should be back to normal by mid-December. Women expecting before the New Year should not be concerned but recognize that policies and procedures may be altered.

If they are concerned, pregnant women should talk to their Ob/Gyn physician to determine how the shortage has affected their local medical facility and establish a birthing plan.

Clear communication between patient and doctor is vital. This communication helps both the patient and doctor by decreasing patient risk and increasing the positive birthing experience for the mother-to-be.