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In Australia, synthetic oxytocin is most commonly known by the brand name Syntocinon, although generic oxytocin preparations may also be used in some hospitals. We do not use Pitocin, which is the brand name for synthetic oxytocin commonly used in the United States.
There is no doubt that synthetic oxytocin has an important place in maternity care and can be instrumental in saving lives. However, even the manufacturers state that it should not be used for routine induction or augmentation of labour unless there is a clear medical indication.
To administer synthetic oxytocin, an intravenous (IV) cannula is inserted into a vein, usually in the hand, wrist or arm. The medication is then delivered through an IV infusion using an electronic infusion pump, allowing the dose to be carefully adjusted according to the woman’s response. Because synthetic oxytocin can have a powerful effect on uterine activity, the baby’s heart rate and the frequency, duration and strength of contractions are monitored throughout the process.
When labour begins spontaneously, the body releases its own oxytocin, which stimulates contractions and works in harmony with other hormones involved in labour and birth. As contractions become stronger, the body also releases increasing amounts of endorphins, its natural pain-relieving hormones. This carefully coordinated hormonal feedback system allows labour to build gradually, helping many women adapt to the increasing intensity of their contractions over time.
Although synthetic oxytocin has the same chemical structure as naturally occurring oxytocin, it does not function in exactly the same way. Natural oxytocin is produced by the brain and released in pulses, creating a complex hormonal interplay that influences labour, pain perception and maternal behaviour. Synthetic oxytocin is administered through an IV infusion and does not readily cross the blood-brain barrier. As a result, it primarily acts on the muscles of the uterus rather than contributing to the full hormonal cascade that occurs during spontaneous labour.
Because synthetic oxytocin is delivered from outside the body and does not follow the brain’s natural pulsatile release pattern, contractions may become stronger, longer and closer together than those experienced in a spontaneous labour. Some women describe having less opportunity to rest between contractions, particularly if the uterus becomes overstimulated. This can make labour feel more intense and may increase the likelihood of requesting additional pain relief, including an epidural.
There is absolutely nothing wrong with choosing pain relief during labour. However, it is important for women to understand that labour stimulated with synthetic oxytocin can feel quite different from labour driven entirely by the body’s own hormonal processes. Understanding these differences can help women make informed decisions about induction, augmentation and pain management during labour.
Dr. Sarah Buckley, one of the world’s leading researchers in the hormonal physiology of pregnancy, labour and birth, has written extensively about the effects of synthetic oxytocin on labour and birth. Her article provides a deeper understanding of the hormonal differences between spontaneous labour and labour that is induced or augmented with synthetic oxytocin and is well worth reading for anyone wanting to explore this topic further.
Because it is difficult to predict exactly how any individual woman or baby will respond to synthetic oxytocin, most hospitals require continuous maternal and foetal monitoring when it is being used for induction or augmentation of labour. This is because synthetic oxytocin can cause contractions to become so much stronger, longer and more frequent than those seen in spontaneous labour.
During every contraction, blood flow and oxygen transfer to the baby are temporarily reduced. In most labours, babies tolerate this very well. However, if contractions become too frequent, too long, or too strong, there may be less time for the baby to recover between contractions, which can increase the risk of foetal distress and, in some cases, reduced oxygen levels (hypoxia). Continuous monitoring is therefore used to assess how both mother and baby are responding to the medication and to identify any concerns as early as possible.
If continuous monitoring is recommended, ask whether your hospital has access to the Monica Novii wireless monitoring system. Unlike traditional CTG monitoring, the Monica Novii uses adhesive patches rather than large elastic belts and transducer discs, allowing greater freedom of movement during labour. Many women find it more comfortable and less restrictive, particularly when changing positions.
If the Monica Novii is not available, ask whether telemetry (wireless or battery-operated monitoring) is an option. While telemetry still uses the traditional elastic straps and monitoring discs around the abdomen, it removes the cord connecting you to the CTG machine, allowing you greater mobility. This can make it easier to walk, change positions and, in many cases, use the shower during labour.
Even with telemetry monitoring, some women report finding the belts uncomfortable and frustrating, particularly as labour progresses. Another downside is that when you start moving like labouring women were designed to do, the monitor can occasionally lose the trace, prompting “big brother upstairs” to become concerned that something must be wrong when, more often than not, baby has simply moved or mum has changed position.
Like all medical interventions, induction and augmentation with Syntocinon (synthetic oxytocin) involve both benefits and risks. It is important that women receive information about these potential risks and have the opportunity to discuss any questions or concerns with their healthcare provider. For your reference, I have included the manufacturer’s Patient Information Leaflet at the bottom of this page so you can read the information provided by the pharmaceutical company that produces the medication.
Synthetic Oxytocin Benefits
It is important to recognise that every woman is an individual and may have different side effects or benefits to the use of synthetic oxytocin. Some of the benefits we know are:
Most women who receive Syntocinon will not experience serious complications. However, synthetic oxytocin is a powerful medication that directly affects the frequency, duration and strength of uterine contractions. As with any medication or medical intervention, there are potential risks and side effects that women should be aware of before consenting to its use.
Potential maternal risks and side effects include:
Potential risks to the baby include:
For women planning a VBAC, it is important to understand that the use of synthetic oxytocin is associated with a higher risk of uterine rupture compared with spontaneous labour. While the overall risk remains low, this is one of the reasons many care providers and hospitals will not induce labour with synthetic oxytocin.
The purpose of sharing these risks is not to create fear, but to support informed decision-making. Every intervention has both benefits and risks, and women have the right to receive balanced information, ask questions, and make decisions that align with their individual circumstances and preferences.
FURTHER RISKS & BENEFITS INFORMATION ON SYNTOCINON – CLICK HERE
This is the information insert found in the packaging of the Syntocinon that all women should read prior to receiving this.
Here are the RANZCOG Guidelines for induction of labour in Australian and New Zealand:
RANZCOG-Birth-after-previous-Caesarean-Section – see Section 5.10
OTHER INDUCTION METHODS
Stretch & Sweep – CLICK HERE
Prostaglandin Gels – CLICK HERE
Balloon Catheter (Foley’s or Cook’s) – CLICK HERE
Artificial Rupture of Membranes (AROM) – CLICK HERE
Hypnobirthing Classes Perth – CLICK HERE
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki