Oxytocin is produced by pregnant women to cause the uterine contractions that precipitate childbirth. It may be administered if a doctor determines that, for any of a number of reasons, labor needs to be induced, or to hasten a difficult labor.

There have been questions raised about the safety and possible extensive overuse of this drug. Because it is introduced to the bloodstream continuously rather than in the periodic bursts with which the body would naturally release oxytocin, the decreased placental bloodflow that occurs as a side effect of a contraction is prolonged, and could deprive the baby of oxygen. If it stimulates excessively strong contraction leading to a violent and rapid delivery, oxytocin can potentially cause cervical lacerations, rupture of the uterus, postbirth hemorrhaging in the mother and other problems.

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Letter: Pains of birth
From Independent, The (London), 10/11/02 by KAREN RODGERS

Sir: I have been following your debate with great interest, since I gave birth to our first child last year. I heartily agree with Dr Steven Ford. I had come under huge pressure to be induced, which I managed to withstand, knowing of the risks involved. Since we were booked for a home birth I was attended by two wonderful community midwives, who came with us when a transfer to hospital became necessary for rehydration.

With the drip I had the lowest dose of the synthetic augmentation hormone Syntocinon; before I had this the contractions were very challenging but manageable; afterwards, they were the most dreadful thing I have experienced. Despite this, my two fantastic midwives provided the feeling of safety I needed to be able to refuse all further medical pain relief and after three further hours I gave birth to our beautiful daughter.

Because I had been given such continuity of care and support, she was born normally, awake, alert with her eyes open and completely relaxed; I will never forget the first sight of her face.

Dr Ford is right; those "powerful negative cultural influences" to which he alludes which push routine medicalisation of childbirth nearly robbed us of the most beautiful experience of our lives.

KAREN RODGERS

Cambridge

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