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What if the Oxytocin is Discontinued?

• If it has been discontinued for less than 20-30 minutes, the FHR is normal, and contraction frequency, duration, and intensity are normal • Resume oxytocin at no more than half

the rate that caused the tachysystole, and gradually increase the rate as appropriate based on unit protocol and maternal-fetal status

• Simpson, 2020, p. s25

What if the Oxytocin is Discontinued?

• If the oxytocin has been discontinued for more than 30 to 40 minutes• restart at the initial dose ordered

• Simpson, 2020, p. s25

Uterine Rupture

• In the absence of prior uterine surgery, the risk in the nulliparas is low• However, remember: uterine rupture can also occur in an unscarred uterus

• Women at risk• grand multips

• fetal malpresentation

• overdistended uterus

• prior cesarean

Hyponatremia (Water Intoxication)

• Because oxytocin structurally related to vasopressin (antidiuretic hormone)

• Known to have antidiuretic properties when given in high doses (> 20 mU/min)

• More at risk if given with large volumes of hypotonic solution such as 0.45% sodium chloride

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•Water intoxication can lead to:•hyponatremia• confusion • convulsions• coma• congestive heart failure•death

Minimize Risk By:

•Using isotonic (physiologic) electrolyte containing IV solution

• Lactated Ringer’s is an isotonic, balanced electrolyte fluid

Hyponatremia (Water Intoxication)

• If high doses are given, increase concentration of oxytocin in solution rather than increase volume delivered

•Watch intake and output carefully!

Hypotension

• Can may occur after rapid IV boluses

• (5 to 10 U)

• Rapid IV boluses of undiluted oxytocin should not be given

• However, not all studies support this • (Smith & Merrill, 2006)

• AWHONN (2015) states that oxytocin should never be administered via IV push

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Other Potential Complications

•Placental abruption

•Precipitous delivery

•Lacerations

• Infection

•Postpartum atony and hemorrhage

•Neonatal hyperbilirubinemia

Issues

Questions…

• Are you comfortable with the Pitocin?• Are you comfortable with the EFM strip?• Are you caught up with your charting?

• Important to get things charted “real time” if possible

•Ask for help if you need it…

Staffing Issues

•Recommended nurse-patient ratio for augmentation or induction is• 1 nurse to 1 patient

• AWHONN (2010, p. 21)

•Note the term “recommended” not mandatory• Refer to Clark et al (2014) study listed in reference list

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Staffing Issues

•What if the provider wants pitocin started and staffing does not allow for appropriate monitoring at the time?•What would you say and what would you do?

Dosage Issue

•What if the provider asks you to increase the pitocin and you do not feel that it is appropriate for the patient at that time?•What would you say and do?

• It is not acceptable practice for nurses to follow doctor’s orders, when, based upon their nursing judgment, they disagree with those orders.

•Nurses are professionally accountable for their own actions.

Sample Documentation

• Discussed oxytocin and uterine activity with Dr. ______ . Nurse __________ notified to review the tracing and uterine activity.

• Lisa Miller, 2016, Common Questions on Documentation. In the Journal of Perinatal & Neonatal Nursing, January/March, p. 10

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Issues

•What if you call and ask the provider to come in and he/she refuses?•What would you say and do?

Issues

•What if the patient does not seem to be informed about why she is being induced?•What would you say and do?

Another Happy Labor Patient With Her Nurses

After a Successful Induction of Labor….References

• Abrão, K. C., Francisco, R. P. V., Miyadahira, S., Cicarelli, D. D., & Zugaib, M. (2009). Elevation of uterine basal tone and fetal heart rate abnormalities after labor analgesia: A randomized controlled trial. Obstetrics & Gynecology, 113(1), 41-47.

• Alanis, M. C., & Newman, R. B. (2009). Inducing labor during a complicated term pregnancy: When, why, and how. www.contemporaryobgyn.net 54(3), 32-44.

• Alfirevic, Z., Aflaifel, N., & Weeks, A. Oral misoprostol for induction of labour. Cochrane Database of Systematic Reviews 2014, Issue 6. Art. No.: CD001338; reviewed 2018 with no change to conclusions

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• American College of Obstetricians and Gynecologists (2020). Fetal macrosomia. Practice Bulletin #216, January. Washington, DC: ACOG.

• American Academy of Pediatrics & American College of Obstetricians and Gynecologists (2017). Guidelines for Perinatal Care, 8th edition. Elk Grove, IL: American Academy of Pediatrics.

• American College of Obstetricians and Gynecologists (2019). Medically indicated late-preterm and early-term deliveries. ACOG Committee Opinion Number 764, January 24, 2019. Washington, DC: ACOG.

• American College of Obstetricians and Gynecologists (2019). Avoidance of nonmedically indicated early-term deliveries and associated neonatal morbidities. ACOG Committee Opinion Number 765, January 24, 2019. Washington, DC: ACOG

• American College of Obstetricians and Gynecologists (2019). Vaginal birth after cesarean delivery. ACOG Practice Bulletin Number 205. Washington, DC: ACOG.

ACOG & SMFM Consensus Statement• http://www.acog.org/Resources_And_Publications/Obstetric_Care_C

onsensus_Series/Safe_Prevention_of_the_Primary_Cesarean_Delivery

• American College of Obstetricians and Gynecologists & Society for Maternal-Fetal Medicine (2014; reaffirmed 2016). Obstetric Care Consensus Safe Prevention of the Primary Cesarean Delivery. Number 1. March 2014.

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References

• American College of Obstetricians and Gynecologists (2014). revitalize: Obstetric data definitions (version 1.0). Retrieved from https://www.acog.org/-/media/project/acog/acogorg/files/pdfs/publications/revitalize-ob.pdf?la=en&hash=D9ECE1577C2A0B535F42C1B8DC492070

References• American College of Obstetricians and Gynecologists

(2013a; reaffirmed 2019). Definition of Term Pregnancy. ACOG Committee Opinion Number 579. November 2013.

• American College of Obstetricians and Gynecologists (2010; reaffirmed 2019). Management of Intrapartum Fetal Heart Rate Tracings. ACOG Practice Bulletin Number 116. Washington, DC: ACOG.

• American College of Obstetricians and Gynecologists (2009; reaffirmed 2019). Induction of labor. ACOG Practice Bulletin Number 107. Washington, DC: ACOG.

• American College of Obstetricians and Gynecologists (2009; reaffirmed 2019). Intrapartum fetal heart rate monitoring: Nomenclature, interpretation, and general management principles. ACOG Practice Bulletin Number 106, Washington, DC: ACOG.

• Association of Women’s Health, Obstetric and Neonatal Nurses (2019). Position Statement: Elective Induction of Labor. Washington, DC: AWHONN.

• Association of Women’s Health, Obstetric and Neonatal Nurses (2018). Fetal heart monitoring. Washington, DC: AWHONN.

• Association of Women’s Health, Obstetric and Neonatal Nurses (2015). Fetal Heart Monitoring Principles and Practices, 5th ed. Washington, DC: AWHONN

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• Association of Women’s Health, Obstetric and Neonatal Nurses (2015). Oxytocin administration for management of the third stage of labor. Practice Brief Number 2 Washington, DC: AWHONN.

• Association of Women’s Health, Obstetric and Neonatal Nurses (2010). Guidelines for Professional Registered Nurse Staffing for Perinatal Units. Washington, DC: AWHONN.

• Austin, S. C., Sanchez-Ramos, L., & Adair, D. (2010). Labor induction with intravaginal misoprostol compared with the dinoprostone vaginal insert: A systematic review and metaanalysis. American Journal of Obstetrics & Gynecology, 202:624.e1-9.

• Ayala, N. K., & Rouse, D. J. (2019). Nondefinitive studies of labor induction methods: Enough already! Editorial in Obstetrics & Gynecology, 134(1), 7-9.

• Baacke, K. A., & Edwards, R. K. (2006). Preinduction cervical assessment. Clinical Obstetrics and Gynecology, 49(3), 564-572.

• Bakker, P. C. A. M., Kurver, P. H. J., Kuik, D. J., & van Geijn, H. P. (2007). Elevated uterine activity increases the risk of fetal acidosis at birth. American Journal of Obstetrics & Gynecology, 196, 313e1-316e6.

• Bakker, P. C. A. M., & van Geijn, H. P. (2008). Uterine activity: Implications for the condition of the fetus. Journal of Perinatal Medicine, 36, 30-37.

• Best, G., Burton, C., & Pressman, E. (2001). The effects of oxytocin on maternal blood pressure during induction or augmentation of labor. American Journal of Obstetrics & Gynecology, SMFM Abstracts, 185(6), S103.

• Blackwell, S. C., Refuerzo, J., Chadha, R., & Samson, J. (2008). Duration of labor induction in nulliparous women at term: How long is long enough? American Journal of Perinatology, 25(4), 205-209.

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• Bor, P., Ledertoug, S., Boie, S., Knoblauch, NO, & Stornes, I. (2015). Continuation versus discontinuation of oxytocin infusion during the active phase of labour: A randomised controlled trial. BJOG, 123: 129-135.

• Boulvain, M., Kelly, A.J., Irion, O. Intracervicalprostaglandins for induction of labour. Cochrane Database of Systematic Reviews 2008, Issue 1.

• Boulvain, M., Stan, C. M., Irion, O. Membrane sweeping for induction of labour. Cochrane Database of Systematic Reviews 2005. Issue 1. Art No: CD000451. DOI: 10.1002/14651858 (edited with no change to conclusions published in Issue 1, 2010).

• Breedlove, G. (2019). Have we ARRIVEd at a new normal? MCN, 44(1), 59-60.

• Bricker, L., & Luckas, M. (2000; no change 2012). Amniotomy alone for induction of labour. Cochrane Database of Systematic Reviews, 2000. Issue 4. Art. No.: CD002862.

• Caldeyro-Barcia, & Poseiro, J. J. (1960). Physiology of the uterine contraction. Clinic Obstetr Gynecology, 3: 386-408.

• Carbone, J. F., Tuuli, M., Fogertey, P. J., Roehl, K. A., & Macones, G. A. (2013). Combination of foley bulb and vaginal misoprostol compared with vaginal misoprostol alone for cervical ripening and labor induction: A randomized controlled trial. Obstetrics & Gynecology, 121, 247-252.

• Chatroux, L. R., Caughey, A. B, Savitsky, L., Sargent, J., & Zwerling, B. (2017). Standardizing the usage of oxytocin during induction of labor with a checklist: A cost-effectiveness analysis. Obstetrics & Gynecology, 129, 38S.

• Chen, w., Xue, J., Peprah, M. K. , Wen, S. W., Walker, M., et al (2016). A systematic review and network meta-analysis comparing the use of Foley catheters, misoprostol, and dinoprostone for cervical ripening in the induction of labor. BJOG, 123, 346-354.

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• Cherouny, P. H., Federico, F. A., Haraden, C., Leavitt Gullo, S., & Resar, R. (2005). Idealized design of perinatal care (IHI Innovation Series white paper). Cambridge, MA: Institute for Healthcare Improvement.

• Chioss, G., Costantine, M. M., Bytautiene, E., Betancourt, A., Hankins, G. D. V. et al. (2012). In vitro myometrial contractility profiles of different pharmacological agents used for induction of labor. American Journal of Perinatology, 29, 699-704.

• Chiossi, G., Costantine, M. M., Bytautiene, E., Kechichian, T., Hankins, G. D. V. et al. (2012). The effects of prostaglandin E1 and Prostaglandin E2 on in vitro myometrial contractility and uterine structure. American Journal of Perinatology, 29, 615-622.

• Clark, S. L., Meyers, J. A., Frye, D. K., Garthwaite, T., Lee, A. L., & Perlin, J. B. (2015). Recognition and response to electronic fetal heart rate patterns: Impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor. American Journal of Obstetrics & Gynecology, 212, 494e1-6.

• Clark, S. L., Saade, G. A., Meyers, J. A., Frye, D. R., & Perlin, J. B. (2014). The clinical and economic impact of nurse to patient staffing ratios in women receiving intrapartum oxytocin. American Journal of Perinatology, 31, 119-124.

• Clark, S. L., Belfort, M. A., Byrum, S. L., Meyers, J. A., & Perlin, J. B. (2008). Improved outcomes, fewer cesarean deliveries, and reduced litigation: results of a new paradigm in patient safety. American Journal of Obstetrics & Gynecology, 199, 105.e1-105.e7.

• Clark, S. L., Belfort, M. A., Dildy, G. A., & Meyers, J. A. (2008). Reducing obstetric litigation through alterations in practice patterns. Obstetrics & Gynecology, 112(6), 1279-283.

• Clark, S., Belfort, M., Saade, G., Hankins, G., Miller, D., & Frye, D. (2007). Implementation of a conservative oxytocin-based protocol for oxytocin administration: maternal and newborn outcomes. American Journal of Obstetrics & Gynecology, 197: 480.e1-480.e5.

• Clark, S. L., Simpson, K. R., Knox, E., & Garite, T. J. (2009). Oxytocin: new perspectives on an old drug. American Journal of Obstetrics & Gynecology, 200: 35.e1-35.e6.

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• Connolly, K. A., Kohari, K. S., Rekawek, P., et al (2016). A randomized controlled trial of Foley balloon induction of labor trial in nulliparas (FIAT-N). American Journal of Obstetrics & Gynecology, September, 2016, 392.e1-392.e6.

• Crane, J. M. G. (2006). Factors predicting labor induction success: A critical analysis. Clinical Obstetrics and Gynecology, 49(3), 573-584.

• Daniel-Spiegel, E., Weiner, Z., Ben-shlomo, I., & Shalev, E. (2004). How long should oxytocin be continued during induction of labor? BJOG: an International Journal of Obstetrics and Gynaecology, 111, 331-334.

• Diven, L. C., Rochon, M. L., Gogle, J., Eid, S., Smulian, J. C., & Quinones, J. N. (2012). Oxytocin discontinuation during active labor in women who undergo labor induction. American Journal of Obstetrics & Gynecology, 207:471e1-8.

• Doyle, J., Kenny, T. H., Burkett, A. M., & von Gruenigen, V. E. (2011). A performance improvement process to tackle tachysystole. JOGNN, 40(5), 512-519.

• Drummond, S. (2018). Oxytocin use in labor: Legal implications. Journal of Perinatal Neonatal Nursing, 32(10, 34-42.

• Dudley, D. J. (1997). Oxytocin: Use and abuse, science and art. Clinical Obstetrics and Gynecology, 40(3), 516-524.

• Durham, L., Veltman, L., Davis, P., et al (2008). Standardized criteria for scheduling elective labor inductions. MCN, 33(3), 159-165.

• Ehrenthal, D. B., Jiang, X, & Strobino, D. M. (2010). Labor induction and the risk of cesarean delivery among nulliparous women at term. Obstetrics & Gynecology, 116(1), 35-42.

• Freeman, R. K., Garite, T. J., Nageotte, M. P., & Miller, L. A. (2012). Fetal Heart Rate Monitoring, 4th edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

• Freeman, R. K., & Nageotte, M. (2007). A protocol for the use of oxytocin. American Journal of Obstetrics & Gynecology, 197, 445-446.

• Gard, J. W., Alexander, J. M., Bawdon, R. E., & Albrect, J. T. (2002). Oxytocin preparation stability in several common obstetric intravenous solutions. American Journal of Obstetrics & Gynecology, 186, 496-498.

• Garite, T. J., & Simpson, K. R. (2011). Intrauterine resuscitation. Clinical Obstetrics and Gynecology, 54(1), 28-39.

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• Garza, M. (2000). Inducing labor increases legal risks. OB-GYN Malpractice Prevention, 7(10), 73-78.

• Girard, B., Vardon, D., Creveuil, C., Herlicoviez, M., & Dreyfus, M. (2009). Discontinuation of oxytocin in the active phase of labor. Acta Obstetricia et Gynecologica, 88, 172-177.

• Grobman, W. A., et al (2018). Defining failed induction of labor, American Journal of Obstetrics & Gynecology, 218(1), 122e1-122e8.

• Grobman, W. A., et al (2018). Labor induction compared with expectant management of low-risk nulliparous women. The New England Journal of Medicine, 379(6), pp. 513-523.

• Grotegut, C. A., Paglia, M. J., Johnson, L. N. C., Thames, B., & James, A. H. (2011). Oxytocin exposure during labor among women with postpartum hemorrhage secondary to uterine atony. American Journal of Obstetrics & Gynecology, 204:56.e1-6.

• Hadi, H. (2000). Cervical ripening and labor induction: Clinical guidelines. Clinical Obstetrics and Gynecology, 43(3), 524-536.

• Harper, L. M., Caughey, A. B., Odibo, A. O., Roehl, K. A., Zhao, Q., & Cahill, A. G. (2012). Normal progress of induced labor. Obstetrics & Gynecology, 119(6), 1113-1118.

• Harvey, C. J., & Witcher, P. M. (2005). Reducing the legal risks of labor induction and augmentation. OBG Management, November 2005, 30-44.

• Hayes, E. J., & Weinstein, L. (2008). Improving patient safety and uniformity of care by a standardized regimen for the use of oxytocin. American Journal of Obstetrics & Gynecology, 198: 622.e1-622.e7.

• Hernandez-Martinez, A., Arias-Arias, A., et al. (2019). Oxytocin discontinuation after the active phase of induced labor: A systematic review. Women and Birth, 32, pp. 112-118.

• Hofmeyr GJ, Gülmezoglu, AM., & Pileggi, C. Vaginal misoprostol for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2010, Issue 10.

• Howard, E. D. (2019). To induce or not to induce: Is that the question? The Journal of Perinatal & Neonatal Nursing, 33(3), 209-210.

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• Howarth, G., & Borha, D. J. Amniotomy plus intravenous oxytocin for induction of labour. Cochrane Database of Systematic Reviews 2001, Issue 3; Edited 2013 (no change to conclusions).

• Institute for Safe Medication Practices. https://www.ismp.org/recommendations/high-alert-medications-acute-list

• Johnson, N., & Montague, I. (1994). The effect of oxytocin-induced hyperstimulation on fetal oxygen. British Journal of Obstetrics and Gynaecology, 101, 805-807.

• Joint Commission on Accreditation of Healthcare Organizations (2005). Do not use list. Oakbrook Terrace, IL: Author.

• Kavanagh, J., Kelly, A. J., & Thomas, J. (2005). Breast stimulation for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2005, Issue 3, no change to conclusions 2010. Art number: CD003392.

• Kavanagh, J., Kelly, A. J., & Thomas, J. (2001). Sexual intercourse for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2001; Issue 2, Art number: CD003093. Edited 2008 (no change to conclusions)

• Khan, R., El-Refaey, H., Sharma, S., Sooranna, D., & Stafford, M. (2004). Oral, rectal, and vaginal pharmokinetics of misoprostol. Obstetrics and Gynecology, 103, 866-870.

• Krening, C. F., Rehling-Anthony, K., & Garko, C. (2012). Oxytocin administration the transition to a safer model of care. Journal of Perinatal Neonatal Nursing, 26(1), 15-24.

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• Kunz, M. K., Loftus, R. J., & Nichols, A. A. (2012). Incidence of uterine tachysystole in women induced with oxytocin. JOGNN, 42, 12-18.

• Lassey, S. C., Napoe, G. S., Carusi, D., et al. (2019). Hyponatremia among parturients transferred to the hospital after prolonged labor during an attempted home birth. Obstetrics & Gynecology, 134(1), 106-108.

• Lin, M. G., & Rouse, D. J. (2006). What is a failed labor induction? Clinical Obstetrics and Gynecology, 49(3), 585-593.

• Macones, G. A., Cahill, A., Stamilio, D. M., & Odibo, A. O. (2012). The efficacy of early amniotomy in nulliparous labor induction: A randomized controlled trial. American Journal of Obstetrics & Gynecology, 207, 403.e1-5.

• Macones, G. A., Hankins, G. D. V., Spong, C., Hauth, J., & Moore, T. (2008). The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring: Update on definitions, interpretation, and research guidelines. Obstetrics & Gynecology, 112(3), 661-666.

• Magro-Malosso, E. R., Saccone, G., Chen, M., Navathe, R., Tommaso, M. D., & Berghella, V. (2017). Induction of labour for suspected macrosomia at term in non-diabetic women: A systematic review and meta-analysis of randomized controlled trials. BJOG, 124, 414-421.

• Marrs, C., LaRosa, M. L., Caughey, A., & Saade, G. (2019). Elective induction at 39 weeks gestation and the implications of a large, multicenter, randomized controlled trial. Obstetrics & Gynecology, 133(3), 445-450.

• McMaster, K., Sanchez-Ramos, L., & Kaunitz, A. M. (2015). Evaluation of a transcervical foley catheter as a source of infection: A systematic review and meta-analysis. Obstetrics & Gynecology, 126(3), 539-551.

• McNamara, H. (1995). The effect of uterine contractions on fetal oxygen saturation. British Journal of Obstetrics and Gynaecology, 102, 644-647.

• Moleti, C. A. (2009). Trends and controversies in labor induction. MCN, 34(1), 40-47.

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Legal and Risk Management

• Miller, L. A. (2012). Elective induction: Is it worth the risk? (A 3-Part Series). The Journal of Perinatal Neonatal Nursing, 26(2), 112-114.

• Miller, L. A. (2012). Elective induction: Is it worth the risk? (Part 2 of a 3-Part Series). The Journal of Perinatal Neonatal Nursing, 26(3), 196-199.

• Miller, L. A. (2012). Elective induction: Is it worth the risk? (Conclusion of a 3-Part Series). The Journal of Perinatal Neonatal Nursing, 26(4), 289-292.

• Miller, L. A. (2009). Oxytocin, excessive uterine activity, and patient safety: Time for a collaborative approach. Journal of Perinatal Neonatal Nursing, 23(1), 52-58.

• Miller, L. (2007). Advanced Fetal Monitoring: Clinical comprehension – Communication – Collaboration. Presented on May 3 and 4, 2007 in Kansas City, Missouri.

• Miller, L. A., & Miller, D. A., & Cypher, R. L. (2017). Fetal Monitoring A Multidisciplinary Approach, 8th ed. St. Louis: Elsevier/Mosby.

• Muzonzini, G., Hofmeyr GJ. Buccal or sublingual misoprostol for cervical ripening and induction of labour. Cochrane Database of Systematic Reviews 2004, Issue 4. (edited no change in conclusions published in Issue 1, 2010);

• Pearson, N. (2011). Oxytocin safety legal implications for perinatal nurses. Nursing for Women’s Health, 15(2), 110-117.

• Phaneuf, S., Rodriguez Lifiares, B., TambyRaja, R. L., MacKenzie, I. Z., & Lopez Bernal, A. (2000). Loss of myometrial oxytocin receptors during oxytocin-induced and oxytocin-augmented labor. Journal of Reproduction and Fertility, 120, 91-97.

• Phico (1997). The induction and stimulation of labor with oxytocin. Mechanicsburg, PA: Phico Group, Inc.

• Phillippi, J. C., & King, T. L. (2018). Assessing the value of the ARRIVE trial for clinical practice: Sea change or just a splash? Journal of Nurse Midwifery & Women’s Health, 63(6), 645-647.

• Phillips, L. D. (1997). Manual of I.V. Therapeutics, 2nd

edition. Philadelphia: F. A. Davis Company.

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• Prasad, M. R., & Funai, E. (2012). Oxytocin use during active labor: too much of a good thing? American Journal of Obstetrics & Gynecology, 207: 439-440.

• Robinson, C., Schumann, R., Zhang, P., & Young, R. C. (2003). Oxytocin-induced desensitization of the oxytocin receptor. American Journal of Obstetrics & Gynecology, 188, 497-502.

• Rohn, A., E., et al. (2015). Unintended clinical consequences of the implementation of a checklist-based low-dose oxytocin protocol. American Journal of Perinatology, 32(4), 371-378.

• Saccone, G., & Berghella, V. (2015). Induction of labor at full term: A systematic review and metaanalysis of randomized controlled trials. American Journal of Obstetrics & Gynecology, 213(5), 629-636.

• Saccone, G., Ciardulli, A., Baxter, J. K., et al (2017). Discontinuing oxytocin infusion in the active phase of labor: A systematic review and meta-analysis. Obstetrics & Gynecology, 130(5), 1090-1096.

• Sanchez-Ramos & Kaunitz (2000). Misoprostol for Cervical Ripening and Labor Induction: A Systematic Review of the Literature. Clinical Obstetrics & Gynecology, 43(3), 475-488.

• Signore, C. (2010). No time for complacency: Labor inductions, cesarean deliveries, and the definition of “term.” Obstetrics & Gynecology, 116(1), 4-6.

• Simpson, K. R. (2015). Maternal oxygen administration as an intrauterine resuscitation measure during labor. MCN, 40(2), 136.

• Simpson, K. R. (2012). Just say no. MCN, 37(1), p. 71.

• Simpson, K. R. (March 28, 2009). Personal communication from Kathleen Simpson.

• Simpson, K. R. (2008). Excessive uterine activity during labor. MCN, 33(6), 396.

• Simpson, K. R., & O’Brien-Abel, N. (2014). Labor and birth. Chapter 14 In K. R. Simpson & P. A. Creehan(Eds.), pp. 343-444, AWHONN’s Perinatal Nursing (4th ed). Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins.

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• Simpson, K. R. (2004). Management of oxytocin for labor induction and augmentation. MCN, 29(2), 136.

• Simpson, K. R., & Knox, G. E. (2003). Common areas of litigation related to care during labor and birth: Recommendations to promote patient safety and decrease risk exposure. Journal of Perinatal Neonatal Nursing, 17(2), 110-125.

• Simpson, K. R. (2020). Cervical ripening and labor induction and augmentation, 5th edition. Washington, D.C.: AWHONN.

• Simpson, K. R., & James, D. C. (2008). Effects of oxytocin-induced hyperstimulation during labor on fetal oxygen status and fetal heart rate patterns. American Journal of Obstetrics & Gynecology, 199(1),34e1-34e5.

• Simpson, K. R., & Miller, L. (2011). Assessment and optimization of uterine activity during labor. Clinical Obstetrics and Gynecology, 54(1), 40-49.

• Society of Maternal-Fetal (SMFM) Publications Committee (2019). SMFM statement on elective induction of labor in low-risk nulliparous women at term: the ARRIVE trial. www.smfm.org

• Society for Maternal-Fetal Medicine; Bernstein, P. S., Combs, C. A., Shields, L. E., Clark, S. L., Eppes, C. S.; and the SMFM Patient Safety and Quality Committee (2017). The development and implementation of checklists in obstetrics. www.smfm.org

• Spong, C. Y, (2013). Defining “Term” Pregnancy: Recommendations From the Defining “Term” Pregnancy Workgroup. JAMA 309(23), 2445-2446.

• Spong, C. Y., Berghella, V., Wenstrom, K. D., Mercer, B. M., & Saade, G. R. (2012). Preventing the first cesarean delivery. Summary of the Joint Eunice Kennedy Shriver National Institute of Child Health and Human Development, Society for Maternal-Fetal Medicine, and the American College of Obstetricians and Gynecologists Workshop. Obstetrics & Gynecology, 120(5), 1181-1193.

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• Smith, J. G., & Merrill, D. C. (2006). Oxytocin for induction of labor. Clinical Obstetrics and Gynecology, 49(3), 594-608.

• Sundin, C., Mazac, L., Ellis, K., & Garbo, C. (2018). Implementation of an oxytocin checklist to improve clinical outcomes. MCN, 43(3), 133-138.

• Swamy, G. K. (2012). Current methods of labor induction. Seminars in Perinatology, 36, 348-352.

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