When oxytocin into a vein is used to help a pregnant woman have her baby, is it better to stop it or continue it once active labour has started?

Key messages

• When a pregnant woman has been given the medicine oxytocin into a vein to start or progress labour, stopping the oxytocin once she is in active labour, rather than continuing oxytocin until the baby is delivered, may make little or no difference to whether a caesarean section (delivery through cut in the tummy) is needed, and it seems to be safe for both mother and baby.

• Stopping the oxytocin when active labour begins may help avoid excessive contractions and reduce unnecessary exposure to medication, but it may mean that labour lasts longer, although the result for duration of labour was very uncertain.

• Decisions about whether to continue or stop oxytocin should be discussed with healthcare professionals and take into account the clinical situation (including labour progress, contractions, current condition of woman and baby), the monitoring that is available, and the woman’s preferences.

What is oxytocin?

In pregnant women, when near the time to deliver their baby ('term', which is after 37 weeks of pregnancy), artificial oxytocin is a medicine that is used to start the womb (uterus) contractions needed for labour or to make them stronger. It is often given through a drip into a vein. Once active labour is established (which is when the cervix has opened (dilated) at least 4 cm and contractions are happening regularly), it is thought that the body produces enough natural oxytocin to keep labour progressing. Continuing to give artificial oxytocin once a woman is in active labour may make contractions too frequent or too strong, which may cause stress to the baby and potentially increase the likelihood of a woman needing to have a caesarean section (cut across the tummy to get the baby out).

What did we want to find out?

We wanted to know whether stopping oxytocin once labour is active decreases the risk of caesarean, and whether it has any benefits or harms for mothers or babies.

What did we do?

We looked for studies that compared the two approaches in women with a term singleton pregnancy (that is, one baby, not having twins or triplets) who were receiving oxytocin for induction or to speed up labour, so that we could find out whether it is better to:

• stop oxytocin once the active phase of labour begins, or

• continue oxytocin until birth?

We searched for evidence up to 17 November 2025. We combined study results where possible to give us the maximum information. We assessed how trustworthy each study is and how confident we can be in the results, based on factors such as the size of the studies, whether they were well designed and carried out, and how precise their results were.

What did we find?

We included nine studies involving 4814 women. The studies took place in hospitals in Denmark, France, India, Iran, Israel, Thailand, Turkey, and the USA. The studies used several different definitions of active labour.

Main results

Stopping oxytocin during the active phase of labour:

• may make little or no difference to the number of caesarean births (8 studies, 4710 women);

• makes little or no difference to the number of instrumental births (5 studies, 3776 women); and

• may reduce the risk of contractions that are too frequent or too strong (called uterine tachysystole or hyperstimulation) (3 studies, 1371 women); but

• labour was about 35 minutes longer on average when oxytocin was stopped, though this result was very uncertain (8 studies, 4141 women).

In addition, during the active phase of labour, there is:

• no clear difference between continuation and discontinuation of oxytocin for Apgar scores (a quick assessment of how well a baby is doing after birth) (5 studies, 2096 women);

• no clear difference between continuation and discontinuation of oxytocin for signs of reduced oxygen supply to the baby before birth, measured by testing the blood from the umbilical cord after birth (6 studies 4086 women); and

• probably little to no difference between continuation and discontinuation of oxytocin in admission to the neonatal unit (7 studies, 4606 women).

What are the limitations of the evidence?

The reliability of the evidence varied a lot. We were sure about the results for instrumental births, Agpar scores, and reduced oxygen supply to the baby before birth, and quite sure about the results for neonatal unit admission. We were a little unsure about the results for caesarean section and uterine hyperstimulation, and very unsure about the results for the duration of the active phase of labour. Some reasons for uncertainty were that:

• study participants knew which group they were in, that is, whether oxytocin was continued or stopped, and this may have affected the results;

• studies used different definitions for the measures they reported, such as the active phase of labour, uterine tacysystole, and uterine hyperstimulation; and

• how long the pregnant women were in labour varied across the studies.

How up to date is this evidence?

The evidence is up to date to 17 November 2025.