Management of Protracted Active Labor with Nipple Stimulation: A Viable Tool for Midwives?

Ellen J. Razgaitis, CNM, MSN; Ashlee N. Lyvers, CNM, MSN


J Midwifery Womens Health. 2010;55(1):65-69. 

In This Article

Physiologic Mechanism of Nipple Stimulation

Nipple stimulation is predicated on the known mechanism of action of oxytocin. Mechanical stimulation of the nipple triggers the release of oxytocin from the posterior pituitary. Oxytocin binds to oxytocin receptors on the cell surfaces of uterine muscle. Once bound to these receptors, oxytocin activates the phospholipase C-inositol pathway, which results in the release of intracellular calcium. The increased intracellular calcium then acts to stimulate contraction of the myometrial cells, ultimately leading to organized uterine contractions. Oxytocin receptors increase in number by 100- to 300-fold at the time of parturition.[8] Despite knowledge of how oxytocin acts physiologically, there is no documentation that nipple stimulation can cause sufficient oxytocin release to resolve protracted labor.


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