A first-of-its-kind research study at Aurora Sinai Medical Center in Milwaukee aims to determine whether chewable calcium carbonate tablets, commonly sold as the antacid Tums, can speed up the labor process for pregnant people.
“Many obstetricians, midwives and nurses have come to believe that a simple dose of calcium carbonate increases the rate of dilation in women who are experiencing prolonged or stalled labor – what clinicians refer to as labor dystocia,” said obstetrician and gynecologist Marie Forgie, DO, Advocate Aurora Research Institute’s principal investigator for the study. “This study will evaluate whether calcium carbonate – in conjunction with the standard use of Pitocin, or oxytocin, to induce labor – makes contractions more regular and effective, thus making labor smoother and shorter.”
Labor dystocia is one of the most common reasons doctors turn to cesarean section during delivery. Studies show that approximately 30% of all births in the U.S. are by cesarean section, and use of cesarean section has increased by more than 30% since 1976.
“Cesarean delivery can be lifesaving for both pregnant people and babies, but it is also associated with greater health risks and complications in later pregnancies,” Dr. Forgie said.
Additionally, prolonged labor and prolonged exposure to the common labor induction drug oxytocin are associated with increased risk of infection for both mom and baby, as well as damage to the mother’s uterus, bleeding and other negative health outcomes for newborns.
Intravenous oxytocin along with repositioning the laboring person are the current standards of care for stimulating contractions during an induction.
“The idea for this study started from labor and delivery nurses, both on our unit and on social media groups, who had anecdotally seen the addition of calcium carbonate as a low-cost and simple solution to prevent or correct labor dystocia,” said Emily Malloy, PhD, certified nurse midwife who is a co-investigator on the study.
The study will compare the use of a chewable 500mg tablet of calcium carbonate every four hours along with standard-dose oxytocin to deliveries using oxytocin only. Researchers plan to enroll 50 participants to voluntarily consent to receive calcium carbonate during their labor and delivery. The experiences of these participants will be compared to a randomized sample of past patients who only received oxytocin.
Calcium carbonate is frequently used to treat heartburn and indigestion and as a calcium supplement. When taken as directed in low doses, it has little to no risk of harm to the mother or fetus.
“We’re hopeful that these findings will be the starting point for identifying the potential impact of calcium carbonate on labor dystocia and can be used to guide future randomized controlled trials,” said Jessica Kram, MPH, administrative director of research for Aurora Health Care’s academic affairs department.
The researchers designed the study after a review of the scientific literature showed that calcium may improve uterine muscle contractility and carbonate may decrease lactic acid buildup that fatigues uterine muscles during labor. The researchers published their findings in the Journal of Patient-Centered Research and Reviews in 2023.
The study has been approved by the institutional review board and is funded by the Aurora UW Medical Group Pilot Funds.
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