Safe Administration of Oxytocin

Overview

Oxytocin is a high-alert medication frequently used to induce or enhance labour. The Institute for Safe Medication Practices Canada (ISMP) defines high-alert medications as drugs that have a heightened risk of causing significant harm when they are used inappropriately. The administration of oxytocin requires careful maternal-fetal monitoring and adherence to clinical guidelines to ensure the safety of both birthing individuals and their babies.

The Safe Administration of Oxytocin initiative is a collaborative effort led by the Provincial Council for Maternal and Child Health (PCMCH), and supported by BORN Ontario and healthcare partners across the province. Together, these organizations have developed and promoted standardized, evidence-based practices to support optimal outcomes and reduce complications during labour and birth.

Why This Matters

The development of the Safe Administration of Oxytocin guidelines and toolkit marks a critical step toward improving maternal and newborn safety across Ontario. Oxytocin is one of the most commonly used medications in labour, yet its administration carries significant risks when not carefully managed—contributing to adverse outcomes and medico-legal claims. A standardized, evidence-informed framework provides hospitals and care teams with consistent guidance that reflects best practices to reduce variations in care and supports safer clinical decision-making.

BORN's Role

Providing clinical reports to hospitals to track oxytocin use and outcomes
Collaborating with PCMCH to align data collection with best practice guidelines
Hosting webinars and training to support guideline implementation and interpretation of data

Impact and Benefits

Mom in the hospital, kissing her newborn's head

For Patients

Safer Birth Experience: Reduced risk of complications from oxytocin such as contractions that are too frequent which may lead to compromised blood flow to the fetus
Informed Decision-Making: Enhanced communication and shared decision-making with providers
Improved Monitoring: Enables early identification of risks and/or timely interventions through continuous monitoring during oxytocin administration

For Providers

Standardized Protocols: Clear guidelines for when and how to administer oxytocin
Clinical Decision Support: Access to hospital-specific data and provincial comparators via the BORN Information System
Training Resources: Webinars and toolkits to support safe practice

For Healthcare

Data-Driven Improvements: Real-time monitoring of perinatal indicators to guide quality improvement
System-Wide Alignment: Consistent practices across Ontario hospitals enhance equity and safety

Eligibility and Access

All Ontario birthing hospitals are encouraged to implement the Safe Administration of Oxytocin guidelines.

Access to BORN’s clinical reports is available through the BORN Information System (BIS), with support from BORN Regional Coordinators.

Feature Story

Publications and Resources

Institute of Safe Medication Practices, ISMP Canadian High-Alert Medication List, 2024.
Provincial Council for Maternal and Child Health, Safe Administration of Oxytocin Guideline Report, Toronto, 2024.

Society of Obstetricians and Gynaecologists of Canada, Guideline No. 396: Fetal Health Surveillance: Intrapartum Consensus Guideline, Journal of Obstetricians and Gynaecologists of Canada, March 2020.

Society of Obstetricians and Gynaecologists of Canada, Guideline No. 432c: Induction of Labour, January 2023.

Did You Know...

Oxytocin is one of the most commonly reported medications in labour-related safety incidents in Canada. Standardizing its use can significantly reduce risks like uterine rupture and fetal distress.

Stay Informed

Stay current with best practices for oxytocin administration by:

Reviewing the PCMCH Safe Administration of Oxytocin guideline
Participating in hospital-led audits, training sessions, or simulations
Engaging in unit or regional quality improvement discussions, including those that highlight key insights from the Safe Administration of Oxytocin report available in the BORN Information System