Well, I haven't received much input in regards to helping me pin down
whether my client really does have a deficit of oxytocin or not. (As she
believes, "no oxytocin at all" as a result of meningitis when a girl).  I
have a couple more thoughts that I want to run by you all.

You may have had few answers because not many people would have experience with this kind of thing.  My own personal experience (which I think I wrote at the time, but maybe didn't, because it is annecdotal) was that I had meningitis, and have/had no problem with milk supply, milk let-down, or orgasm.

First of all, no oxytocin seems a little hard to believe.  Mom had appropriate involution of her uterus, didn't she.   She didn't take pitocin or methergine for three weeks after delivery, did she?   Then oxytocin was present and in sufficient quantities to do its job.

 1)  The mom asked me about her Braxton-hicks contractions...  
  Excellent question, indeed, and I don't know the answer.  But if they do require oxytocin, is that a sign that there is enough oxytocin when needed to promote labor.?

2)  Another possible way to test, a week or so after birth, is to have
her be stimulated to orgasm, ...

Three possible problems with this train of thought:

Do we know "how much" oxytocin is necessary to do each job, and is it a variable quantity in each woman.  That is, can the brain be producing enough oxytocin to cause orgasm, but not enough to cause labor?  Does letdown require the same amount as orgasm or labor.  I know from ample experience with  using pitocin, that some women need just a little nudge from "vitamin P" and others can get to extremely high dosages without every reaching a satisfactory progress of labor.  (Of course, there are those who would argue that those high dosages are preventive of functional labor, but that is another discussion).

  Does oxytocin cause orgasm, or is it a byproduct of orgasm.   When I was pregnant with #5, having had miscarriages with the first four, the doctor said I could have sex, but only if it didn't bring me to orgasm (That was 26 years ago, and HE meant, I suppose, "you can let your husband satisfy his needs, just don't have too much fun yourself.")
His explanation was that if I came to orgasm, I would release oxytocin and possibly bring on a miscarriage.

Women can have fun without having orgasm;  and they may not have orgasms due to other things than lack of oxytocin.  Also, to stimulate mother to an orgasm, at one week post-partum, may not exactly be comfortable to mom, and seems to clinicalize the one of the few pleasant experiences we have left in life.  At one week post-partum, is lack of orgasm lack of oxytocin?  Is it competition between hormones readjusting themselves to non-pregnant life.  Is it discomfort or disinterest on the part of the mother?


  3) Third idea prenatal: Have mom do nipple stimulation and see if it
causes uterine contractions, ala non-stress testing...

There was a period of time in my hospital, probably five-eight years ago, where we tried to use nipple stimulation to induce labor. It might stimulate contractions strong enough for NSTs, but for labor it was      not a reliable agent.  If labor did result, it took a L-O-O-O-N-G time to stimulate contractions strong, long and regular enough to produce cervical change.  Most of the time it didn't work at all -- that is, it caused contractions, but no cervical change.   A few times it caused tetanic labor contractions and moms had to get terbutaline to stop the contractions and let the uterus recover.  

These are  my thoughts only, based primarily on personal experience (both as a patient and the nurse at the bedside), and no reading that I can particularly point to.

Sincerely,  Chanita