The aims of the study were to characterize the uterine activity in sows treated with vetrabutin chlorhydrate (VC), an uterotonic and muscle-tropic drug during farrowing, and to measure the effects of the drug on piglet neonatal viability. The experiment involved 1478 piglets from 130 Yorkshire-Landrace sows, randomly allotted into two groups. Farrowing monitoring began 12 h after PGF2alpha synchronization. Group 1 was given physiological solution (G1, n = 65); Group 2 was treated with VC (1 mL/60 kg LW) at the initiation of fetal expulsion (G2, n = 65). In spite of the total duration of expulsion being significantly longer (P < 0.0001), approximately 35 min in the VC treatment, VC application at the time the first piglet was expulsed favored the alive birth of at least one more piglet. Even though the pressure in the uterus was similar in both groups, the number and duration of uterus contractions recorded were significantly less (P < 0.0001) in G2, favoring fewer births with acute fetal suffering, compared with that in G1. VC treated group compared with the control group also had fewer (5.01% vs. 24%) alterations in umbilical cords, as well as a lesser incidence of secondary apnea (2.08% vs. 7.46%) and bradycardia (1.94% vs. 7.61%), which favored a significantly higher vitality score (P < 0.002). With the intent to evaluate uterine activity in sows during the farrowing process, we propose using the equation used in human medical practices to calculate Montevideo Units applied to swine obstetrics for the first time.