Fill me in on Pregnancy Induction

So my wife is now 2 days overdue with our first. The appointment has been made for an induction in Thursday 24th. Now presumably we still have a good chance of having our daughter before then. But if it does come to it, what is involved?

Of course I mean Labour induction (inducement?) Doh!

It can involve an injection of oxytocin to stimulate contractions and the application of prostaglandin gel to the cervix to “ripen” it (cause it to soften and dilate). Trivia moment: the prostaglandin gel is manufactured using pig semen as an ingredient. In the big book of industries I don’t want to be involved in, that one scores pretty high.

Tabby

My advice is to not go down the intervention highway – but I’m in the minority with that opinion.

What they generally do is get her admitted into the hospital, all nice and “comfy” in a gown, with a wide stretchy band around her belly holding two flat plastic doo-dads connected to a machine. The doo-dads will monitor the baby’s heartrate, as well as give the nurses a general idea of when she’s contracting and how hard the contractions are.

Then a nurse will put an IV in her hand and start a medicine called “pitocin” (it’s the hormone oxytocin) dripping into the IV. Within about 20 minutes or so, your wife should start feeling contractions. (Some women it works almost instantly.)

After she’s contracting regularly and strongly, they’ll probably let her get up and walk around for a bit. Many hospitals now have transponders on their monitors, so she can be monitored while she’s walking the hallways. Some don’t, and the nurse will help her take the monitor out of her belly band while she walks.

As far as the labor goes, it’s often reported that an induced labor is harder and faster than an uninduced labor, but I don’t have any data to support that. The labor I last assisted at was induced, and she was still unmedicated (pain-wise), so if that’s important to your wife, let her know it can be done. Of couse, I’m firmly in the “unmedicated is nice, but there’s no trophy for it, so if you need meds, get 'em!” camp.

I assume they’ve told you things you can do to encourage labor without induction? Nipple stimulation, sex (if her water hasn’t broken yet), lots of activity? I’ll tell you a secret - prostaglandins work orally, as well as applied to the cervix. There’s lots of prostaglandins in your semen. You do the math. :wink:

A bit over 12 years ago I had my labor induced with HallBoy. It remains on my list of “Things I Wish I hadn’t done”. The short story is that the only “medical” reason for inducing him was that he was a big baby (10 lbs. 2 oz, but still smaller than HallGirl 2, born via natural deliver many years prior to his birth). The contractions were the Contractions from Hell TM, and the labor was far worse than anything I’ve ever experienced in my life (this was after two natural births with the HallGirls). Hallboy experienced fetal distress during contractions, which was very bad, very fast. Talk about major panic on my part (and that of my birthing coach). I recall my Birthing Coach calling the head nurse and saying, “CALL THE DOCTOR NOW!” I had an emergency C-Section (in what must have been record time). Thank Og Hallboy was fine, but there’s always a part of me that thinks, “If I’d just waited until I went into labor on my own…”

Personally, unless there’s a damn good medical reason, I wouldn’t recommend it for anyone.

It seems to be the standard in the UK. we’re only 2 days late and we have an appointment for Thursday next week.

I had a very good experience with induction. They started me at about 6 AM, and by 4 PM, my daughter was born. I have not yet had another baby, so I don’t know if the contractions were more or less painful than if I had gone into labor naturally, but overall it wasn’t too bad.

Everything I’ve read about induction puts me right in that minority with you. I’m not technically overdue until Saturday, but I’m going to do everything I can to avoid an induction (my midwife said they won’t let me go past 41 1/2 weeks, though). Even so, I’m really hoping he comes before then because I absolutely do NOT want Pitocin and will even fight my midwife on that one (who I’m typically in complete agreement with). As long as the baby is passing non-stress tests, I would prefer to go naturally as opposed to inducing labor with drugs. Granted, I’m okay with a membrane sweep for myself, but only because I’m already dilating and effacing - if I wasn’t doing either, I’d not do that, either.

From what I’ve read, Pitocin increases the risk of a C-section by forcing the body to labor when it may not necessarily be ready. There was an article in the Wall Street Journal about a month ago (July 12th issue) about some of the risks and how it’s being overused in some hospitals (due to liability, some hospitals are discouraging the use of Pitocin before 39 weeks). I can’t post the article here because all I can find is the text-version from another board, but I’m sure you can find it if you search WSJ.com. Not to mention, Pitocin-induced contractions are apparently 20 times more hellish than contractions without Pitocin. I’ve had friends who planned unmedicated births, were given Pitocin to augment their labor, and ended up with an epidural anyway because they just couldn’t take it anymore (and I don’t blame them at all).

I definitely understand the frustration of late pregnancy and a baby who feels like it’s never going to come (I started feeling that frustration two weeks ago when I started up with major cramping and irregular contractions that just haven’t stopped), but our bodies seem to know what they’re doing most of the time.

It seems to me that some docs are really quick to offer induction, and it’s overused. I really do think that forcing the body to go into labor when it may not be ready is why our C-section rate in the US has gotten higher.

E.

Is that always the case (that pitocin or another drug is given?) The reason I ask is because when I had my son, they broke my water, had me walk around for an hour or so, and within four hours, welcome Kid2U. No pitocin, nothing.

That’s sort of what happened to me. I went into labor naturally, but it stalled and showed no sign of progressing. After 27 or so hours, I agreed to have my water broken, which certainly got things moving. No pitocin required, but unfortunately (since I’d hoped for a natural birth) I did have an epidural because I could no longer handle the contractions. In fact, I nearly had an emergency c-section because the baby was in distress.

So, one of the things I’ve heard about inducing or speeding labor – that it leads to other interventions – was true for me. I’m in the “avoid it if possible” camp.

I’ve heard an Indian is good for kick starting things. Is there any particular curry, or is the active ingredient common to all ndian curries?

Were you in labor and it stalled? They used to break your water then, to try and re-start labor. They shy away from even that today, as it doesn’t always work, and once you’ve broken the water, you’re commited - that kid is coming out in the next 24 hours by one way or another, or you risk infection.

Plus, “dry” labor hurts more that intact water labor.

I don’t know anyone who would choose to break the water as a *first *step anymore.

Y’know, I hear doctors and midwives say this all the time, and I wonder what it really means. “Let me” go past 41 1/2 weeks? Excuse me, but the last I knew, I had to approve any medical procedure done to my body unless you have a judge’s order signed otherwise. The very most they could do is say, “Sorry, I’m not willing to deliver a 42 weeker - you’ll have to check into the hospital on your own.”

You *always *have a choice in your medical care, “policy” aside. This goes for drugs and c-sections and sugar water in the bottles, as well. If that nurse comes at me with an IV needle and I’ve not signed for pitocin, she’s getting slapped with an assault lawsuit.

(In the US, of course. I have no idea what the state of patient’s rights is in other countries.)

I’m not a fan of induced labor, either, by the way. But it’s the OP (and his wife’s) decision, best made after careful discussion with their midwife or doctor. I wanted to answer the OP, not get into a debate.

Some people think that any spicy food will help. I could WAG that because capsasin and some other spices irritate the GI tract, they could theoretically stimulate the uterine muscles, as well. Certainly things like drinking cod liver oil or the dreaded “California cocktail” work because they irritate your bowels. Your bowels start moving, and everything else “down there” starts moving as well. Sometimes. I don’t have any clinical data or studies to back this up, though.

If you’re into herbs, and your midwife/doctor says it’s ok, I’ve had great success with a mixture of tinctures of blue cohosh (Caulophyllym thalictroides), black cohosh (Cimicifuga racemosa) and beth root, also known as birth root, latin Trillium erectum. Discuss with your health care practitioner before use. I am not your herbalist. Herbalists are not licensed in the US, but even if I was a licensed herbalist, I’m not YOUR herbalist.

My son was ten days overdue, and came two days before I was to be induced…and his birthday is August 24, which may become your child’s birthday! I don’t labor well, so even though my water had broken, labor hadn’t started, so they did the enema thing…yuck…but labor started up right away then. But since, as I mentioned, I don’t labor well, I had to have pitocin…also not fun, but at least the labor was shorter than with my first, and he was a much bigger baby…over nine pounds, as opposed to the little six-pounder his sister was. He’ll be 22 next week.

Before the pitocin, they may use Cytotec gel on your wife’s cervix. If the cervix is not already effaced and/or dilated, this may help soften things up and get labor going.

I was induced at 35 weeks due to preeclampsia. I got two doses of the gel, which did pretty much diddlysquat, and then the next day they started me on Pitocin. It’s an IV hooked through a pump that meters it out slowly according to whatever the nurses set it for. I did really well - contractions I could feel, but they didn’t really hurt that bad - on a pretty high dose, right up until my OB decided to strip my membranes without asking me first. My water broke shortly thereafter, and labor turned into nightmarish pain for hours. I think I went for about seven hours, at which point I had dilated up to three centimeters (ten is fully dilated). At that point, I got an epidural, which let me sleep for a while. When I woke up, I was at ten centimeters. I pushed for four hours and then got a C-section.

I would try to avoid induction, but I would really try to avoid artificial rupture of membranes, based on my experience.

I had one induced labor and talked my doctor out of another one. He wanted to induce me on a certain date and I basically said no, not unless there’s a compelling medical reason. He said one more week, since I was (by his calculations) 10 days overdue. I don’t know how they do the calculations but in fact I knew exactly when I’d gotten pregnant and by my calculations, assuming a 280-day pregnancy, I was not overdue by any amount, but would have been when the week was up. Lo and behold, I went into labor before the new inflexible “due” date, and it’s so much nicer that way IMO.

But, if the OB insists on doing it that way, I would recommend your wife make some kind of bargain that an epidural either precedes or follows very shortly upon the heels of any administratin of pitocin. Also I know a lot of people who have had emergency c-sections after induced labor. All well and good as long as you get a healthy baby though. At that point everything’s worth it.

My labour was induced five weeks early, because I was beginning to develop toxemia.

On day 1 they inserted the gel - it induced contractions but they were non-productive and I didn’t dilate.

On day 2 they broke my water. No contractions yet. So they hooked me up to a pitocin drip and contractions started pretty quickly, and I dilated fairly rapidly as well.

From start to finish was about 5 hours (about 40 minutes of actual labour).

It was fast, scary and painful, but the end result was worth it. Good luck!

Thanks for all the info guys. Still nothing doing at this moment of time. Lots of pineapple and oranges being consumed.

Try some eggplant, too - apparently, that’s another one. (I hate eggplant, or I’d be having it for lunch every day). I wouldn’t recommend the castor oil, but it has seemed to work for several friends. I think they use about a teaspoon in a glass of orange juice. I don’t think I’d be that desperate, as it’s also caused serious gastro-intestinal distress for them, too.

WhyNot, when my midwife said they wouldn’t ‘let’ me go past 41 1/2 weeks, I think she was saying it for my benefit because I’m so miserable - he’s so low that I can’t walk without being in serious pain anymore. But both midwives also know that I want a natural, limited-intervention childbirth, so I’m pretty confident that an induction would be up for major discussion first.

E.

I’m glad so many Doper women are with me in the “no induction” camp. Induction … epidual … C-section is a road many, many are forced down needlessly. Unless you strongly advocate for yourselves, many hospitals do exactly what is easiest for them, which is to send you to bed to labor on your back.

With my last baby, I sent everyone out of the room (except my husband of course), told them to leave me alone and gave strict orders that no one was to offer me drugs. I gave birth to my 9-pound, 7-ouncer naturally (also my 8-pound, 7-ouncer in 1997). As with all my deliveries, the doctor did break my water, which was the only intervention I had. My two intervenion-laden deliveries were fraught with disasters (forceps delivery; spinal headache after epidural). Gah.

If only more women would realize a natural delivery is best for the baby, and some discomfort on mom’s part it to be expected. I will say, though – recovery from my natural deliveries was much, much easier.

[Disclaimer: I’m not saying anyone is a better mother for doing it naturally. Of course medical situations arise, like toxemia and preeclamsia already mentioned, among others, which necessitate interventions.]