I have a date for my induction - and a little freaked out about it!

[trumansmom]

I guess this falls in the category of "be careful what you wish for". I've had a pretty rough pregnancy, and have been really, really eager to get it over and have my little one home. There have been several times over the past month or so where it looked like I was going to have to be induced, but then things always got better or test results came out surprisingly well, etc, and I've been able to continue my pregnancy.

Well, now I'm almost 38 weeks and my doc has decided it's time. Because I'm just barely starting to dilate (I'm 1 cm, but still very firm and high), she has scheduled it for a week from now in hopes that I progress more. I thought I'd be all excited, but now I'm freaking out at the thought of being induced. If I haven't progressed any further, she plans on using cytotec (and I've read both the horror stories and the happy stories about it), and then pitocin. Even though I went into labor naturally with Truman, I did end up having pitocin after about 20 hours of labor when I had spent several hours stuck at 4 cm. I don't have any negative feelings about it at all.

Anyway, sorry this is so longwinded. I've read some old threads on induction, but would love to hear others' stories as well.

Thanks!
Jeanne
Mom to Truman 11/29/01 and EDD 4/23/04!

[Rachels]

Why are you being induced? There are good reasons to do it and totally unjustified reasons to do it. I ask because if you're feeling freaked out at the thought, it might help you evaluate your choices if you were sure why your doc was recommending that. Remember that you DO have choices. If there isn't a medical reason for this induction, you don't have to agree to it. Cytotec can really be dangerous, as you know, and combined with pitocin it's a scary thing. I personally would never, ever agree to that unless there were clear evidence of immediate distress-- in which case it would be unlikely that an induction would be scheduled for a full week from now. Induced labors are often harder and include more interventions, because neither your body nor the baby were ready. It is NORMAL to still be pregnant at 38 weeks (or 39, or 40, or 41...) and you can decide to reclaim your authority about your body and your pregnancy.

I mention all of this because you're feeling upset at the thought of the induction. It's important to remember that you're a consumer, that your doctor works for you and not the other way around. You don't have to submit to medical procedures that make you uncomfortable, and if you and your baby are not imminently at risk, it's actually safer to refuse.



-Rachel
Mom to Abigail Rose
5/18/02

[aliceinwonderland]

No advice here, but a lady here at work HAD to be induced will all three of her boys: not because of pregnancy complications, but just because she would just never go into labor! SHe had good experiences all three times.

Looks like you'll beat me :) I'm still stuck at 80-85% effaced, no dilation. Basically the same as last week.

best of luck to you, do keep us posted if you can!

eri and the bean, due April 19th (follow the light, buddy!)

[AngelaS]

Both times I was induced, they got my labor started by simply breaking my water and seeing if I'd progress on my own---which I did. :D Is this an option for you?

(I'd be induced this way again if it was recommended by my midwife--my second delivery was exactly what I wanted even if I didn't start labor all by myself!) :D

[khakismom]

Wow Jeanne, so exciting! Can't wait to hear the good news around the corner! :)

I was induced with both girls and had no problems from the inductions. I would absolutely do it again if I had to. Both indictions were done with pitocin but I was already 2-3 cm dilated both times. (I was induced at 41w with Kathleen because I was overdue, and with Ellen at 39w because they were estimating that she'd be a large baby.) Got the epi with both because those pitocin contractions can be *very* painful, and I had no problems pushing. 30 mins with Kathleen and 5 mins with Ellen. No tearing or episiotomy with Ellen either.

Good luck, you'll do great!!! :) We'll be thinking of you!

[Rachels]

Eri, see my email! :) You're NOT stuck. You're just not laboring yet.

-Rachel
Mom to Abigail Rose
5/18/02

[COElizabeth]

Jeanne,

As you know, I had preeclampsia as well and was induced at just over 38 weeks. I just went back to check my pregnancy journal to make sure I got my facts straight, so I thought I would share what my doctor said at the time (keeping in mind that every case is different!).

At my 36-week appointment, my cervix was dilated to 1 cm and getting softer but was not at all effaced. My doctor and I were discussing induction, because she was fairly certain she would need to induce before I got to term. I asked how she would do it, and she said that if my cervix were not ready, I would go in the night before and have prostaglandin gel inserted and then start pitocin the next AM. I asked specifically if she would use Cytotec, and she told me that she probably would not in my case because it's less predictable than the other product (prostin?) and can cause really strong contractions. She said that given my complications, she could not be sure what the baby's environment was (my amniotic fluid was also measuring on the low end of normal) or how healthy the baby was, so she did not want to risk using Cytotec. She added that since I was already starting to soften and dilate, I "didn't need a bomb to go off in there."

At my 38-week appointment, my cervix was soft and dilated to 1.5 cm but still not effaced. At that point, we were planning an induction for 6 days later, and my doctor said she thought I could go straight to pitocin but that I might have a faster labor if I did the prostaglandin gel first. As it turned out, the next day's tests showed my preeclampsia was worsening, so I was induced that day. By then I was at 2 or 2.5 cm. The resident who inserted the gel said that my cervix was favorable, and that sometimes they were trying to induce when the cervix is completely hard and closed. I needed only one dose of the gel, and the pitocin was started about 4 hours later, and DS was born about 6.5 hours after that.

By the way, this isn't directly related to induction, but if you are under epidural anesthesia, I highly recommend asking your doctor about "passive descent." I was dilated to 10 cm, but the baby was still very high, so the nurse and doctor agreed that instead of pushing right away, I should just hang out and sit back in bed and let gravity help the baby down. When I started pushing over two hours later, I had to push for only 8 minutes before DS was born! Rachel told me that this technique makes sense, because women in natural childbirth tend to have a period when they are fully dilated but do not yet have the urge to push. I have also since read that "passive fetal descent," or "laboring down," as it is also called, tends to help babies avoid bad positions and lessens the overall amount of time spent pushing.

Best wishes for a safe and easy delivery of this baby girl!

Elizabeth, Mom to James, 9-20-02
EDD #2, 10-30-04

[trumansmom]

I guess I should have explained why. With both my son, and with this pregnancy, I've always skirted the line with preeclampsia. Although my labs have been coming back fine, every week my blood pressure has been sneaking up more and more. This is in spite of modified bedrest. Also, I have borderline gestational diabetes. Also, I have a softball sized ovarian cyst that is starting to cause pain again, but hasn't torsed. (Is that how you use that word?) Basically, while there isn't one thing that screams "induce", my doctor feels that the combination of everything, plus the fact the baby is measuring a bit large and I've been unable to gain very much weight this pregnancy, that it's in the best interest of my health to get the baby out of there.

In the meantime, she will be trying to strip my membranes first. She's actually tried twice now, but I haven't been dilated enough.

I see her again on Thursday, so one of the reasons I posted was to be fully armed with questions to ask.

Thanks!
Jeanne
Mom to Truman 11/29/01 and EDD 4/23/04!

[Calmegja2]

I had to be induced with my last three babies, and while I understand and appreciate what Rachel is saying, in cases that could turn eclamptic (which is where you sound like you're at), or like mine, where the risk of placental abruption is very, very high, sometimes you reach a point where all things being considered, induction becomes the greater good.

With all three of my inductions, we knew we were aiming for 36/37 weeks, as soon as we had positive lung amnios. We were scheduled from about 30 weeks on for our first "try date" which was usually in the 36th week (amnio in the morning, if lung function was a go, then induction).

I wish you the absolute best of luck. My last induction took place with a quarter tab of Cytotec (which did nothing much), and a break of the water (which crescendoed in baby being born about 45 minutes later)....I was very, very hesitant about the Cytotec, and read until I thought my eyes would bleed about it, but was very comfortable with my situation, with baby's situation, and with the care I was receiving, so we did choose to use it. The other two utilized a small amount of Pit and ruptured membranes.

Just ask questions until you know you've gotten everything you need to know. And ask anything you need to know here...I know so many of us have been induced, and can be helpful with what we've learned around the way.

My best advice for being induced is to bring something to do while you're going in. It generally takes longer than you'd expect to get the show on the road. I read an entire Kinsella novel waiting for baby boy, last time... ;-)

[firstbaby]

I completely understand where you're coming from. I was also induced and very freaked out. I was induced because I went one week + past my due date. I had an OB appt on my due date and when they said we should set an induction date for the following week I started to cry (side note - it freaked my husband out as he thought I was not happy about the baby but really I was just freaked out about having it :) ) The day before my induction I had another Dr. appt so that they could see if I'd progressed at all. I had been 2 cm for weeks but not really effaced (spelling?) but my OB didn't think I needed anything to thin.

I would go through the induction again tomorrow - I had a great experience. They broke my water, gave me pitocin and I was actually excited when I could start feeling contractions. I think part of what really bummed me out about an induction was I had this "romantic" vision of my water breaking or laboring at home and then sweetly turning towards my husband and telling him "it's time, honey - we need to go to the hospital" which probably never would have happened!!! When I got to 6 cm I got the epidural - part of me worried about having the energy to push - the contractions were kicking my butt!

They also had me wait for a little while once I was complete to push and let gravity help me out. In the end, I pushed for just over an hour and had a very healthy 9 pound boy.

I can totally understand your feelings of anxiety and apprehension. Please let me know if you have any questions I can help you with. Good luck!!! :)

[amp]

Hang in there, Jeanne. You're almost there! Good luck with the induction next week. We'll be thinking of you then!

[chantal66]

I highly recommend that you question the necessity of the induction and that you are convinced yourself that it is the right thing to do.

Nature has its way of doing things that doctors/medecine will never understand. There is a chemistry between the baby and the mother when everything is ready which pitocin cannot replace.

I was induced for my first one with a horrible experience.
On my second, I was pushed towards induction but did ask a lot of questions and delayed the induction date and finally went in labor on my own and it was a wonderful experience. It went so fast that I did not even needed any medications. I was in the shower 30 minutes after birth.

I am expecting my third and my doctor knows my position about induction. I am almost 38 weeks and I will not let anyone convince me that induction is the way to go. In fact my induction date had to be set and it is now 12 days after due date which should give me plenty of time. I plan on walking a lot and let nature runs its course.

I would never want to repeat my induction experience with the first child. Baby was not ready and was not well positioned so I ended up with vacuum, forcept and the whole nine yards !

Induction is a convenience for the doctors. They like to do it. They don't need to wake up in the middle of the night for delivery.
Breaking the water is not ideal either, this water acts as protection for the baby during the contractions.

Make sure you feel very confident about your choice before you embark into it or you may regret it later.

Chantal
Expecting #3 April 22nd !

[jubilee]

Best of luck on your induction! You soon will be holding a true gift from God! :)

[starrynight]

Just wanted to wish you luck!! :D

[Calmegja2]

"Induction is a convenience for the doctors. They like to do it. They don't need to wake up in the middle of the night for delivery.
Breaking the water is not ideal either, this water acts as protection for the baby during the contractions."


*****

Not in every case. I completely agree that there are too many inductions performed for convenience, and that nature should be, if possible, allowed to take its course.

I also know that there are inductions performed properly and for the right reasons, because if nature took its course, it might be disastrous.

My peris didn't induce for convenience. For me, and for others who are high risk, they induce because it can mean the difference between a positive outcome and a negative one.

Just food for thought. I know there are some strong anti-inductions feelings out there, but when truly medically necessitated (and with eclamptic indications, I see cause, or like mine, when baby was safer outside than in due to risk of abruption, dangerous for both of us) an induction can literally be a lifesaver. My inductions went easily, and without complications (outside of my existing medical status), and most importantly, resulted in my youngest three children.

I admit personal bias in this. I know I'm passionate about it. I would have done anything in the world I could do to protect my babies from harm, and it's hard when you know the reality is that your body can't handle the job properly (carrying the baby until nature labor onset), and that if you don't get the baby out at the first opportunity you have to do so in a controlled environment, that you could be risking everything.

Peace.

[COElizabeth]

Very true, Jessica. I don't think that blanket statement that "induction is a convenience for the doctors" was fair. Some women and babies would die or suffer long-term disability without induction. And I'll add that with my induction a doctor did have to come to the hospital in the middle of the night, and my own OB stayed with me until 9:30 in the evening. It certainly wasn't convenient for either of them, but it saved me from getting sicker. I'll certainly refuse any induction that is proposed for convenience, but it it's necessary for my health or my baby's, I will do it again.

Elizabeth, Mom to James, 9-20-02
EDD #2, 10-30-04

[Rachels]

>I had to be induced with my last three babies, and while I
>understand and appreciate what Rachel is saying, in cases that
>could turn eclamptic (which is where you sound like you're
>at), or like mine, where the risk of placental abruption is
>very, very high, sometimes you reach a point where all things
>being considered, induction becomes the greater good.

Jeanne, I totally agree. This is a solid medical reason to induce. It's an appropriate use of the technology. While I still question the cytotec, I think that what I said before is more applicable if there's NOT a good medical rationale for induction (and, quite often, there is not). But you have to do what's safest for yourself and your baby. Try to spend the week resting as much as you can, and be good to yourself. You'll have that little one in your arms soon!

[chantal66]

No doubt that medical intervention is sometimes necessary, I was just saying to not only put all your faith in your doctor but also have a judgement on your part based on the fact and the info that you get from your doctor.
If you do not say anything, doctors will never take risks (it can be very bad for their insurances). If they see that you try to understand the situation and understand your feeling about it, they can explain better the situation and the risks and why they are doing a certain procedure. I find that they do work with me better when I educate myself and ask questions.

I am not saying do not go for it, I am just saying ask questions so you can be in peace with your decision.

The birth is just a couple of hours, if it could have an impact on you or your baby, it is not worth taking any risks.

Good Luck !

Chantal

[pritchettzoo]

I hope your delivery goes smoothly and uneventfully (except for the big event of the baby of course!). My induction didn't work, but I still got a baby out of the deal. ;) You'll have one soon too. We can't wait to see pictures.

Anna
Mama to Gracie (9/16/03)

[egoldber]

Jeanne, no advice, just wanted you to know I'm thinking about you. I know how relieved you'll be to finally hold that little girl safe in your arms!

Take care,

[jojo2324]

Good luck Jeanne!! We'll be anxiously waiting for the news!! :)

[lisams]

From my research, cytotec is not approved for use in inductions and some pretty scary things have happened with it being used for induction. When I was induced they used prostaglandin - a gel that is placed at your cervix. It worked like a charm at softening my cervix and then I was given pitocin (the prostaglandin actually started my contractions). I would question why your dr. wants to use something not approved over something that is.

Good Luck!!
Lisa

[NancyJ_redo]

My induction went perfectly (I was 2 weeks overdue, with only slight effacement and dilation). They administered prostaglandin, broke my water and gave me pitocin, and later that day I delivered a beautiful baby boy.

You'll be in my thoughts Jeanne, I can't wait to hear of the little one's arrival!

[Calmegja2]

Cytotec has been used for quite awhile for inductions. Many medications are utilized in an offlabel manner. Cytotec is not unique, and has been analyzed carefully through obstetric testing, to weigh the benfits.

It has gotten a bad reputation, and articles about it like were found in Mother Jones didn't help, but when you look at the data, the information just isn't there to make the case.

http://www.childbirth.org/articles/cytotec.html

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=12302

***edited to add

I'm not trying to sound like a Cytotec pimp. I'm certainly not. How to induce is a decision dependent upon many things, and only a patient and her doctor working together should decide it together. I'm just trying to point out that Cytotec is not the debbil it sometimes is portrayed to be....with the right indications (patient's current health status and history, it can be used safely, at the same rate as other inductive agents)...it isn't the agent of choice for every delivery, but for some, it absolutely is.

[trumansmom]

Thanks everyone. It's amazing the difference 24 hours can make. I'm sure my emotions will continue to waffle over the next few days, but I'm feeling much, much more comfortable with this decision for many reasons.

First of all, I had a truly horrible day physically yesterday. I basically spent the entire day with intense back pain, which of course, sent my blood pressure up. And I know discomfort isn't a good reason for induction, but it sure made me look at it more fondly!

Secondly, I really spent time thinking about my relationship with my ob, and I do feel very confident that her suggestions are truly in my best interest. We discuss every option before finalizing anything, including the date of the induction. One of the additional reasons we chose that particular date was my level of comfort with the backup physician on call. We wanted to make sure if she couldn't be there for whatever reason, I had someone else I trusted. Also, I met this doctor for the first time when I had my first miscarriage. She was amazing. She has always gone the extra mile for me with each of my losses, and fought to get me in with the RE 3 months earlier than is normal when I was ttc this baby. She has a sister who has gone through similar battles having children, and has always made a point of treating me the way she wants her sister to be treated. I could go on and on about this wonderful woman, (and sort of already have!), but suffice it to say, I completely trust and respect her and believe that she will always take my concerns and feelings into consideration whenever possible. She respects that I research the heck out of any issue I encounter, and that I should be partner in any decision making.

And third, I'm starting to think I may go into labor naturally before next week! I had contractions 6 minutes apart for about 4 hours last night, and a heap of bloody show (I know, tmi!) this morning. So, maybe this is all a moot point.

Once again, I want to thank everyone for their stories and opinions. I knew this might be a controversial topic when I posted, and I really appreciate everyone making the effort to express their views without being contentious. It's one of the things I truly appreciate about this board. (Most of the time!)

Thanks again,

Jeanne
Mom to Truman 11/29/01 and EDD 4/23/04!

[nitaghei]

Jeanne,

Just wanted to say good luck!! And hope you go into labor naturally! It's great to have a doctor you trust - and yours sounds incredible.

Nita
mom to Neel, January 2003
dog mom to a cocker and a PWD

[bluej]

How did I miss this thread? Sounds like you might be getting ready to start labor on your own Jeanne! How exciting! Either way you will have your sweet baby girl in your arms soon! Good luck with everything and I hope you have a smooth labor and delivery.

[NEVE and TRISTAN]

Jeane,
I was thrilled to read your post and update!!!!
Our thoughts are with you and it sounds to me like you are in great hands to help you with your decision!!!!
However you get that precious baby will be the "right" way I have no doubt!!!!...
Big hugs and know we are all cheering for you!!!!
Neve
http://home.nc.rr.com/ourbabytristan
AKA "mama2be"-forgot password
and Baby Boy Tristan born @UNC
Feb 25, 2003
Brother to 3 pups "gees" and 2 kitties

[Rachels]

Woo hoo! Sounds like things are getting started! Best wishes for a wonderful birth!

-Rachel
Mom to Abigail Rose
5/18/02

[muskiesusan]

I just wanted to add my best wishes!! I can't believe we are so close to our dates and you will have a baby next week!!!!!

I will be thinking about you.

Susan
Mom to Nicholas 10/01/01
& Baby #2 due 4/23/04!!!!

[jamsmu]

Jeanne,

I loved being induced! Maybe I'm a wimp, but I didn't have the labor pain that I saw all the other girls going through. While I was checking in, then laying in bed laboring, I watched other girls walking around the ward, bending over and screaming, sweating, holding their breath... sure, I missed out on using the labor ball and taking a shower and all that I learned in class... but my active labor was faster than a lot (pitocin began at 7:40 am) and he was out at 4:33. I did staidol and epidural. The day was wonderful!

BTW-- I had to be induced as well. the water broke at 7:30 am on the 27th, I was sent home from the hospital at 1:30 that day to labor on my own. Nothing happened, so the induction was scheduled for 7:30 am on the 28th.

[aliceinwonderland]

YAY! Exciting!! Looks like the little miss is getting ready. I am living vicariously through you. Contrax and bloody show, my oh my!

BEST OF LUCK with your little April baby :)