scheduled induction!???

[trales]

Okay, so after DD was born almost 7 years ago, I suffered a lot of pelvic floor damage, that has been getting worse over time in terms of muscle control of bladder and bowels. So, after seeing 3 specialists, the recommendation is that I either have a scheduled c-section or that I am induced 1 week early so that the baby has a potentially smaller head, if things do not progress well, then I may still end of up with the c-section. My OB is a good friend and we have talked at great length about this, it would be ideal for me to go into labor early on my own, but we cannot count on that. Another good friend is an OB who is very, very pro vaginal delivery with no intervention and is pro VBAC etc. He really feels this plan is good for my particular circumstances. Everyone keeps expressing, that it is totally up to me and I can do what I want. They also agree that no matter what I will most likely end up having reconstructive surgery and the idea of having a c-section makes another fairly major surgery so it would be best to try to get the baby out vaginally and early and smaller.

It is taking some getting used to. I can't have my membranes stripped b/c of course, I tested Strep B Group +. The plan is cervidil and then 12 hours later having pitocin. If I could figure out a way to induce labor "naturally" before I get to the hospital and have to go through the whole hospital induction thing. Opinions, commiserations, ideas. . . . .

[SnuggleBuggles]

How much smaller will baby's head really be? I just don't know if the difference would really be at all significant. I'd imagine birthing position matters more. I obviously come from a wait and see approach though. Lots of inductions go really well, especially with experienced moms. Good luck!

[schrocat]

I've had 3 inductions, all with pitocin, one with both cervadil and pitocin. In the case of my first child it was an induction at over 40 weeks and I had to push for 3 hours because his head was too big and stuck . I wish I had been induced a week earlier. My 37 week inductions were both relatively easy with pushing though the last induction I had took forever.

[rin]

Sex. To completion. Semen contains prostaglandins which soften the cervix and totally serve as a labor inducer. It works best if y'all aren't generally having sex, since apparently you can sort of build up a tolerance.

[AshleyAnn]

I delivered DD thru an induction using cervidil and pitocin with no epidural (she was rather small for 37 weeks, roughly 35 weeks size) and while it was intense the pushing was quick and not difficult for me like some women I've seen on birthing shows. I felt the "ring of fire" as they call it and then knew it was time to PUSH and 2.5 pushes she was here.

[KpbS]

I had a repeat c-section with DD. DS2 was a complete shock emergency c delivery which we later learned through pathology was not an abruption but nonetheless presently the exact same. I felt confident in the pathologist's diagnosis however I had no interest whatsoever in a vbac, even though DS1 was a vaginal birth. I was nervous about my scheduled repeat C but it went perfectly well and such a different experience than the emergency.

Honestly in your case where you know there is existing damage to the pelvic floor muscles affecting bladder and bowels I would most definitely repeat the c section versus risk further damage unless your DC was somehow at risk.

Hugs! :hug:

[trales]

The last time was not a c-section, it was vaginal with a 4th degree episiomoty, which did all the damage. I guess the feeling between the 2 pelvic floor folks and the OB is that C-section does not necessarily prevent pelvic floor issues and since I am facing one surgical repair, it would be better to avoid another at this time.

[SnuggleBuggles]

I'd have a hard time going the c-section route and having 2 surgeries. I'd probably roll the dice on the definite surgery.

[KpbS]

The last time was not a c-section, it was vaginal with a 4th degree episiomoty, which did all the damage. I guess the feeling between the 2 pelvic floor folks and the OB is that C-section does not necessarily prevent pelvic floor issues and since I am facing one surgical repair, it would be better to avoid another at this time.

I see, I misunderstood! I wish they could somehow combine the two, c-section, then scheduled pelvic floor repair. I agree, the fewer surgeries, the better. Hoping for a smooth delivery for you!

[pinay]

I was induced with both DD1 and DD2- DD1 was more or less at 40 weeks, DD2 was slightly earlier at about 38 1/2 weeks. DD2 was about 1/2 lb lighter than DD1 and delivery was much faster, I pushed for maybe 20 minutes with her vs. the 2 1/2 hrs I did with DD1. I also tore quite a bit with my first delivery and was unsure how it would go the second time around but it wasn't nearly as bad and my recovery was much quicker. It was probably a number of contributing factors, but I'm sure the baby's size also played a role. All this to say that being induced really wasn't that bad and I think if you have an experienced doctor delivering you who is aware of your concerns re: your previous episiotomy they can do things to minimize what needs to be repaired after the birth. Good luck!

[Katigre]

That is a really tough decision. How big was your first baby? What led to the 4th degree episiotomy? (Yeeouch!)

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[trales]

Dd was only 8lbs, but her head was in the 95%, it was angled funny! the placenta tore, I started bleeding. They cut me and sucked her out with a vacuum, I had been pushing for 4 hours. In labor 72hours. It took a few hours to put me back together. New practice this time, they are going to do no "tools", limit pushing etc. we have a plan for thresholds before we decide to swap to a c section. It just all seems so calculated, and medical.

[onyx8]

I have a friend who successfully used acupuncture to bring on labor in her 3rd pregnancy. I would try it to avoid a C in your case. Good luck!

[Katigre]

Dd was only 8lbs, but her head was in the 95%, it was angled funny! the placenta tore, I started bleeding. They cut me and sucked her out with a vacuum, I had been pushing for 4 hours. In labor 72hours. It took a few hours to put me back together. New practice this time, they are going to do no "tools", limit pushing etc. we have a plan for thresholds before we decide to swap to a c section. It just all seems so calculated, and medical.
The malpositioning makes so much sense. It's a bear to deal with, btdt.

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[AshleyAnn]

4 hours of pushing? Wow.

I had a 3rd degree episiotomy with DD because I began to tear upwards and my doc was concerned about the risk of damaging my clitoris so he cut me. I asked him if it was likely I'd tear in future deliverys and he told me typically he does not need to do repeat episiotomies.

[abh5e8]

i'd avoid the c-section if possible. two surgeries (or even if they combined them into 1, still working with different organs in abdomen and risk for adhesions, scar pain, etc would be increased) would not be my choice.

have you tried things like spinning babies http://spinningbabies.com/ to help with positioning? and checking carefully for diabetes, getting exercise and all to help minimize risk of a big baby?

i woul dgo with an induction early over a scheduled c-sec. (but would work hard at home with all the more natural methods of induction as well).

[SnuggleBuggles]

So, in that 4 hours, what kind of pushing did you do? Count to 10? What position(s)? Did you have an urge to push the whole time?

This is the best resource I have found on optimal fetal positioning. It has handy things you can do in pregnancy, labor and pushing to improve outcomes. http://motherspirit.net/articles/pregnancy/preventpost.htm

Fwiw, ds1 was posterior so I worked with my midwives and prenatal yoga instructor to make sure ds2 was in great position and stayed that way. Ds2 was perfectly positioned and birth was much easier!

[JBaxter]

I will say my induced 10.5 baby with 15.5 in head was a much easier delivery than my 7lb15 oz w/ the 14.5 in head NON induced. Position is the key. I also had the cervidil placed the night before and was contracting very regular by 8am. They broke my water about 10 ish and I didn't start pit until later that after noon. Hang in there it isn't always bad with an induction. Jack was 1 week post date and we knew he was big.

[Philly Mom]

I was induced with DD2 to prevent a C. I would do it again.


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[Tondi G]

I would suggest finding an acupuncturist in your area! I had 2 treatments ... I think 2 or 3 days apart. After the 2nd appointment DS was born about 14 hrs later! My Ob was talking about wanting to induce on DS2's due date cause he was measuring big on the U/S. He was 7lbs 5 oz ... not all that big! I was glad I went with acupuncture instead of induction.

You could also try Evening Primrose Oil. take 1000mg of EPO 3times a day and poke a hole in a capsule and insert it into your vagina to help soften your cervix.

[essnce629]

I really can't imagine how much smaller a baby's head would be just a week earlier, as babies are just mostly adding body fat those last few weeks. I'd go to a chiropractor now that specializes in pregnant women and ask for the Webster Technique to make sure baby is positioned correctly. A malpositioned baby (posterior, head tilted, etc) will lead to a much longer and more difficult labor and birth. I've had 2 best friends with posterior babies-- one had a 36 hour labor that ended in a c-section after failing to progress past 8cm and another friend who did manage to push out her posterior baby but it also took 4 hours and an episotomy. So I'd try my hardest to get baby positioned correctly now. The #1 thing to prevent posterior babies is to not slouch. Ideally you should be sitting on a birthing ball at all times when watching tv, on the computer, etc but if you do have to sit on a couch or cushy chair then make sure you put a pillow or two behind your back to make sure you are sitting completely upright or leaning forward, you never want to be leaning back with your tailbone tucked under. In our Bradley class they told us to sit backwards on a kitchen chair with a pillow in front of us leaning forward. Slouching on a cushy couch leads to posterior babies. Also, if you can get your provider to let you push on hands and knees or side lying that will take the pressure off the perineum and decrease the chances of a tear.

And if you really don't want to be induced, I have a castor oil regimen that is 100% successful so far. I and 12 other women I know, including some on this board, have used it. If you do it right there is no diarrhea, stomach cramps, etc. PM me if you would like it! The last success story was last month, with poster sachminu!