Inductions

When it comes to inductions, I always discuss this as being a possibility early on with my clients so they are starting an open and informed conversation with their doctor from early in the third trimester. Some gentle and creative ways to bring up this conversation are:

How many weeks does your practice typically let patients go?
If you are under 39 years old and overall healthy with a healthy pregnancy, this answer should be close to 42 weeks

Do you see any reason I would not be able to go until 42 weeks if I haven’t gone into labor naturally yet? If you have tested positive for gestational diabetes, fluid is low, baby is measuring way too small, or your health is at risk they may suggest that 42 weeks is not on the table for you, better to know early on in your pregnancy so you can prepare.

If you made it to 40+ and now there is a medical reason to induce, let’s chat about what those reasons may be.

I am always hesitant on the reasoning “Your baby is measuring too big”. According to Evidence Based Birth “ultrasounds are right about half the time and wrong abut half the time when they predict a big baby. Although 1 out of 3 U.S. women are told they have a big baby at the end of pregnancy, only 1 in 10 babies is actually born big. Ultrasound results are usually anywhere between 15% above or 15% below your baby’s actual weight.”

Remember the decision is still yours! Do the research, go with your gut. Has your baby been big all along? Do you trust that your body will only grow a baby that is the right size for you?

There is always room for a second opinion with many reasons for induction. Size of baby, fluid levels, impatience,

What can I do to naturally induce before my scheduled date?

There is still time! Check out all of our natural induction methods here: 5 Natural Induction Methods

What can I pack as I head in to ensure I am best prepared?

My favorite topic! Packing for an induction is so much more involved than packing for a delivery. You want to assume your first night is just for hanging out with your birth partner and getting sleep. Most likely they will put in a cervical ripener (this is in the next section) and the goal will be to get some sleep before they start labor the following day. So, what do you need to bring?

• Comfy Blankets and pillows for you and your partner
• Healthy snacks (ask in your last appointment if your Dr. or Midwife will let you eat during the first part of your induction
• Ipad/Movies/playing cards/affirmation cards
• Diffuser with essential oils (We recommend plastic so it’s light and if it falls there is no glass on the floor)
• Bring an amazing eye mask and ear plugs!
• If the hospital you are delivering with doesn’t have peanut balls or birth balls make you bring both, you can bring a small air pump and inflate them when you need them
• Head over to our other packing list for normal labor birth bag info
• Dress comfy! If ever there is a reason to buy the pretty gowns, an induction is it!

Lets go to what to expect with various methods of induction next:

Cervadil – This is a cervical ripener that goes in similar to a tampon but much smaller. The goal is to place it right behind the cervix so it can release dinoprostone, similar to a natural prostaglandin found in your body. This signals your body to thin and begin opening your cervix.

Currently, it is known as the least invasive way to signal the start of labor. While the hope is that it will work on it’s own, it is usually combined with Pitocin after 12 hours.

What to expect:

Your Dr. or Midwife will place the Cervadil and you will spend the first hour laying down so they know how you and baby are reacting to it. Occasionally, it can trigger real labor to start right away, but more often then not it will be in there for 12 hours. Many practitioners will let you move around, snack lightly and drink fluids while the Cervadil is doing it’s job. You may feel crampy but the goal will be to do this at night so you can get some sleep.

Tips: Lots of laughter, watch funny movies, and walk around or sit on the birth ball next to the bed when possible. When you got to sleep, sleep with the peanut ball between your legs. Positioning for the peanut ball can be found here: Peanut Ball

Cytotec – This is also a softener and the goal is to start labor by taking small tablets (often doctor will give 1/4 or 1/2 the tablet to start to see how baby handles it)

What to expect:

Non stop baby monitoring other then small walks or bathroom breaks. Some doctors do not allow eating and recommend a fluid IV. Same suggestions as above with distraction and sleep.

Rupturing Your Membranes: This is more common with second, third time, etc moms if the baby is low and the cervix is showing sign of change already.

What to expect:

Dr. or Midwife will put you on the monitors and rupture your water to see if it starts labor. You will probably start cramping and then hopefully the start of contractions, the goal is this will then begin a normal labor pattern. After about 30-45 minutes on the monitor you should be allowed to walk the halls, start working through normal labor movements and be off monitor intermittently.

Pitocin: Pitocin is an artificial Oxytocin and while some doctors like to start this first for an induction, as doulas we do tend to ask that other methods are tried first.

Pitocin contractions can be strong and a bit more spastic then a normal contraction and not everyones body responds to it the same way. Some people mimic totally natural labors while others feel pitocin is too intense. The statistics of cesarean and epidurals both do rise once pitocin is introduced into the mix for various reasons.

What to expect:

It’s a very slow and steady process. They start the pitocin on low and slowly rise it every 20-30 minutes depending on how the mom is responding.

Foley Catheter: This is a catheter inserted and pumped with saline fluid to physically expand the cervix. This method can be used if the cervix is at least 1 cm and will fall out when you get to 4cm.

What to expect:

It can be uncomfortable to get in but once it’s in its usually fairly easy to rest and relax as it does it’s job.

OK GUYS! While this is a very brief overview, I’m also happy to answer any questions on our live videos or IG or email me: info@ommamas.com