Engagement, Induction and related issues...

[remijo]

Ok, hopefully I can make this understandable. I am almost 38 wks and on a timeline to be induced next week. First of all, I don't want to be induced. I was induced with my DS and I really wanted to go into labor naturally this time around. The reasons for induction are mild pre-eclampsia and pretty bad polyhydramnios. My uterus is measuring at 42 wks, I have an amniotic fluid index of 33 and I have been in prodomal labor for about 6 wks now. Every time they hook baby up for her NST to make sure the high fluid level isn't affecting her, I have contractions every two minutes. I basically walk around contracting every two minutes constantly. I even have contractions in the middle of the night. I don't even feel the small ones anymore. I have been dilated to 2 since 34 wks but no change since then. My cervix isn't changing anymore because baby is happily bouncing around in her huge swimming pool and refuses to engage. I know walking helps to engage baby but I'm on minimal activity because they don't want my BP to rise anymore. Is there anything else I can do to get her to engage? Would more activity even help in my case since gravity obviously isn't working as well because of all the fluid?

OK, here's another question: If I do have to be induced, can I avoid the pitocin because I'm already dilated? Can I request that they try to strip my membranes first and only use pitocin as a last resort? I was on a pit drip with DS and didn't start to dilate for about 11 hrs, I had him 7 hrs after I started to dilate. (I had pre-e with him too and was young and stupid and didn't know what questions to ask). I think they're concerned with cord prolapse because I have so much fluid. Is this really a valid concern?

There's alot of questions in there, I guess I am looking for advice and reassurance. I don't think I can avoid the induction with all the medical concerns, I am worried for baby if I don't do it but I want to do it on my terms and try everything in my power to start labor on my own before I have to be induced.

[Astraia]

I don't have an answer for a lot of your questions but I'll take a stab with what I know

If the baby is not engaged, then YES breaking your water definitely increases the chance of prolapse.

You can get your HCP to strip your membranes as an out-patient thing, you don't need to be in hospital doing an induction for that. What they do is separate your bag of waters from the outside edge of your cervix by running their finger around the inside of your cervix. Uncomfortable, can cause spotting/accidental water breaking, but can be pretty successful if your body is ready.

If you really want to avoid pitocin... IDK, I'm not sure how undilated you need to be for the cervical ripening things to be considered (ie, cervadil). Might be worth a check, though?

For helping baby engage- squatting, stair climbing or lifting your knees up high as you march in place. I've also heard walking on an unlevel surface can help- like, one foot on the curb and one on the road. Not sure if you can recreate that at home. You don't need to do SQUATS (ie, squat and stand up repeatedly as an exercise) but sit in a squatting position. If you can get into tailor pose that's really good or sit on an exercise ball.