Labor Induction

[trimestersdoula]

Ok, I know it is a little early for this BUT starting at 36 weeks I am going to do everything in my power to induce labor. I know this may sound strange coming from a very natural minded doula but I feel it is something I need to do.

I delivered DD a bit before my due date, by c/s because of pre-e. I wish I could say that pre-e for me is unlikely a second time since DD was my first pregnancy, but I have already had changes in my blood pressure. It was way up at the doctors office last week (170/100). She has had me take my blood pressure at home this week and I go back to see her again on Thursday. I have been doing things to keep it down now and it seems to be working. It is actually a little on the low side (110/70) but I don't see it staying there. I know the closer I get to my due date the higher the chance for pre-e. If I do end up getting it again, they can't induce. Its an automatic c/s and I DO NOT want that.

So, about 16 weeks from now (doesn't seem that far away does it?) I am going to be doing what I can to naturally (well as naturally as possible) induce myself.

I am going to be doing things like RRL tea to tone everything, Floradix to prevent PP hemorrage etc. For induction I am willing to try a few things. Accupressure is where I am starting first, as well as nipple stimulation and heat packs on my breasts. If those things fail I am going to getting my OB to do a deep membrane stripping. If that fails I will do it again and then get her to insert a foley catheter. I wont try things like castor oil and such because it seems that it may cause more harm than good. I also am not sure about the use of EPO in someone who has had a previous cesarean. I have read its fine but have also heard not to use it.

Anyone else have any other suggestions, tips, natural induction stories on what worked and what didn't etc. What things are you all planning to try if you get to that point where you need to?

[maciascl]

High blood pressure on it's own doesn't signal pre-eclampsia. However, if you are also swelling & spilling protien in your urine then that is different. Have you ever heard of the Brewer diet for pregnancy? When Dr. Brewer was a live he did A LOT of work with women to avoid pre-eclampsia/toxemia (same thing, different name) with good nutrition. He has a great article on high blood pressure in pregnancy on his site as well as one on pre-eclampsia.

Only you know your situation best, but my suggestion would be to not stress yourself over how to try to induce yourself & rather focus on managing the blood pressure & avoiding pre-eclampsia all together. Good luck!

[trimestersdoula]

Haha, I guess I should explain more. Im not going to try and induce if my bp stays down. If I have no problems this pregnancy can go on for as long as it likes.

I understand pre-e. I have also done a lot of research on the brewers diet and talked to a few midwives who don't actually recommend it. Wierd I know. Not sure why exactly, just that they have had poor outcomes with it. I have also talked to a lot who do recommend it so I am really not sure where to go with it. I have been eating a lot of protien and it seems to be helping my blood pressure.

I'm not stressing about inducing myself. I am actually really looking forward to labor (spontaneous or otherwise) LOL. I just want to be ahead of the game in case I need to do these things

I like to be totally prepared for everything and I didnt want to be stressing researching things if/when pre-e does show up.

[dannic]

With my first, I swelled like crazy (cant recall bp)! My new MW with the others rec'd gallon water/day and 80 grams of protein. I've not swelled since. (This is my 4th child). Not sure if that helps or not...
I'd also take chlorophyll as it helps with pp bleeding as well. GL, that's a tough spot to be in. Does exercise help?

[CrunchyChristianMama]

If I were in your shoes and my BP was becoming a problem, I would try more natural induction methods too to avoid ending up with a medical induction or c-section.

I would personally try acupuncture first. I would do so after a few weeks of EPO orally and vaginally though. If it really came down to it I would give castor oil a try too.

I have heard mixed review about Brewer's as well. My mw is a fan though. I think the important thing is lots of protein and as little sugar as you can muster.

Here's hoping you won't have to do any of this though!

[MyFillingQuiver]

I'm with Dannic...as it seems I am with most things. We must be soul sisters, LOL!

Anyway, I'd look at it with a two-pronged approach. #1, In what can I do to avoid pre-eclampsia? Obviously it's not all in your hands, but I truly believe a good part of it is. As I have said before, I was told I'd never get pregnant again, but if I did, I'd likely have a very poor outcome. While I look at this humbly, I truly would love to speak to the OB's who said that to me 13 years ago...after 4 more healthy pregnancies, and hopefully another on the way! #2, Back up plan for naturally inducing if need be. I don't think you are wrong for thinking along these lines, with the idea you PLAN on not having to use it!

Look at data from midwives who have been practicing this art for years. What successes do they have in avoiding pre-e? What comes to mind for me is data from Ina May's Guide to Childbirth. Her statistics from The Farm are incredible! Mostly because she incorporates ALL data-including those who ended up having transfers and care elsewhere! She has VBAC moms and previous pre-eclamptic mom's, etc. Her true pre-eclampsia rate is very low.

Things such as adequate salt intake, 80-100 mg protein a day, a gallon of water per day, mild exercise, fish oil, vitamin C, and a baby aspirin for women who are prone (like me) with providers approval, and general overall health and wellness are key. Pre-e (as you already know, I'm sure) can't always be pinned on nutrition, but it's prevention is quite successful when related to it!

As far as induction..I really believe nothing short of nasty drugs will get you to go into labor before you are ready. However, encouragement can tip the scales. I did EPO from 36 weeks orally, and at 38 added it in vaginally. I was so soft and stretchy, and my VBA2C was fast and easy...I do 3 cups of RRL a day, and will add nettle the last trimester, along with chlorophyll and alfalfa for PP and placental health.

Nipple stim is a great thing to do...either in the shower, with DH's help or with a pump. I got killer contractions from it, but it wasn't time so they did nothing more than fizzle after a couple of hrs..but may have helped ripening!

TMI, but we had lotsa sex...it was so fun to be huge and ready to deliver and wonder...and I did get good contractions afterwards in the last week or two.

In the end baby comes when baby is ready, unless majorly intervened in. Let's think positively that maybe it won't be your worry this time!

[trimestersdoula]

I am eating well, exercising, drinking a ton, generally being healthy. I was last time too, but nothing helped.

I like accupressure. I did it with DD but of course she wasnt ready to come, so she didn't. Plus its something I can do myself Accupuncture I would do but it is VERY expensive here.

I won't resort to sweeping/foley unless an induction is absolutely necessary to avoid a cesarean. If the option is that or c/s I will pick the non-med induction.

Thanks for all your input! Nice to hear what others have tried/done.

[amyrobynne]

One of my friends really, really wanted to avoid a c-section with baby #3 after having 40-41 week 10+ pounders. She did all the things you are talking about and ended up with a vaginal, natural delivery around 37 weeks with a 9 lb baby. So I can understand where you're coming from and it can work to naturally induce at that point.

[lunarlady]

I friend of mine managed to get labor going by having quite a bit of sex, and then doing HOURS of nipple stimulation. And she said you really have to tug/pull on them to get the needed response. Very unpleasent, but better than a section in her book. I've also heard of people having good luck from jumping on a trampoline (can you imagine?), jogging (another can you imagine?), LOTS of RR tea, and the use of certian herbs that stimulate contractions (sorry, I can't remember what they are!). No matter what method you choose, I've heard that it takes hours to get a true labor going. With my friend it took about 10 hours to create a labor that wouldn't stall out as soon as the stimulant was taken away. So you have to find something that triggers contractions for you, then keep at it. I hope you manage to avoid pre-e all together, but good luck getting baby out naturally a bit early if it does pop up.

[MonP'titBoudain]

Personally, I'd be really wary of herbal labor stimulants with a VBAC. I'm not sure of the research there, but it seems like it would be along the same lines as a medical induction and significantly increase your chances of uterine rupture, previa, etc (I think you already said you weren't going to do castor oil or EPO and since those are gentler than cohash, etc. I imagine you are probably also wary of herbal labor inductions). Unfortunately, I can't think of anything else to add to your list, beyond herbs

[trimestersdoula]

Yeah, I will be staying away from herbal inductions.