Induction contractions versus natural contractions

[MammaB21]

This is kind of a spin off of the other thread about first labors that were inductions. But I have a specific question so I didn't want to high jack.

My question is about the pain/feeling of contractions. I am especially interested in those of you who have experienced contractions with cytotec or cervidill and then went on to experience contractions either naturally or with pitocin.

My first birth was induced with the gel and labor kicked in on it's own but progress rather slowly. It took 22 hours to get to 6cm. Those contractions were pretty manageable. I was barely vocalizing through them. Then one more dose of gel and I went from 6cm to holding baby in just 45 min. The contractions I experienced in that time frame were quite unbearable. I'm planning a homebirth this time and I know my labor will likely be quite different. I never really thought of the gel as being super harsh, but I've recently heard that it acts the same as pitocin does when it comes to intensity of contractions.

So again, original question, has anyone been induced with the gel and like to share your experience? How did contractions feel for you? Were they less or more painful that other births (either with pitocin or with no induction)? I guess what I'm really trying to get at, is if contractions brought on by cytotec or cervidill are as intense/painful as contractions brought on by pitocin, or if they are closer matched to natural contractions brought on by mother nature. Thanks in advance for indulging this curiousity of mine.

[kcparker]

Just to clarify - cervidil is the one on a tampon-type insert. I think the gel is prepadil. The hospital where I go tends to favor cervidil or cytotec; I have never seen prepadil used.

So, my personal experience with DS1 - the contractions I had with cervidil in place (it fell out when I was 6 cm dilated) were indistinguishable from whatever my body had already started doing on its own, which was a gradual ramp up from menstrual cramps at the start of labor to contractions that I would describe as very intense and feeling like the top of my uterus was being wrung out like a dishrag. They were, even at their strongest, like Ina May's "interesting sensations that require all your attention," but I would not describe them as painful, just intense and all-consuming. I think I had a pretty good birth hormone high going by the time all was said and done too.

With DS2, the contractions were very powerful. Honestly, I can't remember quite what they felt like because I was more focused on making an O sound and seeing the letter O in my head and consciously relaxing my hands, and then gratefully resting in between with my torso on a stack of pillows. What I remember from this labor was thinking "I'm not sure I can do this until midnight" (probably at around 7 p.m., and he was born at 8), seeing in my mind's eye when my cervix dilated from 6-7 cm (don't ask how I know that is what I saw - probably I felt it and my brain translated it into a picture?), and feeling my tailbone push out what felt like an inch as he moved lower.

What I can tell you from observing doula clients of mine who have been induced is that I think the prostaglandin-type ripeners are more gentle than pit. I think they are more likely to tip you into a physiological labor if you are right on the edge of it, obviating the need for pit., and then it's really your body doing the work. I think it also matters how long they are in (overnight, 24 hours), when the pit. gets started, and how fast the nurse titrates the pit. Start at 2, and then go up by 2 milliunits every 30-60 minutes is nice and gradual, and the standard is supposed to be that they stop titrating up once you have a good 2-3 min. cxn. pattern going. But I would also say that pit. contractions are pretty brutal compared to physiologically generated contractions. I think they are longer, harder, without the gentle slope into/out of the contraction - it's like a table compared to a bell curve, if that makes sense. And I think they do hurt more (partly because there's no pain-dulling effect that the natural oxytocin has in the brain), they give women less recovery time, and are just a stinker of a ride to have to go on in labor. They are harder on baby too.

Maybe your last 45 min. with the first baby was not from the ripener, but just because you had a freight-train of a transition and pushing stage. If you think of the work of dilating, effacing, and pushing as a certain amount of energy that has to be released/transformed over time, your body compressed that work into one explosive effort instead of parceling it out in dribs and drabs (sort of the opposite of the women who get 4 hours of crampy prodromal contractions every night for a week before they go into active labor).

[SubliminalDarkness]

I would venture a guess that the intensity you experienced was more because you were in transition than because they were "induced" contractions. I've experienced all kinds of contractions, and natural transition ones were definitely the most difficult to handle.

[XanaduMama]

I can't comment on the cervadil, but having experienced pitocin contractions and natural contractions, I wanted to emphasize that they were TOTALLY different. The pit cx's felt like being hit by a train...I had a fast labor once the cx's got going (3.5 hours from first contrax to baby), so I guess I went straight into transition, but the worst thing about them was how overwhelmed I felt--I was physically unable to speak, for the most part; got virtually no break between them; and felt like I was going to lose it at the peak of each one...it was scary.

By contrast, my natural HB labor felt totally manageable right up to the end--even in transition, at the very end, I could think rationally and control my responses. I was laughing and chatting in between contractions, and felt so much more peaceful. The hormones were definitely doing their thing; there was a gradual build-up from one stage of labor to the next AND within individual contractions; and emotionally/mentally it was an infinitely better experience. My recovery was much, much easier, too.

So, in short, my advice would be to avoid any artificial augmentation of labor, and let your body do its thing!

[is it puppies?]

I've only had one baby (she's a month old now) but having to go in to be augmented with pitocin after about 4 hours + of pushing at home I could safely say that the full dose of pit (raised gradually over 2 hours) didn't make much difference to me. My MW said everybody needs an epidural by the time they get that much pit in them, I found the ctrx were virtually identical in my case. I still ended up pushing on pit for 2 more hours with fairly long breaks between pushes, I think my legs falling asleep felt worse to me than the contractions themselves (not that I was enjoying them, especially while they made me stay in bed pretty much on my back for 2 hours while I reached max dose- that sucked big time but mostly because it was very hard not to push when my body wanted me to).

[Carolyn R]

After reading through the responses so far, it seems like everyone's contraction experience has been very different.

FWIW, I was induced with a combo of oral Cytotec and IV Pitocin with my third birth, and I can honestly say I didn't notice any difference in the contractions compared to my natural deliveries. Contractions were manageable, and I didn't require any pain relief.

It may have helped that I have a really good relationship with our doctor...he is very naturally-minded and approached the induction very patiently. I never felt scared or hurried during the whole induction process, which I think can alter perception of pain.

[lemonapple]

I can't comment as to the gel, but my labor was supplemented with pitocin after my water had been broken for nearing 12 hours. I only allowed a very low dosage of pitocin, but once it was in my system, I literally thought I was going to die...I went from 3cm to 6cm in like an hour and spent that whole hour on my hands and knees shaking because there seemed to be no end to my contractions. The midwife thought I might be in transition, but once I found out it was only 6cm, I had the pitocin turned off and labored naturally for 6-7 hours until my son was born. I have to say that my natural transition contractions were RIDICULOUSLY bearable compared to what I experience while on pitocin.

sidenote: we were convinced to augment with pitocin because baby was so high...he apparently hadn't dropped yet, and I did have back labor the whole time, so maybe the combo of dropping baby down, back labor, and opening 3cm so quickly all just happened to occur while on the pitocin?...because seriously it was like the lowest dosage ever! lol.

[MammaB21]

Thanks for the thoughts ladies. I hadn't really realized that the gel was any different than cervadil or cytotec (although I have heard some pretty bad things about cytotec). I suppose I was more 'ready' for labor than I thought. I think the contractions I experienced were pretty close to natural contractions. The last 45 minutes was most likely super intense because of the quick progression through transition and pushing.

I thought it would be interesting to hear other peoples experiences as well since I've heard recently that some women experience induced contractions as much more intense (and obviously pit contractions are the worst of the worst).

It's interesting to hear some of your experiences of the pit contractions being just as intense as regular contractions. I wonder if the majority of the pain/intensity is truly coming from transition contractions. (I've heard pit inductions produce transition like contractions just through the whole labor).

[Megan73]

Originally Posted by SubliminalDarkness

I would venture a guess that the intensity you experienced was more because you were in transition than because they were "induced" contractions. I've experienced all kinds of contractions, and natural transition ones were definitely the most difficult to handle.

I agree. I had one spontaneous labor and one induced with cervidil and pitocin. The contractions felt pretty much the same, manageable until transition when in both cases I felt like I was on a freight train.
The worst thing about the cervidil is that it makes vaginal exams EXCRUCIATING.

[GreenMomPhD]

I was induced with Pit, and it took FOREVER to get to 6cm since my baby's head was not quite positioned right to cause me to dialate. I started at 3cm at 9am and by 5pm I was only at 6cm. By that time, I had a Pit rate of 20 for several hours. I feel that they were very intense, but managable. My doula said she'd never seen someone on thta high a level of Pit for so long. But it did tire me out, enough so that I decided on an epidural to get me the rest of the way. Maybe if I had progressed better, I could have lasted until 10cm. But in the end, my epidural pump stopped working, and I had to push pretty much without pain meds- WOW! I don't know if I could do that again!