how to avoid induction?

[sarika]

Hi Everyone,

I'm new and looking for advice. (Desperately seeking!) 

I have some autoimmune issues and have not had a particularly easy pregnancy - My joints are all swollen, I've had hyperemesis, am persistently anemic, in the third trimester still am unable to keep much food or my prenatal vitamins down no matter what I do, etc. This combined with my preexisting condition has prompted my OB and MFM specialist (going with a midwife was unfortunately never an option for me) to decide that I shouldn't be "allowed" to go past my due date. I've still got a little while to go (I'm not due until Nov 17), but am kind of obsessing about this.

I'm a little afraid to put up much of a fight, partly because the pregnancy has been so difficult and I am genuinely concerned about the higher incidence of early placental deterioration in women with my disorders. On the other hand, I had intended to pursue a natural childbirth, no meds, wanted to avoid pitocin at all costs, etc., so this is not only disappointing but frankly pretty contrary to any choice I would ever usually make. 

I would still really, really like to avoid getting hooked up to monitors and placed on a pit drip if at all possible, and so have begun considering using evening primrose oil and red raspberry leaf to try and encourage my body to go into labor a teensy bit early - not super early, mind you, just enough to avoid hospital induction. I'm feeling somehow a little unsure of whether this is the best idea in the world...and looking for others' thoughts on the matter. 

Not only as to whether it's a good idea, but when you would start if you were me, and any experience with whether this actually works? (Note I am not keen on things like blue cohosh or castor oil - it seems a bit too much to me!) I know I can't actually get medical advice over the internet, but am seeking personal experiences from other mommas just to give me more to think about... Also if you have any thoughts about other natural "induction" techniques I'd love to hear them!

So ANY thoughts are appreciated! 

- ika

[starrlamia]

there are quite a few things you can try that are more natural. Castor oil, blue cohosh, nipple stimulation etc.

[mamapigeon]

I was induced and ended up with a c-section. I think I was too sedentary at the end of my pregnancy, so I would definitely recommend walking as much as you can (comfortably). Spicy food and pineapple supposedly get labor to start (didn't work for me though).

Good luck!

[HappyMonkey]

Lots of people opt for the NST stress tests to check to see how the baby is doing, to reassure the DR that the baby is fine.. maybe that might be an option for you too? It might be worth exploring.

[sarika]

Thanks for all the advice, everyone...I'm still looking for more options. The NST is actually already on the table (I'm going every week for now, then twice a week beginning at 34 wks), so I don't think that is going to appease the doctors. I will definitely keep walking - that hadn't occurred to me as something that might make a difference, so thanks! 

Is it wrong that I would almost (ALMOST) rather schedule a c-section than do pitocin induction? I know that isn't actually "better" - and it's not that I'm afraid of labor/pushing, it's more that everything I hear about that drug just makes me so wary of using it!

[thencamehenry]

Something to research and discuss with your doctors would be exactly how the induction would go.  I am pretty firmly anti-induction if it can be helped, but I have had numerous friends go the induction route. Some have been very gentle and some not so much.  You can have a foley catheter in the cervix instead of ripening it with medication.  I have read that the effectiveness of pitocin can vary greatly from patient to patient so I would insist on starting with the lowest possible dose and increasing it very gradually.  I would talk to the doctors at length about the time constraints they place in laboring women and let them know that you are in no hurry as long as baby looks good.  Wait as long as possible to break your water because that starts the clock in the hospital.  Basically be very open about your ideal birth, acknowledge that things might not work out that way, but insist that they do their best to support your wishes.  Make sure you and your doctors have the same definition of NCB.  For many OBs natural=came out of a vagina, regardless of induction, epidural, etc. I would imagine specialists who do tons of high-risk births see less normal labor and more inductions and c-sections so I would be very detailed about what you are hoping for. Request a NCB-friendly nurse when you are admitted.  Get a doula if you can.

There are things you can do to induce labor naturally but there is no guarantee they will work. It might be worth preparing for the possibility of induction, and even c-section, as best you can.  Hopefully doing so will ease some anxiety as well. 

[ElliesMomma]

forum crashing...

... i too was worried about induction. as it turned out i went a week early. maybe b/c i had a nursing toddler. nipple stimulation = powerful contractions.

maybe b/c she was incredibly active and i was literally running to keep up with her (running the bases with her after minor league bball game about 48 hours prior to delivery, and running alongside a motorized "train" on uneven ground during a picnic about 36 hours before delivery).

i'm also a believer in the benefits of gardening and stair climbing (which worked for my first -- she was also about 5 days early). 

and my doula swears by "curb walking" -- have someone hold your hand, but walk with one foot on the curb and the other on the road. once again, it's that "uneven ground.'

finally, as a veteran of NSTs myself (due to "age"), ask them to up the order to "biophysical profiles" which is like a very detailed ultrasound in which the baby has to prove its healthy by fulfilling a set of five specific criteria each and every time. ask your doctors too -- but it was my understanding that those things WILL spot a problem (if there is any) in time to save the baby. 

have you discussed your desire for a natural birth with your HCP? 

[Beccadoula]

Do all you can to get the best possible nutrition.  VITAL.  Besides that, the rrlt and evening primrose can do wonders if your body is really ready for labor - if not it is still great prep and can reduce your labor time and recovery time.  Don't use the ep before 38 weeks.  GET a doula...seriously.  And if you must be induced you can require that the Pit be used in the smallest possible dose and only turned up when you agree to it.  One of the major problems with Pit is the liberal use of it - the quanities are so high that your body thinks you're in transition the whole labor...and if it lasts too long you give in and accept other measures you weren't planning on using.  Stay moble during your labor - move and rest then move again - don't allow yourself to get stuck in bed.  Best wishes!

[kathrineg]

I would rather have a c-section than an induction that didn't work because the end result would be labor AND a c-section...so I don't blame you one bit for wanting to go straight for the c-section if it comes to that. Sending good thoughts your way for a happy and healthy mama and baby!

[Mushy1127]

I had two post-date inductions.  One medicated and one not.  I can tell you my story and if you'd like to chat more feel free to PM me.  Prior to the inductions here are the things I tried:

EPO (this will not put you in labor, it just helps prime the cervix)

Sex (see above)

Membrane Sweeps

Black/Blue Cohosh

Castor Oil 

Enemas

4 hours of daily nipple stim

***ACUPUNCTURE***

CHIROPRACTOR

INDUCTION MASSAGE

Pineapple

Walking

Yoga

Red Raspberry Leaf Tea

Borage Oil

I take EPO orally my whole pregnancy and then vaginally starting around 25 weeks.  That is aggressive but I am/was desperate to avoid an induction.  If I were you, I would see the chiro and acupuncturist NOW, consider orally taking EPO, start your RRL tea and put the rest on the back burner until 37 weeks or so.  At that point consider your options, talk to your practitioners and go from there.  Maybe they'd be against the cohosh but ok with the Castor oil.  Against the Castor oil but no the enema.  Whatever.  I got daily membrane sweeps with my second that might be an option for you as well.  

Now my medicated induction took HOURS.  I mean, like 50+ hours.  I credit the fact it ended in a vaginal delivery to PATIENCE, and the fact my midwives were willing to unhook the pit at night. I was able to shower, take an Ambien and get some sleep.  I want to say I had a four break every night but I can't be certain.  Regardless it was heaven.  They kept me well fed, well rested, and laughing.  If you do end up with a csection at least you know you tried.  You can look back on it and KNOW you did everything anyone could under your circumstances.  If you go straight for the c/s, I'd worry you'll spend your life wondering if you missed the chance at a vaginal delivery "Maybe my induction would have been successful?  Maybe I should have waited."  I also have friends who blame every respirator infection their children get on their csection.  Unfounded or not, it's hard to reason with Mother Guilt.  If you end up with a c/s that was going to be the out come if you skip the induction anyway.  You may as well try.  

The key is to make sure you are well rested, well fed, and have realistic expectations.  Make sure your doctors understand that once they plug you in you are starting at 0.  You didn't have the luxury of having days of prodromal labor, or the night or two or indigestion you blamed on the Chinese buffet only to find out 27 hours later it was labor starting.  Expect an induction to take days or hours although it might not.  If they aren't willing to let you eat enough, have someone bring you food.  INSIST on the unplugging at night, my second night there I had to really fight for it.  But in the end my wishes were what counts.  Sure it would have been nice to have my baby 8 hours sooner, but that sleep, I am certain, is what kept me going.  I don't see how I could have had the stregnth to push otherwise.  

Don't set yourself up with expectations of unmanageable pain, contractions on top of one another, horrors!  I know plenty of people, myself included who didn't have that with pitocin.  I labored naturally for three days- watching movies with my husband.  Eating Olive Garden take out with my mom.  Playing cards, checking my email, etc.  It wasn't how I envisioned my birth, but it wasn't a horrifying nightmare of a birth either.  I was sorry to have missed the birth center, but I wanted a healthy baby, a vaginal delivery, and no regrets/informed consent.  I got all of that, and that's what matters.  I was treated respectfully, wasn't separated from the baby, and released to go home as quickly as possible.  Some people have terrible experiences with pit, some don't.  Just stay positive and assume you'll be in the "don't" category.  

With my second, I had a good pocket of fluid under the babies head.  They broke my water and prepared for me to need breast pumping (I was refused an induction because of "macrosomia" blagh) but instead my labor took off like a shot!  They broke it at 6:30am and my baby was born at 8:18am.  If I end up post-date again this is my plan.  I'll do all of my Stuff that I do to try to stick to term (I am already seeing the chiro and accu), have them break my water, and then resort to pit if it comes to that.  Keep in mind there is no reason that couldn't work for you too.  You'll have to see what your Bishop Score is, how dilated you are, babies positioning and all of that.  But it can and often is done!  

Hell, you may also naturally go into labor!  You never really do know until after wards, eh?  

Good luck!