Any advice on how to manage pain with pitocin-induced delivery?

[mweb]

Obviously I will ask them to start at the lowest dose possible, but I am still scared that the contractions will come on too strong and fast to leave me capable of doing anything other than crying! This is a hospital birth, and I apparently have no choice other than to wear external monitors (and thus be confined to the bed). Any stretches or other bed movements I can do to help?

Please, no flames - I'm in tears already. I do agree with my OB that induction (early next week, at 42 weeks) is necessary due to declining amniotic fluid levels and a complete and utter lack of progress so far (no dilation, no effacement, head is not yet engaged). I'm taking evening primrose oil orally and vaginally, drinking red raspberry leaf tea, and am considering trying cohosh tinctures and/or castor oil this weekend. But if all these fail, I'm seeking advice and/or reassuring stories.

Thanks in advance!

[TCMoulton]

Okay - I had pitocin with my 1st daughter and as long as I kept the monitors on I was allowed to move as I pleased - mind you the cords are not endless in length, but I was able to stand up, lean against the bed, crawl around my bed on hands and knees, sit in a rocking chair, and they did disconnect me whenever I had to go to the bathroom.
You can do it although pitocin is nasty! My daughter was the same kind of story except my water had broken at home - she was born vaginally later in the day with the cord around her neck 4x!
Best Baby Wishes Mama!

[stafl]

the "complete and utter lack of progress so far" may mean that induction will not work. If you really want my advice, I'd tell you to get a second opinion before agreeing with your doctor's plan to induce.

If, after seeking a second opinion, and doing some research on the risks of induction and the risks of not inducing, given your particular situation, you still think it's the best thing to do, I would strongly urge you to refuse constant monitoring and get up out of that bed as much as possible. Move around, change positions. Grab the IV pole, and drag it along as you walk through the halls. You do not have to agree to anything just because they recommend it. Educate yourself, know what the risks really are, and know what your options really are. Don't just blindly follow along with what they tell you that you have to do.

[alegna]

Personally I would refuse the pitocin. With your lack of other progress you're very likely to end up with a section if induced.

good luck

-Angela

[GoldBerry]

mweb,

first of all, I was in your place- twice- and it does not mean you will end up with a c-section. If you must be induced it is possible to keep out of bed. At both of my births, I was induced due to low amniotic fluid (after trying many natural methods), but with both births I was mobile. I did a lot of walking the halls and used the tub during my second labor. Also, I used a birthing stool which was very helpful!

So, if you must be induced, it is still possible to have a wonderful birth experience! Ask your midwife/dr. for help keeping mobile. Do they have a remote moniter? The birth center I was at used a remote moniter when I was in the tub.

About the pain. I have nothing to compare it to, but my contraction did not come on suddenly. It took many hours to build up. All methods for dealing with labor pain without induction are just as good with induction.

You can do it!

[MindfulBirth]

Have you considered homeopathic remedies? Speak with a good "classical" homeopath http://www.homeopathy-cures.com/html...omeopaths.html who can recommend which remedies to take at which stage of labor. While they will not reduce your pain, per se, they can help you deal with fright, stress, fatigue, anxiousness, back labor, ineffective contraxs, etc.. Let the homeopath know that you are being induced so that he/she can recommend a stronger potency that will work with the pitocin. You can also get a homeopathic birth kit here http://www.abchomeopathy.com/kits.php. They ship very fast.

-tina
PS. they also might be able to recommend a remedy that could help get things progressing before your induction date to make it go more smoothly for you.

Best wishes!

[mweb]

Thanks to those who closely read my question and gave advice. TC - you really reassured me that some movement is possible despite cords. I also plan to ask to go to the bathroom more than is actually necessary - don't know if you were hinting at that, but that's the lesson I'm hearing! Salvia - alas, they do not have remote monitors (unbelievable, I know - no tub either!). Thanks much for sharing your experience that the contractions didn't come on fast and terrible.

Angela - any recommendations as to how I can avoid induction if the methods listed don't work? I simply do agree w/my OB that induction is necessary if I reach 42 weeks.

Stafl - I am not following blindly, thanks. As a moderator, don't you think it's nice when responders give the benefit of the doubt? I think it's pretty obvious that I have done some research. I'm simply asking what can be done when movement is restricted.

I totally respect women who are comfortable with absolutely letting nature take its course, even if that means a 44 week labor. But I'm not comfortable with that, especially since I know the exact date of conception (done via IUI & injectibles).

[crysmomofthree]

I have had two pit induced labors and both times deliver successfully without any pain meds, but I was up moving and our hospital policy is monitoring for 15 minutes every hour. so I was pretty mobile, and did a lot of walking and in the shower. I have to tell you that it was really a lot worse pain than I had during my non induced labors. But if you are really comitted and insist on being mobile than it is possible.
good luck
crystal

[TCMoulton]

MWeb - Yes! Visit that bathroom as much as possible and remain as long as fels comfortable!
My daughter may have had the cord around her neck, but she came out vaginally and all of the nurses were in awe - never seen a babe born with a cord x4! Pushing took awhile but patience is the key!
Also - they will start the pitocin at the lowest dose, that it standard, but if the pain gets too intense ask them to back off a bit! Yes pitocin is horrible, but honestly the contractions with my 2nd daughter when I dialated from 0 to 8 in two hours with no pitocin were much worse...go figure!
You can do it - stay strong and just do what your body tells you is the right thing to do!

[bluets]

I had a pitocin-induced labor as well (because of a positive GBS test and because my water broke before any contractions)... The good part was that I was able to be quite comfortable in the labor/delivery suite and viewed it as my "nest". No racing to the hospital in the car in the middle of major contractions. So while I was very upset when I found out I'd have to be induced, I was actually quite comfortable once I accepted that this was how the birth was going to be.

** The nursing staff can be very helpful in achieving a non-medicated birth (beyond the pitocin, that is). Make your wishes clear and ask for help.

** Have your birth team take advantage of the monitors - those monitors can help indicate when a contraction is coming and how bad (relatively) it is. For example, my contractions started on the upper right side of my abdomen and radiated around, until they ended with a driving, searing pain into my sacrum. My dh would watch the monitor and apply a hotpad to my sacrum during a contraction; he'd massage my lower back between contractions. He could also tell how bad the contraction was going to be. So those monitors, while they are a PITA, also turned out to be useful. My doula, in the meantime, was reminding me how to breathe, to focus, etc.

** Keep your strength up! I made sure that we had food and drinks - gotta keep up that energy because you never know how long labor will be. Granola bars, bottles of water... Miso soup, heated in a mug at the nurses station, was my beverage of choice. Of course, the nurses thought it was for dh. Little did they know it was for me. Hee hee.

** Make your nursing staff work for their bucks (but be nice to them!). This is your birthing experience, after all. My labor/delivery nurse literally did acrobatics to accommodate my different positions when applying the monitor. There was only one time that she couldn't get the fetal heart rate on the monitor and had me try a different position - and that was after trying for 30 minutes. My nurse was able to contort her body around mine and between me and dh to give me a cervical exam.

** Be firm with your doc. In fact, the biggest PITA (even more so than those monitors and the IV) was my doc. I had to crawl from the floor back up to the bed, between ever-closer contractions, for a cervical exam. I guess the doc is too good to wiggle around on the floor like the nurse. I also should have been more forceful with the doc about pushing positions - I really wanted to squat with the squat bar but he wanted control. We both lost - I didn't squat exactly but I also didn't have my legs up in stirrups; ds came so fast that doc didn't have as much control as he thought he would.

Have I mentioned that this is your birth experience? You need to be the boss and bark orders once the whole process starts. Best wishes.

[mweb]

Thanks, Crystal - I will try to insist on intermittent monitoring, using the argument "other hospitals do it"! (Hopefully it'll be more persuasive that when DB tries to get me to buy plastic junk saying "But moooom, all the other kids have it!")

[alegna]

Originally Posted by mweb

Angela - any recommendations as to how I can avoid induction if the methods listed don't work? I simply do agree w/my OB that induction is necessary if I reach 42 weeks.

Since you asked I would avoid induction by saying no. But I would not have had the u/s that your ob is using to pressure you into it either. I don't think that "low fluid" and 42 weeks is a reason for induction.

I hope you find the answers you're looking for.

-Angela

[MamaTaraX]

I haven't read all the other replies, so forgive me if I'm repeating anything.

It is completely possile to have a good birth even with Pit! I've been to more Pit.l inductions this year than I ever though I would. It's probably not going to work out very well if your cervix isn't favorable. This doesn't mean you'll end up with a c/s, but it can mean a much longer labor. If the natural methods don't work togive you some progress, see if you can request doing Cervadil the night before. They start Cervadil 12 hours before the Pit. Sometimes that's all that's needed, and most of the time a dose or two of it will be enough to make the Pit.worth the effort. Definately ask for the lowest dose possible but don't be surprised when they crank it up regularly anyway. Something you CAN do is tell them thatwhen ctx. are regular you'd like to turn it off and see how your body does. Sometimes Pit. is just needed to kick start things.
You can do a surprising amount of moving with continousmonitoring. You can request intermittant monitoring, be prepared to be frowned up, espeically with Pit. There is some reason tobe monitored on Pit. It can cause funky contractions and babies regularly don't tolerate it. This doesn'tmean that monitoring intermittantly is any less effective though as long as everyone is watchingfor other signs. If you do go the continous EFM route though, you can do all kinds of things! On the bed, a chair next to the bed is great (rocking chair, straight back chair which you cansit on backwards), a birth ball. You can labor in most any position withthose straps. They can get in the way or uncomfortable though. The biggest hassle with the monitoring is that if the tracing of the baby is lost, someone will be in to move the straps around. This can be very annoying for a laboring mom.
Ah, I have more to say but I need to get going. Best wishes!

Namaste, Tara
mama to Doodle (6), Butterfly (23mos), and Rythm (due at home 1/06)

[mweb]

TC, thanks again!

Bluets - your response was so full of helpful information I am once again in tears (of gratitude this time!). Using the monitors as helpful tools is a genius idea - I've seen the room set-up so I know they're easily visible both as paper scrolls and on a nearby computer monitor. I already planned on being as nurse-friendly as I possibly can be (and hey - that'll probably be easier since I'm not meeting them in pain, which can make me a little curt), and I've met 2 nurses already through classes taken at the hospital. My OB seems to be supportive of varying positions, but he is fond of the monitors. Doubt he'd get on the floor, but I WILL ask if need be. Oh, and did you have a Cervadil/cytotec suppository beforehand? If so, did was your doula present for that as well? Thanks!

[mweb]

Tara, thanks very much. Cervadil inserted the night before is planned. I too am in a rush so can't respond fully, but if you do get a chance to reply again, know that you already have my gratitude!

[tug]

mweb - another pit induced mama who birthed without other meds here. the pit definately made everything intense, but i agree that it can be done. i moved around a lot (same thing as bluet with a fabulous nurse who followed me around with the monitors). i totally used the birthing bed. had them put up the bar (looks like a roll bar) and pull off the foot section so i could hang under the bar, over the bar, kneel onto the bed, hang off of the bed. had the doc do exams while i squatted holding onto the bar. worked well. i also made lots of noise. go ahead and let it out. i figured that i had free license to holler since i was doing the birth without pain meds and with pitocin. also, warm showers felt good to me. i would say i had to go to the bathroom and then run water over me. even running it on my feet felt better. i did it and my son was even sunny side up so it was pretty intense all around. you can do it!!

bluet - wow! wish i'd thought to have someone put heat on the sacrum. that sounds great.

[BensMom]

Be aware that the cervadil can start labor. I had a cervadil induction and when ctx started, I didnt even realize it, because I had it in my head that we would not be starting the induction til the next morning. It was back labor, so it was hard for me to realize what was going on, other than I thought I was just uncomfortable trying to sleep in that stupid bed with those stupid monitors.

If the cervadil starts labor, you should be able to pushf or intermittent monitoring. If you have to have the pit, they will push very hard to have constant monitoring. And while I am not a fan of monitoring, I do think there are reasons to monitor with Pit.

I have doula-ed for 2 women who had Pit augmentation and both went without pain meds. We used the birth ball extensively! And lots of counterpressure, hip sqeezes, standing, rocking. I highly recommend a doula and see if you can find one who has experience with women who are being monitored (and this limited mobility).

Also, the nurses will automatically want to keep raising the Pit on a regular basis. One off my clients had a heck of a time fighting off those nurses every 10 mins who came in and bumped up the Pit without saying a word. Very frustrating. Once a good ctx pattern is established, you can even try to get them to take the Pit off alltogether.

That said, so some research on low fluid. How low is the fluid? The research just doesnt play out with benefits for inducing for low fluid as much as doctors like to do it.

[roundpegmom]

Pardon me if someone already mentioned this and I missed it, but my midwife suggested a TENS unit during my pit induced labor. It worked very well, maybe you can check to see if a TENS unit can be available (it is like a little walkman sized thing with electrodes that stick to your back that people use for back pain)

I second (or third) the recommendation for the birth ball.

Good Luck to you!

[MrsMoe]

From what I understand and have read, pitocin doesn't "greatly" increase typical labor pains unless you are given it during the actual active labor itself to speed things up.

[orangebird]

Originally Posted by stafl

the "complete and utter lack of progress so far" may mean that induction will not work. If you really want my advice, I'd tell you to get a second opinion before agreeing with your doctor's plan to induce.

Absolutely! I was fully closed and cervix still firm and my babies' heads were still floating high the day before I went into labor with both my kids. It doesn't mean a thing. Drink lots of water and get a second opinion!

If, after seeking a second opinion, and doing some research on the risks of induction and the risks of not inducing, given your particular situation, you still think it's the best thing to do, I would strongly urge you to refuse constant monitoring and get up out of that bed as much as possible. Move around, change positions. Grab the IV pole, and drag it along as you walk through the halls. You do not have to agree to anything just because they recommend it. Educate yourself, know what the risks really are, and know what your options really are. Don't just blindly follow along with what they tell you that you have to do.

Agree again. Staying in bed on those stupid monitors is going to make it difficult. Maybe you can find stuff to do around/near your bed within the cords reach like sit on a birth ball, hands and knees, whatever makes you comfortable. I have a strong feeling they won't let you get intermittent monitoring with pitocin. Pitocin is dangerous so I can understand. The best thing you can do right now is work on avoiding it. If your body isn't ready it won't work well anyway.

If you do end up with it, fight tooth and nail to get what you need, to be able to move around. I hope you go into labor before that time on your own, don't let the cervix and high baby thing discourage you. I was that way with both mine (my first two weeks late) and went into labor on my own despite the firm closed cervix and floating baby.