41 weeks & they want to start doing stuff.

[day_sleeper]

I am 41 weeks and 2 days. The first problem is that my midwife reviewed my dates a few weeks ago and determined that my previous due date was wrong, so she took away 5 days. GRRRRRR. Now I have to be at the hospital in 4 hours for a NST. Also, she said I need to go ahead and schedule my induction for Thursday, "just to have it on the books." She doesn't think I'll need it, but come on. I totally feel I won't go into labor on my own by then.

Questions:

1) Is the NST anything to get worked up about? I pretty much know what's involved, but in anyone's experience, has it led to a panic? My baby is moving just fine, but I'm scared there's going to be one odd blip on the radar that's going to result in me ending up in the OR. Am I just being paranoid?

2) If it comes down to an induction, do I have a realistic chance of giving birth with no epidural? I've heard even the toughest ladies cave in with pitocin contractions. Has anyone been induced and gone on to deliver without pain meds? Is it likely that I'll even need pitocin? Could the cervadil do the trick on its own? Thanks!

[Persephone]

I'll tell you my experience.

I was just over 40 weeks when I was induced. A NST is fine, I can't imagine they'd look hard enough to find something scary by that point. And the worst that can happen, is that they'd induce you. They just want to make sure the baby is still reactive.

I was induced with Cervadil. My cervix was anterior and dilated 2 cm when they started (I was suprised, cause I had NO labor symptoms to that point, just some BHs). 12 hours later, they took it out, and I had begun mild ctx. The nurse checked me, and I was dilated to 3. She said Cervidil isn't supposed to dilate you at all, just ripen your cervix, so I was lucky. I ended up having a fast 6 hour labor (very intense) after the Cervidil came out. So, IME, you can end up not needing pit, but I don't know how common my experience is. If I hadn't started contracting on my own, they would have given me pit, (a low dose at my request), and bumped it down as they saw fit. (Doc wanted to see ctx 2-3 mins apart, before he'd do anything.)

One thing I did do with my birth was make peace with myself if I did end up needing medication. Pit ctx are not the same as natural ones, and it's ok to not deal with them as well.

[day_sleeper]

Thanks for your perspective Persehone. You're right, the NST was no big deal. In my case, it's just a big inconvenience because my midwife doesn't have the equipment to do them at her office, so I have to drive a long way to the hospital (which we were hoping to go to ONCE, haha). I won't get my hopes up based on your induction story alone, but it does make me feel a little better. I have it in my head that if I agree to an induction, I might as well sign the c-section consent form.

[Persephone]

No, that's a defeatist attitude! Just because you're induced, doesn't mean a csection! I agree, avoiding induction would be the best thing, but if you have to be induced, it's not a death sentence. And you're actually better off, because you know how induction can lead to a section and take steps to make sure that doesn't happen. Honestly, any birth can lead to a section, if the baby goes into distress or whatnot. If you do end up having to be induced, just ask for the lowest dose pit possible, ask if you can still move around during labor (that was my big thing, thank goodness my BP cooperated), ask the dose to be dropped if you're having regular ctx, avoid pain meds if at all possible. You can do this!

[ajsgirl]

I was induced too, for a calcifying placenta with pg #1. My induction wasn't with pitocin though. The midwife broke my water as a means to induce and it worked immediately (I was already 3cm). Those contractions are powerful too, but not as bad at pitocin ones (so I hear). Did she say that they'd induce with pitocin?

[ajsgirl]

I also want to reiterate what Persephone said... you can do it! Education is your weapon. Think positive!

[MAMom]

Chiming in from Feb DDC....

Glad the NST went well.

Just remember, you don't HAVE to consent to anything. It's your body, your baby & your choice.

I was induced with baby #1 - supposedly low amniotic fluid from the ultrasound that accompanied the NST - the 2 done together are called a biophysical profile. But in my research since then I realize that since everything else looked great, I should have refused the induction & had them redo the ultrasound to check amniotic levels again after hydrating & eating.

Anyway, I had the downward spiral & ended up with everything I didn't want...induction with pitocin, pain meds (epidural) and finally a c-section.

Anyway, I guess what I'm saying is decide what YOU want and what is right for you, and don't feel pressured to agree to stuff you really don't want or feel is necessary.

Sending lots of labor vibes your way!

[MamaTaraX]

MAMom is right -- you don't have to consent to anything.
Inductions don't have to involve Pit. My favorite kind are ones with Cervadil. Yes, it's a cervix ripener, however, if your cervix is favorable, you'll dilate with it, as happened with Persephone. Someitmes you have to ask for Cervadil, sometimes you have to beg or fight for it. Pit should neverbe a labor starting point. Inductions won'/t work if your body isn't ready in the first place, so it only makes sense to start with a cervix ripener. Cervadil can be inserted, removed, and replaced many times over. I recommend that if you can, get your doc to be on board with using Cervadil until ctx are regular before even considering Pit. Ifyou do Pit, get the lowest dose possible and have it turned off once a "good pattern" is established. It's actually not something that one is meant tobe on continuously, even though that's how it is regularly used.
Pit. ctx are definately different than natural ones. I have attended Pit. inductions/augmnentations where the mom had no pain meds, but they are pretty few. I commend those women greatly and can tell you honestly that the ones who had no drugs, the labors went quickly so they didn't really have time for anything anyway. I'mall for avoiding Pit. at all costs, if for no other reason that it reguires constant monitoring. Well,` it doesn't, but most care providers aren't willing to do intermittant monitoringon itbecause it still has to be done rather regularly.
Consenting to an induction isn't consenting to drugs and its certainly not consenting to a c/s. I think I attended 19 births while I was pregnant. Of those, over half were inductions and they were all vaginal births except for one (and that c/s was related to the epidural the mom receieved, not the Pit or the induction itselfactually) Inductions reguarly end in vaginalbirths, so pleasedon't let the thought of an induction scare you into thinking anything else. Even with an induction, you can make your birth what you want of it. It's still your body and your birth. I wish you the best of luck on a beautifulbirth and moreso I wish for you that you don't need your "on the books" induction (which I personally woudln't schedule because in my mind, that's where I'd end up if I wrote it down) Peace!

Namaste, Tara

[KarenEMT]

Lurking from July...

I too was badgered by my doc starting at 41 weeks. I finally did consent to an induction (wish I wouldn't have) at 41 wks 5 days. They kept harping that the baby was big, etc., etc.

I was able to have a med-free birth with the Pit-induced contractions, but just barely. If it had lasted any longer, I would have had the epi. I went in at 7:30 a.m. and had my water broken, then Pit. was started at 9 a.m. I was complete by 2:15 and delivered DS at 2:28. The Pit contractions were horrible, multi-peaking, but I just tried to relax as much as possible. DS was 10.9.

This time, I am having a homebirth with a MW who won't "force" induction. Good luck to you!!

[Nature]

My water was broken at the hospital, and I didn't require pitocin. (after having it for one labor, I WILLED myself not to need it this time) Not all inductions end up as pitocin horror stories.

[odessac]

Coming out of lurk to say that a very good friend of mine had an induction at 42 weeks. They started with Pit. She labored for 19 hours with out pain meds and delivered vaginally. It was a tough labor, but she made it through. Don't give in to a section before you have to. You can do it!!

[day_sleeper]

Thanks for the responses. To clarify, I see a CNM who works in a birth center practice of mostly CNMs and a couple of OBs. Because of insurance, I have to birth in a hospital, but it's the hospital the birth center recommends (good reputation for being hands off, natural, etc.) and the staff has privileges at. She said they wouldn't start with Pitocin, but with Cervadil. I don't know how much time they'd give me, but I read something to the effect of you shouldn't even start Pitocin until 12 hours after the last dose of Cervadil (IIRC). Anyway, we didn't schedule an induction. Quite honestly, after looking back at my calendar last year, my cycle was in no way normal, so I think it's highly likely that my due date is off. Considering it's been moved up 5 days, we're going to bring this up and see if she is willing to change it to buy us a few more days. On the other hand, I'm afraid (this is mostly thanks to other people) if I wait too long, something bad will happen. Sorry, I know this feeling is nothing new, and many of you have felt this way before. I just needed to vent.

[RainRaven]

I was induced with sylotec ( not spelled like that ) it worked great. no pit thay broke my water as babys head was coming out. I went in at noon with no labor symtoms at all, and I gave birth at 7:56 pm. I was indused for low fluid a day short of my due date. all and all it was not horable. and all natral except for the sylotec.

[BethSLP]

Originally Posted by RainRaven

I was induced with sylotec ( not spelled like that ) it worked great. no pit thay broke my water as babys head was coming out. I went in at noon with no labor symtoms at all, and I gave birth at 7:56 pm. I was indused for low fluid a day short of my due date. all and all it was not horable. and all natral except for the sylotec.

Glad everything worked out for you. Cytotec is a risky option as of yet. See below:

Cytotec's only FDA-approved use is treating ulcers. In August 2000, Searle, Cytotec's manufacturer, sent physicians a letter reminding them that Cytotec was not approved for use as a cervical ripening agent and that it was contraindicated for use in pregnancy (14). The letter listed serious adverse effects associated with using Cytotec, including maternal or fetal death, uterine rupture, and severe vaginal bleeding and shock.

[ozzyemm]

I agree with Beth on the Cytotec. Cervidil is MUCH better-- it is like a tampon in that it can be removed if necessary. Cytotec is like an aspirin-- It is a pill, and if it works "too well" you can't remove. Also, you can't give accurate doses.

[day_sleeper]

There's an article about Cytotec by Ina Mae Gaskin on this very website somewhere - it's probably the same as her section on it in Guide to Childbirth. Needless to say, I've been scared of that stuff for awhile! In fact, I was planning to add to my birth plan, fwiw, that I do NOT want it used.

[peilover010202]

Hey, not in your DDC, but I wanted to add my epi-free pit story!

My dr put me on Pit since my water had been broken for more than 24 hours. I slept through most contractions for the better part of the day and was in transition for a short 10 minutes before I started pushing. The contractions through transition were tough and I asked dh and the doula for "DRUGS", but thankfully, dh started using visual imagery relaxation with me and it worked so well. No epi or any other drug needed!