Popping in...
What is it that you want to know, exactly?
With an induction you are continuously monitored. The cervidil (make sure that it's cervidil and not cytotec) will require you to remain in bed for a few hours. Try to stay upright as much as possible, to encourage the baby to get into, or to remain in,
a good position for birthing. This is a HUGE part of the induction - staying OUT of the bed (when you're in labor), so that the baby doesn't turn into a posterior position. I'll say more on that in a minute.
First I want to suggest that you find out what your Bishop's score is before you decide for sure on an induction. A
Bishop's score is a scoring system that gives the doctor (and you) insight into how likely your induction is to be 'successful', or, how likely you are to avoid a cesarean. It's not hard to figure out, if you know how dilated/effaced you are. I would have a discussion with your doctor about your score before discussing an induction - if your score is 1 or 0, you may want to sleep on that information before deciding for sure - or you may not.
If you decide to be induced, think hard about the hospital room and how you can make it feel more safe, comfortable and nurturing for yourself. Bring your own quilt or pillows, bring photos of loved ones. Bring any birth art that you've created. Bring anything that will help you to feel *open*, relaxed, and present. Set the stage! You don't have to wear a hospital gown if you don't want to- if you have a nightie that helps you feel more comfortable, bring it! Bring slippers or socks too, because gross things land on hospital floors and you don't want to be barefoot.
Bring some snacks too, something light on your stomach. Different hospitals have different policies about food in labor but physiologically, you can't be effective running a marathon if you've been starved for 12 hours beforehand, ykwim? The thing they worry about is if you needed a cesarean, they would want your stomach to be empty so that you don't run the risk of aspiration - it's your decision, I always go for eating!
So when you arrive, you'll have some blood drawn and a heplock put into place. They'll check your cervix and then depending on what they find, they will either give you the Cervidil or will start Pitocin. (If your cervix is already dilated a bit and effaced, the Cervidil would be redundant.) You should ask for telemetric monitoring (I would call the hospital TODAY to find out if they have telemetric monitors), they will allow you to move around out of the bed, out of the room. Some of them are even waterproof so you can get into the tub and labor there while still being monitored. Don't wait until you are in labor to find out if this is an option! If telemetric monitoring isn't an option, don't feel like you have to stay in bed (even if that's where the nurses set up your straps). Get in the rocking chair, sit on a birth ball -
stay out of that bed. You have the full range of where that machine can be wheeled, and as far as the monitor cords will reach, for range of movement- take advantage of it!
So after the Cervidil is placed you may start to feel contractions just from that, you may not. My first client had one dose of Cervidil and it put her into labor, without any need of Pit, but she also hyperstimulated a bit (a risk of Cervidil or any induction drug) and needed an IV to slow down contractions that were on top of each other. When I was induced I had several doses of Cervidil and don't remember having contractions from it. After your cervix changes a bit (they want to increase your Bishop's score before they start Pitocin), you'll get Pit via IV. They *always* start out at the lowest possible dose, just FYI. It is dangerous to pump a large amount of Pit into your system right off the bat, it could cause your uterus to rupture- so they will *always* start out at the lowest possible dose. You will continue to be monitored throughout the induction. See if you can get the inserts for the Cervidil and Pitocin to bring home and just inform yourself of the risks and benefits before you decide.
This is the time for you to get something to eat (bring something to the hospital), and get some rest. Labor is hard work and you need to have as much rest and strength to get through it as possible. Don't be afraid to sleep, even if it's mid-afternoon! Once your baby comes sleep will be far more precious, and the less of the early labor you feel, the less you'll be obsessively watching the monitor. (I'd turn the monitor away from where you can see it - the less you stay in your *head* (observing, calculating, thinking, processing information), the easier labor can come on. Cover the clocks, too!)
As things pick up, keep the lights low and voices low too. Don't have the TV on, it's distracting and keeps you in your *brain*. Music would be great if you like it, make sure to bring something with you that soothes you. Keep laughing!! The best births are the ones where we laugh all the way through, even if things don't go down the way you expected. Kiss, touch, shower together- anything to keep you skin to skin, in close proximity to each other. Will you have a doula? I HIGHLY suggest one, especially for an induction!
The contractions with Pitocin are differnet from spontaneous contractions in that they tend to be more like cliffs than mountains. You will see the pattern on the monitoring strip look like you jumped straight up into the peak, and then when it is over, you come straight back down again. So it does feel more intense than spontaneous contractions, which ease into the peak, and ease back out. ("ease" might not be the right word, but you get the idea.) Pitocin contractions can also have a longer peak, and also can double peak as well. These are some of the reasons why women choose medical pain relief (but not ALL women, I've attended a few inductions where there was no medical pain relief). There's a whole physiology to epidural that I don't really have time to get into here (I have to leave, trying to get this all written up for you!) but I can come back and write on it if you want. Know that with an induction you are more
likely to desire pain relief, but that doesn't mean you are
going to need it. I hope that makes sense.
I'll come back and write more later!!
