I've had Pitocin with no pain meds!! I was in active labor, but stalled at 6 cm for several hours, so it wasn't pitocin to induce, but for progress. I was supposed to report for induction that morning, but went into labor on my own (after every "natural" induction method I could find to avoid the drugs) at midnight the night before. In retrospect, I know I didn't "need" the pit, but I was delivering w/ a CNM at the hospital, and I'm sure she felt pressure to get me progressing before the OBs came in to start pushing a c-section. I went into labor at midnight, started getting pitocin aroun 12:30-1 the next day, delivered DD at 7 pm.
If you are facing induction, I would make the following requests:
1) will they try cervadil before pitocin? I don't know all about cervadil, but my CNMs would do 2 applications of cervadil before resorting to pitocin. Cervadil ripens the cervix, whereas pitocin stimulates contractions. I felt more comfortable with the cervadil b/c then I felt like the contractions would be more natural. my CNM's office would do one app. of cervadil, give it 12 hours to work, then another for 12 hours, then if labor wasn't underway would turn to pitocin. It seemed more gentle an option.
2) negotiate the dosage. I talked to my CNM - what do you want to see? what frequency and duration of contractions? how will you monitor that? when you see that pattern, we will STOP CRANKING UP the pitocin (they generally crank it up every 30-60 minutes unendingly). I was straight up with her that I was only willing to consent to the minimal effective dosage, not the standard business as usual. In restrospect, I wish I had demanded that the pitocin be shut off when I was fully dilated and ready to push. I just didn't think about it (and wonder if my 3rd degree tear was related to the meds). But they will leave it on forever - I had to demand that they turn it off when she was born and remove the IV, otherwise they leave it on to contract your uterus and for fluids, even after you deliver the placenta.
3) ask for portable monitors - my hosp had telemetry monitors that were strapped on, but wireless. so even though I had to be monitored while on the pitocin, I could move around, sit on the birth ball, go to the bathroom etc. I think even if your hosp doesn't have portable monitors, you can ask the nurses to help you get to a birthball, chair, etc. near the bed. And if they don't have portable monitors, I'd feel free to disconnect them when you want or need to. Nobody's actually watching them most of the time anyway - they just look at the strip when they come it. I personally think if they want to monitor you they can park their butts in the room and monitor you. Plus, Ctx monitors are notorious for missing tons of ctx, and every time the baby moves the heartrate monitor doesn't work...
4) Tell your MW that you want to avoid an epi or other pain meds and ask for support and cooperation. Ask that they NEVER be offered, and develop a "safety" word with your partner. Ask in advance for positive attitudes and encouragement. Try different positions and relaxation techniques. PRACTICE them before you get induced so they will be familiar.
5) It's mostly mental - you have to really psych yourself up. The contractions are unatural and excessive. but you can handle it. You can handle anything if you believe that you can.
Personally, I would not agree to an induction without demonstrated medical need. Meaning, significantly low fluid, concerning heartrate, or fetal distress. I feel like for me, my body was stalling b/c it needed a break - I'd been up for 24 hours and been in labor for 7-8 when the dilation stopped. I wonder if I had had a nap, rested a bit between ctx, then been able to labor w/o deadlines and pressures how it would have went. I was fine for labor to last over 24 hours, so I wasn't antsy. The lesson I learned is that when you are in a hosp., even with a CNM, you are subject to the timelines, pressures and policies of that hosp. But I also found out how strong I am and what I can handle. I felt like a superhero when it was all said and done!