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Inducing....opinions? Please be kind.  

post #1 of 38
Thread Starter 
I am only 23 weeks, so I have some time, but I am seriously considering being induced on my due date assuming conditions are good. Here's the story... I have had 5 babies, the last 4 at a hospital 45 mins away with CNMs. All vaginal, all undrugged and fast except #1. #1 & 2 were born on their due dates. I'm usually efaced and dialated to 3-4 cm about a month before I'm due.
#1 was posterior and 2 days in labor wound up with pitocin and an epidural. :
#2 was 2hrs start to finish with an intense drive to the hospital.
#3 was a week past dd, broke water to induce, 2 hr labor.
#4 was 4 days past dd, not induced 35 min labor, waterbirth. (Happened to be at hospital!)
#5 was 3 days past dd, strep b, broke water to induce after 2 courses of abx were in, 2 hr labor.

We have switched to a new cnm practice that has a hospital only 20 mins away, but I would like to labor through transition in the tub, but they only have 2 tub rooms. I am also worried about making it to the hospital as my labors are so short (or so long if you want to look at the ctx I start having at 3-4 mos!) DH is even more worried about this. Assuming I am my usual ripe and 3-4 cm at my due date, both dh and the cnms want me to be induced by breaking my water on or close to my due date. I like the idea of being certain to get a tub to labor in (or I'll wait until there is one to get induced) and not being in transition in the car and possibly not make it, as well as being able to plan a bit better for the older kids. And the possibility of a slower labor, 2 hrs are less intense than 35 mins! The overwhelming likelihood is I would not need anything other than them to break my water, (the cnms also would not do this unless I was 3-4 cms) but even with my good history I do fear the slippery slope. I also know how much nicer it is to labor with an intact bag of waters. We are relatively positive of my due date as I am regular and my ultrasound matched dates. I know this is sort of rambling, but I'd like some experienced mama opinions. My ideal would be a UC at home in my own tub, that would take care of all of this, but for various reasons that is not an option and I respect my husband enough not to intentionally do that on my own. Please no dh rants, he is great.
post #2 of 38
I can't honestly answer your question and follow your rules. No way I'd induce.
post #3 of 38
Quote:
Originally Posted by SublimeBirthGirl View Post
I can't honestly answer your question and follow your rules. No way I'd induce.
:
post #4 of 38
There is absolutely no guarantee that this baby will be ready to come on the due date. There is also no guarantee that this baby would come in 35 minutes like #4 or in 2 hours like #2.

Questions for you to ask your husband that you don't have to share here:
You've had 4 children with no problems, exactly what is he afraid of?
Does he understand how harrowing the drive was for #2?
Does he realize that being *in* a hospital doesn't usually get you to an OR for a c-section any faster if (heaven forfend) that should be necessary?
Does he really *want* to deal with coordinating getting 5 kids and a pregnant wife to the hospital?
Does he understand that inducing, no matter how things have worked out in the past always comes with certain risks? Including the risk of the baby not being ready?

Separately from that, if you do decide that it's best for all concerned to be induced in the hospital I'm just concerned that breaking the water is an all or nothing proposition. It starts that stupid 24 hour clock and means you can't just say "okay, guess the baby's not ready, let's stop and try again another day."
post #5 of 38
Elective induction is fine in my book if you really know all your options and are prepared for whatever may come of it. I would never choose AROM to put me into labor because of the off chance it didn't put me into labor, even at 3-4 cm. Once your waters are broken, you are on a clock, good or bad.

Have you thought of doing a membrane sweep to put you into labor? I'd much prefer that, because if I did that and it didn't work, I could still wait until I was ready. I like the idea of nudging along without actually forcing it. But this is all what I prefer, sounds like you'd probably do just fine with your plan.
post #6 of 38
I would never induce without medical reason.

-Angela
post #7 of 38
i have to say that i can never support an induction for no medical reason. your labours are fast but you are experienced; is it really the end of the world if you don't make it to the hospital in time? is it really that big a deal if you don't get to spend an hour in the tub?
i've been through an induction and it was hell. i'm not saying all inductions are, but i think it's way too big a risk to take, especially since your labours are so short anyway. inducing didn't give me a slow labour ~ i went from 3cm to 10 in 2.5 intense hours, contraction on top of contraction. it's not something i would ever choose just for convenience, and who's to say you won't go into labour before your scheduled date anyway.

i'm not trying to be rude by saying this, but it sounds like you have pretty quick and easy labours, why complicate it?

i would just learn everything i could about UC, and since that's not what your DH wants, hope you make it to the hospital in time. i think even if he doesn't want a UC, there's obviously a very real risk of having one, and he should take some responsibility for learning how to do one safely. induction is a big risk, and shouldn't be done because your DH doesn't want a UC. is there anyone (mom, sister, friend) who can come live with you as your EDD approaches and be there in case of a UC?
post #8 of 38
I would never induce again, barring a medical neccessity. I was induced w/ DS and it was the worst experience of my life.
post #9 of 38
Did you try some of the less absolute induction methods before AROM, in the past? Nipple stim, black cohosh, membrane sweep, etc.? I'd probably try that route first.

I have had two fast births, also, so I know how intense it is. No way would I want to be driving to the hospital. That's why I chose to birth at home last time.

If that absolutely wasn't an option, I might consider your route. It sounds like you're really informed about your options and the risks. So, it's really up to you. I'll send you some slower labor vibes, though!
post #10 of 38
Nope, I'm with a pp, your labors sound short, there doesn't seem to be any pressing medical reasons, and you're not regularly way overdue. All things considered, I'd avoid the potential risks of induction and let your body do "it's thing" when its ready for a healthier labor.
post #11 of 38
Are your labors short and mild or short and intense? I think if they are short and intense then it is understandable why you wouldn't want to be driving to the hospital during them, and why you would really need the tub durring transition.

Is your husband against homebirth, or just against UC?

Could you possibly try to make a deal with your DH, instead of the two extremes of hospital versus UC (not saying they are "extreme" choices, but just to phrase it that way for DH), why not compromise on having a homebirth with a midwife. If she doesn't make it on time, then no biggy, it sounds like you are very comfortable with the idea of UC, and DH can't get mad because you planned on a midwife.

I can understand fast and intense labors and not wanting to be without a tub. I personally would not try to solve the problem by inducing though. I plan to have my next Dc at home, and to educate myself about UC just in case the midwife doesn't make it. If that wasn't an option for me, then I'm not sure what I would do, I never really thought about it. I think I would be afraid to start an induction because then there is such uncertanty about how my body will respond. But I really can understand why you need the tub, and it is kind of a dilema if you simply can't, for whatever reason, have a homebirth.
post #12 of 38
Quote:
Originally Posted by jennica View Post
Could you possibly try to make a deal with your DH, instead of the two extremes of hospital versus UC (not saying they are "extreme" choices, but just to phrase it that way for DH), why not compromise on having a homebirth with a midwife. If she doesn't make it on time, then no biggy, it sounds like you are very comfortable with the idea of UC, and DH can't get mad because you planned on a midwife.
:

-Angela
post #13 of 38
Thread Starter 
Quote:
Originally Posted by sapphire_chan View Post
There is absolutely no guarantee that this baby will be ready to come on the due date. There is also no guarantee that this baby would come in 35 minutes like #4 or in 2 hours like #2.

Questions for you to ask your husband that you don't have to share here:
You've had 4 children with no problems, exactly what is he afraid of?
-Something going wrong and people blaming him, even if we both know it wasn't his fault. Unfortunately there is precedent for that.
[/QUOTE]Does he understand how harrowing the drive was for #2?[/QUOTE]
-Oh yes, that is why he doesn't want to do that again.
[/QUOTE]Does he realize that being *in* a hospital doesn't usually get you to an OR for a c-section any faster if (heaven forfend) that should be necessary?[/QUOTE]
-Could you explain this, because I don't think I know this?
[/QUOTE]Does he really *want* to deal with coordinating getting 5 kids and a pregnant wife to the hospital?[/QUOTE]
-The older kids are old enough to stay home and watch the littles, but he very much does not want to deliver the baby himself. While he is great in labor, he has not read anything or feel knowledgeable about birth. (He knows more in practical knowledge than he thinks!) He feels comfort in having a midwife who knows what she is doing there. If we had insurance that would fully cover a homebirth with a midwife, he would be cool with that, but we can't afford the out of pocket part. (Insurance pays some, but pays 100% at the hospital.)
[/QUOTE]Does he understand that inducing, no matter how things have worked out in the past always comes with certain risks? Including the risk of the baby not being ready?[/QUOTE]
-I don't think either of us have really considered that, since that hasn't been our experience, its something good for us to think about, that's why I asked the question.

[/QUOTE]Separately from that, if you do decide that it's best for all concerned to be induced in the hospital I'm just concerned that breaking the water is an all or nothing proposition. It starts that stupid 24 hour clock and means you can't just say "okay, guess the baby's not ready, let's stop and try again another day."[/QUOTE]
-Now THAT is a really good point, since that is the reason I wound up with pitocin and by extension an epidural (I was so exhausted and had heard such horror stories about pitocin that when we were getting close to 24 hrs and they insisted on pitocin I told them that if they were giving me pit they were giving me drugs. ) my first birth with the OB. It was an awful posterior labor. I NEVER want to go down that route again!
post #14 of 38
How would they manage the induction? Stripping of the membranes sounds like a good way to do it. I was able to be induced with cervadil but they were doing a "medical induction" so I would have ended up with pit if I hadn't advanced. The more they start screwing with your body the harder things get and you are taking a bigger chance of having a c-section. As far as the c-section in hospital vs transfer goes even if you are in the hospital they have to prep a room, give you an epi so it can take a couple of minutes. If you are in an ambulance on your way to the hospital they call in advance to have things set up. Since you have insurance can you have the ambulance pick you up once you are in labor (avoiding the driving) and then a paramedic can deliver if needed? My ex-BIL is an EMT in a rural area and he has delivered a few babies en route.
post #15 of 38
Thread Starter 
Quote:
Originally Posted by jennica View Post
Are your labors short and mild or short and intense? I think if they are short and intense then it is understandable why you wouldn't want to be driving to the hospital during them, and why you would really need the tub durring transition.

Is your husband against homebirth, or just against UC?

Could you possibly try to make a deal with your DH, instead of the two extremes of hospital versus UC (not saying they are "extreme" choices, but just to phrase it that way for DH), why not compromise on having a homebirth with a midwife. If she doesn't make it on time, then no biggy, it sounds like you are very comfortable with the idea of UC, and DH can't get mad because you planned on a midwife.

I can understand fast and intense labors and not wanting to be without a tub. I personally would not try to solve the problem by inducing though. I plan to have my next Dc at home, and to educate myself about UC just in case the midwife doesn't make it. If that wasn't an option for me, then I'm not sure what I would do, I never really thought about it. I think I would be afraid to start an induction because then there is such uncertanty about how my body will respond. But I really can understand why you need the tub, and it is kind of a dilema if you simply can't, for whatever reason, have a homebirth.

Yes, short and intense and I have done it with and without the tub and it is a huge difference.

Just against UC. And he is open to the possibility that if I go really fast we may have a UC whether we want to or not. I think he is afraid of something going wrong (even though we both know the liklihood is very small) and people blaming him. Unfortunately we have precedence for that. Our insurance will only pay a small part toward a homebirth with a MW. They pay 100% at the hospital. I am working on getting a waiver through, if that happens we will go HB with a CNM. Its not looking too promising at this point though. We can't afford to pay a few thousand out of pocket. I have seen others saying they just reorder their budget in order to afford it, but that is just not a realistic option here. Honestly I was sort of hoping to be unassisted at the hospital (just have everybody standing around twiddling their thumbs while I birth)and show myself and DH that I could do it. #3 I delivered the head myself (midwife didn't make it), but I had help with the shoulders. I think I get panicky and want to get the shoulders out before the baby turns. (I only read about that recently) Thanks for understanding about the tub. With my fast intense labors it made a huge difference, and the shower was not helpful.
post #16 of 38
Thread Starter 
Could someone share info about some of the other things suggested, especially black cohosh and membrane sweeps. I had a membrane sweep with #1 and had my water break and a rough labor. Its not logical, but I think I have an aversion because of that. But I'm thinking that may be a really good option for me. Did I read somewhere that that only works when you are pretty much ready anyhow? Is there a usual timetable with doing that? I have been nursing almost every pregnancy, so I'm not sure how much of a difference that nipple stimulation will make for me. Oh, and another thing I forgot to post, although certainly not worth a csection or sick baby is DH transports inmates and likely could be on the road when I go into labor (although I tend to go at night when its on my own.) and may very likely not make it home. My due date happens to fall on his day off. Just another thing that figured into the equation.
post #17 of 38
Quote:
Originally Posted by alegna View Post
I would never induce without medical reason.

-Angela


:
post #18 of 38
It really sounds like a homebirth with a midwife would be an ideal situation for you. That way the only person worried about getting anywhere is the midwife instead of you and your dh and the kids. It sounds like it would be much less stressful that way.

I promise you that a homebirth would be worth the money and you will never regret it. If you think that being in the tub is great....you should try being in your own home with your own toilet, tub, shower, clothes etc. Its so much more comfortable at home.

Try talking with some midwives....the big majority of them will work out a payment plan with you so that it doesn't stress your budget too much....many will barter too.

Good luck!

Oh...and no, I wouldn't induce either....certianly NOT by breaking the waters right off the bat. The baby needs that coushin of water to be able to move into a good position for the birth.....not to mention the risks of cord prolapse or cord compression once the water is broken.
post #19 of 38
Quote:
Originally Posted by alegna View Post
I would never induce without medical reason.
:

My 4th labor was 45 minutes so I know how intense that can be but #5 was 6 hours and very managable here at home. So just because you have had fast labors doesn't mean this one will be too.

I know your DH says he couldn't forgive himself if something happened but could you forgive yourself if YOU chose induction and something happened?

Keri
post #20 of 38
Quote:
Originally Posted by SublimeBirthGirl View Post
I can't honestly answer your question and follow your rules. No way I'd induce.

I agree. Definitely not worth it to get into a tub that I'll be made to get out of before the baby comes.
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