To induce or not to induce?

[KCMommy]

Well, my water broke during the night (7 hours ago) and I am now 4 cm dilated, but with no contractions. Not feeling any and none showing up on the Non-Stress Tests. I assumed the doctor would just want me to let things progress on their own, maybe with some antibiotics to ward off infections.

But the doctor asked if I wanted to be induced with an IV drip. I said, "Not yet," for the time being, unless there was a compelling medical reason for it. He said the only concern at this stage would be infection, but that he wasn't too worried about that yet. So the ball is in my court.

What do you Mama's think I should do? If I don't progress, how long should I wait before inducing? Or should I even consider inducing at all? Can anyone share their induction experiences? I will go and do a search through older posts after this, too...

Thanks!
- Krysta

[zoebird]

i would keep all vaginal checks to the absolute minimum--as these increase the risk of infection.

if you're in the hospital, then they'll have policies. at a certain point, they'll induce you because of the risks. it's standardized, usually, around 24 hours.

so, keep hands away from your vagina and hold off until the hospital won't let you any more. you may go into labor on your own.

here's hoping! good luck to you and i hope you have an awesome birth!

[rmzbm]

Screw "policy" - YOUR BODY! You can say NO to anything at anytime...and, I would! Good luck!

[amygoforth]

Originally Posted by zoebird

i would keep all vaginal checks to the absolute minimum--as these increase the risk of infection.

if you're in the hospital, then they'll have policies. at a certain point, they'll induce you because of the risks. it's standardized, usually, around 24 hours.

so, keep hands away from your vagina and hold off until the hospital won't let you any more. you may go into labor on your own.

here's hoping! good luck to you and i hope you have an awesome birth!

Exactly. Keep everything out of your vagina and stay home as long as possible. Are you still leaking water? Is it clear? As long as the fluid remains clear and non-smelly, I wouldn't fret at this point. Be aware, some hospitals want you to DELIVER within 24 hours of your water breaking.

Enjoy your easy, early labor!

[Kappa]

I'm sure you'll go into (active) labor ANY MINUTE now! Good luck!

[attachedmamaof3]

Also, keep in mind that your amniotic sac CAN reseal!!

If you are still leaking and it's still clear/sweet smelling I wouldn't even worry.

Definately wouldn't induce for sure and no more "checks" either.

[JanetF]

No need for any medical palaver, this is perfectly normal. Try this: http://www.joyousbirth.info/articles/isthataleak.html

[alegna]

I would not.

BUT-

ABSOLUTELY nothing in the vagina. Nothing. Do not, under any circumstances, let anyone put their hands in there. Period. Paragraph. End of sentence.

-Angela

[huggerwocky]

I was in this situation, with a midwife, and no, I did not consider inducing. i did not get contractions for 3 days, I doubt any doctor would have nodded that off.

Vaginal exams are a very bad idea in this situation,too! he should know better! No more checking for progress!!

[mamabearing]

different answer

I would go into the hospital and then do nipple stim. I wouldn't want to do it out of hospital ( ie off the fetal monitor ) because rarely you can cause contractions that are too long and too strong. You have a great start and I suspect you are already in labor and not reading this...but just in case!

If there is no sign of infection at 24 hours I would want the pitocin. I am a rare bird here and very conventional but I don't think the risk of infection is worth it after 24 hours. You want to start labor by 24 hours, not have the baby in your arms.

I agree with no vag exams until you are in labor. The only exception to that being before they start the pit they do Leopolds and make sure the head is down...if they aren't sure, and you are about to get pitocin, you want to be certain the baby isn't breech.

[alegna]

Originally Posted by mamabearing

I agree with no vag exams until you are in labor. T

NO VEs PERIOD. In labor or not. NO VEs with broken water. NO NO NO.

Very bad idea.

-Angela

[huggerwocky]

Originally Posted by mamabearing

I agree with no vag exams until you are in labor. The only exception to that being before they start the pit they do Leopolds and make sure the head is down...if they aren't sure, and you are about to get pitocin, you want to be certain the baby isn't breech.

You don't need a vaginal exam to check for breech presentation.

[AmyLaz]

This happened to me during my first preg, only my water broke on a Saturday night, and I didn't go to my OB until the following Thursday! It started as a very slow intermittent leak, so I thought I was losing control of my bladder and was just peeing on myself The leaking got progressively heavier and more frequent, so I went to the OB for a check. I was only 34 weeks, so I really thought he'd just confirm that I was peeing on myself. He checked me and saw that it was fluid after all and that I was 4cm dilated (I had no contractions). Since my water had been broken for 5 days, the risk of infection was pretty high, so they whisked me up to the hospital and hooked me up to IV antibiotics and pitocin. DD was born several hours later, weighing 7lbs even with no breathing problems at all - just some jaundice. Turns out I had incompetent cervix.
Sorry - didn't mean to hijack your thread! I just wanted to add that if my water had only been broken for 7 hours, I would refuse an induction.

[mamabearing]

usually

Originally Posted by huggerwocky

You don't need a vaginal exam to check for breech presentation.

I agree....MOST of the time. But just in case she is a rare case where they aren't sure, I know my preference would be not to go through labor with pitocin and then find the baby is breech. You read I said they should to Leopold's first I hope? I meant if they are not sure ( and with a big mom or a weird presentation sometimes you aren't....I have seen very GOOD experienced midwives and doctors be wrong) I think one VE prior to pitocin would be worth the risk. Only if there was doubt about the presentation externally.

[SublimeBirthGirl]

I would NOT NOT NOT go into the hospital if I was not in active labor. I would keep everything (including "sterile" fingers) out of my vagina, stay home, and get some rest. For me personally, I'd go indefinitely as long as the water was clear and I felt okay. I wouldn't even consider induction til my water had been broken 48 hours, and if the leaking stopped I'd assume it had resealed and go about my business.

A great number of my students who have had cesareans had them because of PROM and no immediate labor. I'm very, very lucky to have avoided that with my first.

[cottonwood]

For me it would all hinge on whether there had been a vaginal exam yet or not. With a VE having been done, I'd be thinking about possible infection. I would still probably not induce, but if I hadn't gone into labor within 24 hours I'd want to do some monitoring.

With no VEs, I wouldn't worry about infection at all. The fluids are coming down and out, how is anything supposed to get up there unless you put it up there? Especially in a hospital, who knows what you'd be exposed to there.

If you do decide to stay home, just remember to stay hydrated!

[KCMommy]

Thanks for all the replies, gals! I'm at 18 hrs since water broke now and no apparent contractions. Aside from those first two vaginal exams they did in the beginning, no one else has been inside me. I'll take everyone's advice and try to stave that off, if possible. They're starting me on antibiotics in the morning, to be given every 4 hours by IV.

[JanetF]

But if you have no infection or illness why would you have abx and potentially jeopardise your health, your baby's health and your birth? That's why we have superbugs in hospitals because healthy women get given abx they don't need. If you want to do something proactive, take your temp every 4 hours because a temp rise can indicate infection is present. Take vit c in large doses, echinacea, and grapefruit seed extract if you wish but if you're not ill, avoid the abx like the plague. The UK guidelines I posted show that the vast majority of women commence labour with 96 hours and they don't automatically induce. Guess what? Their c/s rate is lower than that of the US too... A leak without labour is not a medical condition. I had a MASSIVE hindwater leak and no labour till 8 days later. Baby born a few days after that again. I had no VEs, no problems, just stayed home and then gave birth. Once you go into a hospital without being in strong labour, and without needing their technology, you face an up hill battle to avoid more and more interventions. Please please reconsider. You don't HAVE to do anything, least of all take major drugs when you're not even ill. Just stay home, monitor yourself if you must, and go to hospital once strong labour is established. If you're not having a homebirth that will at least keep you as safe as possible.

[BirthFree]

Originally Posted by mamabearing

I would go into the hospital and then do nipple stim. I wouldn't want to do it out of hospital ( ie off the fetal monitor ) because rarely you can cause contractions that are too long and too strong.

As soon as you stop stimulation, the oxytocin stops (unlike an IV pitocin drip), it would be VERY VERY unlikely to cause any ctx. that are "too long and too strong" *especially* compared to any artificial labor stimulation.

An OB required a client (doula) of mine to be on the monitor when she did nipple stimulation because otherwise he couldn't control it. I honestly laughed when he was out of hearing range. Does everything have to be controlled? Could not a Mom say, "hmmm, that seemed too long" and just stop doing the stimulation on her own? My guess is yes - no amount of artificial monitoring will replace a Mama in that dept.

Hoping you have a peaceful birth and are not coherced into anything by staff that is impatient. Time is something you have a lot of - if there is no obvious danger, you and your baby are ok. Just keep that in mind.

Good luck.

[SublimeBirthGirl]

Originally Posted by JanetF

But if you have no infection or illness why would you have abx and potentially jeopardise your health, your baby's health and your birth? That's why we have superbugs in hospitals because healthy women get given abx they don't need. If you want to do something proactive, take your temp every 4 hours because a temp rise can indicate infection is present. Take vit c in large doses, echinacea, and grapefruit seed extract if you wish but if you're not ill, avoid the abx like the plague. The UK guidelines I posted show that the vast majority of women commence labour with 96 hours and they don't automatically induce. Guess what? Their c/s rate is lower than that of the US too... A leak without labour is not a medical condition. I had a MASSIVE hindwater leak and no labour till 8 days later. Baby born a few days after that again. I had no VEs, no problems, just stayed home and then gave birth. Once you go into a hospital without being in strong labour, and without needing their technology, you face an up hill battle to avoid more and more interventions. Please please reconsider. You don't HAVE to do anything, least of all take major drugs when you're not even ill. Just stay home, monitor yourself if you must, and go to hospital once strong labour is established. If you're not having a homebirth that will at least keep you as safe as possible.

This is so, so true. The overuse of antibiotics and vaccinations is, IMO, going to be one of the most likely causes of human extinction. We are slowly creating sicknesses that will kill us all. It's frightening. *Why treat yourself and your baby with antibiotics when there is no infection to treat*?