I need induction help please

[joshs_girl]

Hey mamas, no flames please, just constructive words of advice if you have them.

I've apparently developed pre-e (I've been struggling with PIH for about five or six weeks now and am now spilling protein.)

My doctor is so not concerned about the baby - she's doing awesome and is totally healthy. She's passed both biophysical profiles with perfect scores and had a great NST today. (Side note, during the u/s, we got to see both of her little feet and counted ten toes!) She's practicing her breathing and still has plenty of fluid and my placenta looks great.

So the doctor is much more concerned for my health and not her's. I've been on BP meds for two weeks now and they're having a minimal effect on my BP - it keeps creeping slowly up and will only continue to go up the closer I get to delivery. (The average today was 130/90 - that's three different readings over two hours.)

The doctor wants me to go to the hospital Thursday morning and they'll prep my cervix with Prepidil and hope I start having some contractions. (If I'm totally honest with myself, I know they'll probably throw in some Pitocin because I know they want to see how I do with contractions.)

Worst case scenario: my BP goes up during contractions and I don't handle it well - they'll keep me Thursday night and start a "real" induction Friday morning.

Best case scenario: my body handles the contractions, they discharge me Thursday afternoon and I go into labor "naturally" during the weekend.

Mixed case scenario: I do okay with the contractions, they discharge me, and nothing happens over the weekend. I have an appointment with my doctor for Monday morning and they'll re-evaluate me and either try some more Prepidil on Tuesday morning or, if I've made more progress, a full fledged induction Tuesday morning. Although my doctor is a really, really reasonable man and hates inductions, so I think if I've made progress by Monday and my BP appears stable and no extra protein in my urine, he probably would let me go a few more days without more interventions.

Anyway, so the long story short is, I know all of these things are just opening the door for more interventions and I'm scared of what I'm getting myself in to. However, I also know that my body isn't healthy right now and that my health and my baby's health are linked and I don't want to do anything to endanger her (or myself, but I'm more concerned about her.)

I trust my doctor and I know he's not concerned over nothing and he's not an alarmist. So when he tells me it's not healthy for me to carry to 40 weeks, I believe him.

I just, I just don't know what to do. My gut is telling me that I'm a healthy person (not pregnant) and that what my body is doing isn't normal or healthy for me and that I need to do something about it. My head though is telling me that all of this is what I've struggled so hard to resist - all these interventions are just going to lead me to an inevitable c-section.

Any advice mamas? I'm in an emotionally fragile state right now as this was not the news I was expecting today (to say the least.) If you think for my health that an induction is a good way to go - any at home induction advice you can offer would be greatly, greatly appreciated.

My body does appear to be preparing for labor - baby is head down, engaged and I'm 1 cm dilated and 50% effaced - for what all that is worth.

[janasmama]

Sorry this is happening to you. The good thing is that we have medical interventions for when things similar to your situation are happening.

I honestly don't think that any at-home induction methods are going to put you into labor unless you are literally within hours of starting labor naturally.

And with this being your first baby (is that right?) the baby's head being engaged and being dilated is totally normal to happen a couple weeks before labor ever starts.

I am a huge NCB advocate and homebirther. So with this in mind:

You know your doc and the situation. I don't think that you should allow the fear of further interventions keep you from starting a necessary induction for health reasons.

I understand your fear of interventions, I have them also...but I don't think that we should let our emotions override our logical thinking.

[olliemi2005]

You are so wise to try to gather more information and support. I think researching this stuff helps us feel more on board since we become educated about the process.

Though is sounds like you trust your MD and his judgement, it doesn't sound like you are at peace with the plan your doctor has. Perhaps if you thought of some more questions to ask to clarify what exactly will happen in each scenario and then also some moms find it helpful to ask what the repercutions are if you go with an alternate plan ...maybe you want to wait a few more days to be induced such as on the following Monday.

I don't know if this helps but good luck!

[starparticle]

nak but,



you are approaching this with a great perspective - do you have a doula or friend to bring with you? can help to have an extra advocate when you are in situations where you aren't totally at ease.

remember, since you + baby are healthy you can always ask for more time (even overnight) to make decisions and take things at your own pace. stay calm

[whalemilk]

Originally Posted by janasmama

I am a huge NCB advocate and homebirther. So with this in mind:

You know your doc and the situation. I don't think that you should allow the fear of further interventions keep you from starting a necessary induction for health reasons.

I understand your fear of interventions, I have them also...but I don't think that we should let our emotions override our logical thinking.

:

My first was born at home, and last week I found out I am going to need a c-section for medical reasons. So emotionally, I have kind of BTDT and know what the internal struggle is like. Honestly what I would do in your situation is very similar to what I am doing right now in preparation for my birth: rest as much as possible, eat good food, take my vitamins, and focus on being in as good of health and spirits as possible going in to the hospital. Call in your support network and just act like you're on vacation as much as possible. Rest, relax, listen to your favorite music, buy yourself a special treat to take to the hospital (a new cd or lotion or something), and just try to keep your spirits high.

I know how scary this can be. I am scared right now too. I will be thinking of you this week!

[stephck]

every time i told someone i was planning an out-of-hospital birth i prefaced it with "as long as me and the kid stay healthy"
pre-e is why we need OBs and hospitals sounds like you have a great,reasonable doc who can talk you through the possabilities. good luck and take care off yourself!!

[coyotemist]

It sounds like you are making a good informed decision!

Also, it sounds like your body is preparing itself for labor, which decreases the chances of c-section.

The only way that *I* would feel comfortable waiting through the weekend to deliver the baby is if I had a blood pressure moniter at home, and spent the whole weekend resting, hydrating, and monitering blood pressure. If the blood pressure got out of control, or I developed a headache or other weird symptoms, I would head into the hospital.

One of my best friends went quickly from pre-e to HELLP, and after watching that situation, I know that some people stay in pre-e forever, and others need help quickly. You aren't going to know how you react because we are all so different.

My first baby was born at 38 weeks 0 days, and she did very well. We had mild trouble getting the latch down, but she was a very typical newborn.

Interventions aren't bad when they keep you healthy. Hugs and best wishes!

[funfunkyfantastic]

All I can say is *hugs* and send you lots of : I hope everything goes well for you. No one is judging you hon... you do have a serious medical condition and we all understand that.

[lwuertz]

Don't know much... however, my friend had Prepidil because she was 10 days overdue to induce labor. It did succeed in starting labor, but I guess they required that she be on her back the whole time which she said was really painful. Even though it did manage to start labor she didn't make much progress so then they started her in on the Pitocin which she said "was the devil". Still didn't make much progress. They did an ultrasound and baby was head down, but sort of tilted and not engaged at all. So then she wound up with a c-section in the end.

I hope that doesn't scare you, that's the only experience I know of with the stuff.

If I were in your position I think I'd start researching some natural/home induction methods.

[Charmie981]

I PMed you, but..

What is your 24-hour protien in urine? What have your highest BP readings been (not the average)? Do you *feel* like you have high BP when the readings are high?

My biggest concern, once the BP started going up, was that the few times it was high, it was scary high and it was totally unpredictable. I didn't feel bad at all, but my BP was high enough a couple of times that I could have had a seizure. For that reason, I wasn't comfortable bedresting at home until 38w, which was one of the options that the doc gave us. If I'd been able to have someone with me (ie DH could have taken off or we had family in the area), that might have been different. According to my doc, the thing with pre-E is not that your average BP is high, but that you have vasospasms that cause you to have errant high BP readings, which can be as much as 4 hours apart. Those spasms are actually more dangerous because your body isn't used to dealing with high blood pressure like that and that increases the risk of your placenta abrupting or you having a seizure or stroke.

Okay, so that's the scary stuff. The not-so-scary stuff is that you have a doc who is on top of it and is willing to go slowly with your induction. I'd go tonight and get some EPO capsules and do 3 caps vaginally every 6-8 hours until about 6 hours before the cervadil is started, then if you go through the weekend, continue to do the EPO (and maybe have lots of sex) then. You might also ask your doc about doing a foley induction (search in the Birth Professionals forum for more info on this). The idea here is that if you can get to a 3 or 4 before the pitocin induction is started, you'll have a much better chance of a successful induction that doesn't end in a c-section. And if you do end up opting for an epidural (because pit contractions can be hard and because being on pit limits your range of motion--via IVs and monitors-- and therefore your coping ability), try your darnedest to get to 5 or 6cm before you go for it. It's possible that your BP will only be acceptable on your side, which might make for a really misearble labor. In this case also, think epidural because it will have a side effect of lowering your BP. And yes...do you have a doula or a friend with NCB experience to attend your birth? Because this is likely to be pretty overwhelming for even the most supportive DH (mine included...and I'd say he was supportive of NCB to a fault ).

[Charmie981]

Originally Posted by lwuertz

but I guess they required that she be on her back the whole time which she said was really painful

Yes, I forgot that part...they did require me to be laying down for 2 hours after inserting the cervadil. It's more of a gravity thing than anything else...they need it to stay in contact with your cervix. I don't know if the 2 hours was just for me (we only did 4 hours of cervadil before moving on, but the usual dose is 6 hours), or if that's the standard. I can see that if they started pit at the same time or if the cervadil started labor, that could be a pretty miserable couple of hours. For me, I needed to pee right after they inserted it. By the time 2 hours was up, I had to pee so badly I wanted to cry (but not badly enough to use a bedpan ).

[moderngal]

how do you feel about trying EPO? Or other "induction" methods (ie nipple stim, acupuncture, castor oil)? I think that if I were in your shoes, I'd try some of the other things- even if they don't put you into labor, they might help get the conditions a little more favorable for a medical induction.

that said, mama. it's not easy to deal with this stuff at an already emotional time.

[boobyfeeder]

In your situation, I'd say that an induction is warranted. You can, however, do things to make it more favorable and less likely to end in c/s. Start taking EPO immediately, at least 1000mg by mouth and 1000mg inserted vaginally, to help ripen your cervix. If you can, also have sex. The fact that you are not closed shut should hopefully help your case a bit. Rest as much as possible, and mentally prepare yourself for any scenario, just in case. It's normal to be scared, this is a scary situation. But it sounds like this may be the best option health-wise for you (and in turn, the baby).

[alyssatuininga]

Oh Kati I am so sorry that you have to go through this! I don't have any advice but I just wanted to send you some love and support. I can imagine that you must be overwhelmed and scared. You and Poppy will be in my heart and thoughts. Trust your own instincts mama. Whatever your birth ends up being like you will have a beautiful Poppy in your arms soon.

[joshs_girl]

Thanks so much mamas! It meas a lot to me to see all the positive words and support.

I am taking a LOT and I mean like 4000mg of EPO orally, but haven't done it vaginally. I'll start that tomorrow. I also have a wonderful doula - and I know that's going to be invaluable. We've also been having sex almost every night for the past two weeks

We've made lists of all the little last minute things to do and get done so hopefully that will help keep me busy and keep me from stressing too much in the meantime.

So I'm just trying to get my mind ready - my heart has been ready for this for a much longer time!

[Azryel]

((Hugs)), Kati. it's definitely a good thing that we have the ability to detect and deal with serious issues that arise during pregnancy. I wish you lots of luck. Take good care of yourself! * Jaime

[mynetname]

[Montse]

Originally Posted by alyssatuininga

Oh Kati I am so sorry that you have to go through this! I don't have any advice but I just wanted to send you some love and support. I can imagine that you must be overwhelmed and scared. You and Poppy will be in my heart and thoughts. Trust your own instincts mama. Whatever your birth ends up being like you will have a beautiful Poppy in your arms soon.

I feel the same way as Alyssa! I don't have any advice but wanted to let you know I'm thinking of you and feel confident you will make out great with your DD in your arms soon!

[slgt]

My SIL had pre-e with both of her kids and was induced for both - a far cry from her hope of a home birth with her first. BUT - she was cared for and her health and that of her babies' were protected, and she has two beautiful, healthy kids.

The biggest thing I can say is prepare yourself to be ready to do what you need to do for your own health and that of your babe's...having a peaceful, positive mindset about come-what-may, even if it's the farthest thing from your dreams, can help make everything go more smoothly. Be prepared to work with your body, make sure your DP is well-prepped to be your advocate if needed so that you can focus on what you need to do. It sounds like you have a doc that you trust, and hopefully that translates to a birth team that you trust. If you don't have a doula, that may help no matter what ends up happening...

I spent a lot of time in the month prior meditating in a not-at-all-organized fashion on preparing my mind and releasing fear about the possibilities - it made a big difference.

Good luck, JG!

[Jezzy]

Sorry this is happening to you!

My mw suggested 2 TS of castor oil mixed with orange juice and champaign to try to induce at home....