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#1 of 22 Old 06-30-2014, 10:08 AM - Thread Starter
 
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Induction experience?

Unless my daughter decides to make an appearance within the net week, I will be induced on 7/7. I have heard negative things and people haven't been that supportive of the chances of avoiding an epidural during an induction. Does anyone have any personal experience that they wouldn't mind sharing? Anyone successfully avoid an epidural during an induction? I'd appreciate any tips!
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#2 of 22 Old 06-30-2014, 10:40 AM
 
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I know a good amount of women who have been induced and gone without pain relief, so it is certainly possible. The problem is that the uterus greatly (exponentially) increases its oxytocin receptor sites in the days before labor, so if you aren't in that window already, the pitocin won't be able to make your uterus contract effectively, and will lead to a very long, very slow process, and potentially a "failed" induction. So in other words, they can crank in as much pitocin as they want to, but there are only so many receptor sites to work with. What people don't often realize is that the women who had successful inductions probably would have gone into labor very soon anyways, though some certainly "make it" with less ideal timing of course. Feel free to ignore this question if you don't want to take the thread this direction, but what is the indication for your induction? I only ask because, as I'm sure you know, there are many increased risks, and according to the research, inductions almost never have any benefit as far as improved outcomes. And if yours is scheduled so far out, it doesn't sound like an emergency situation. Severe pre-e is the only reason I would ever consider being induced personally and the evidence doesn't necessarily even support that. This is a good, balanced article, although I would argue that even the legitimate reasons she gives are not actually good reasons at all (based on evidence she didn't include in the article). http://www.childbirthconnection.org/...e.asp?ck=10652
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#3 of 22 Old 06-30-2014, 11:06 AM
 
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Great info Margo! I second that I would NEVER choose induction or even allow it unless the situation had no other options. Even though I too have heard of some women doing well and going quickly that wasn't the case for me. The info on whether or not the uterus will respond well or not hit the nail on the head.

I was induced with my full term stillbirth and I will never forget it. The pitocin was relentless. The contractions were so much more intense or better said unbearable with maybe 60 seconds in between. I know it's probably not the response you would like to hear but I wish someone had told me before hand and I would have opted to wait for him to come on his own. I just didnt know. Real pain kicked in around 3a.m and he wasn't born until 10a.m so what seemed like an eternity.
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#4 of 22 Old 06-30-2014, 12:49 PM - Thread Starter
 
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I am comfortable with the idea of being induced. I will be 39 weeks at time of induction. My son was born at 39.6. I'm thinking that my body should be ready or close to ready. I have an appointment tomorrow and I should know more about the current state of my cervix then.

The reason I am having an induction is due to concerns regarding the still birth rate, due to my age and previous experience. Within the last few years, at least three different medical studies conducted within and outside of the US have suggested that induction can significantly reduce the rate of still birth in women my age - 40 and above. I read the studies some time back so I don't remember all of the details of each, but at least one recommended induction no earlier than 38 weeks, suggesting between 38 and 39 weeks being optimal.

As for increased rate of complications, I am familiar. One of the studies previously mentioned, I think it was the one done in the UK, cited an increase in cesarean of approximately 22%. I'm comfortable with that increased risk, given the significant decrease in the risk of still birth.

I try to make natural choices. My natural choice here is to do whatever might be medically or scientifically suggested to improve my rate of having a live birth.

Thanks for the information, ladies!
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#5 of 22 Old 07-02-2014, 02:54 PM
 
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I had an induction for my first - started with the lesser dose of Cervidil (cervical ripener) and were going to re-evaluate after that. I had an OP baby with a rather large head. Total time from induction to birth was under four and a half hours. I was able to move around with intermittent Doppler monitoring after the first hour. Active labor lasted under half an hour once I changed position. I didn't have Pitocin or any pain medication, although the intensity of active labor was incredibly overwhelming.

I'm not sure if that helps, but you could possibly discuss with your health care provider (I'm assuming an OB?) what your options are as far as an induction - trying a cervical ripener as opposed to immediately having Pitocin, for example.
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#6 of 22 Old 07-02-2014, 04:10 PM - Thread Starter
 
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Originally Posted by Caledvwlch View Post
I had an induction for my first - started with the lesser dose of Cervidil (cervical ripener) and were going to re-evaluate after that. I had an OP baby with a rather large head. Total time from induction to birth was under four and a half hours. I was able to move around with intermittent Doppler monitoring after the first hour. Active labor lasted under half an hour once I changed position. I didn't have Pitocin or any pain medication, although the intensity of active labor was incredibly overwhelming.

I'm not sure if that helps, but you could possibly discuss with your health care provider (I'm assuming an OB?) what your options are as far as an induction - trying a cervical ripener as opposed to immediately having Pitocin, for example.
Thank you so much for the information! This was exactly the type of response I was hoping for. Yes, the plan is to use a cervical softener first and then progress to Pitocin only if needed. Everything is going to start at low dose and progress conservatively, if needed. Thanks again for sharing your experience
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#7 of 22 Old 07-02-2014, 07:20 PM
 
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I am glad to hear they will be taking a gentle approach to the induction. I strongly believe that the Cervadil would have done it for me as it was my 3rd but they pushed the pitocin and kept increasing it. I felt so hopeless bc they would NOT turn it down and I had no pain medicine whatsoever. NIGHTMARE.

It sounds like the induction you may have will be much better! Good luck!
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#8 of 22 Old 07-02-2014, 10:12 PM
 
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I'm Crashing here, but I couldn't help but reply when I saw your post come up in "new posts"--in light of my recent experience in late May. I was induced at 39 weeks for high BP (not pre-e) and age (AMA). Maybe not great reasons but to be honest, I was exhausted from fighting with my high risk and regular OB. At my appt at 38+5 I was fingertip dilated and 25% effaced, cervix was getting ready, but not "favorable". OB thought that by my induction date more things would be happening....My induction was scheduled for. 39+1. When I arrived at the hospital at 7 am I was 2 cms & 75% effaced. I agreed to AROM only and that's all I needed. I was 4 cms 2 hours later and had my first "real" contraction shortly thereafter. I went into active labor around 1 pm and was holding baby by 3:30 pm. No epi, pit, no drugs at all, not even postpartum pit! I was a second timer, as you are& that makes a world of difference. I also had intermittent monitoring and could move as needed as well as no IV fluids and ate/drank thru my labor. Really, a great birth. So it can be done mama! Best of luck!
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#9 of 22 Old 07-02-2014, 10:14 PM
 
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& to add, I was adamant about going slowly too, if pit was needed, starting with cervadil if my cervix hadn't been favorable.
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#10 of 22 Old 07-02-2014, 10:31 PM - Thread Starter
 
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Originally Posted by sierramtngirl View Post
I'm Crashing here, but I couldn't help but reply when I saw your post come up in "new posts"--in light of my recent experience in late May. I was induced at 39 weeks for high BP (not pre-e) and age (AMA). Maybe not great reasons but to be honest, I was exhausted from fighting with my high risk and regular OB. At my appt at 38+5 I was fingertip dilated and 25% effaced, cervix was getting ready, but not "favorable". OB thought that by my induction date more things would be happening....My induction was scheduled for. 39+1. When I arrived at the hospital at 7 am I was 2 cms & 75% effaced. I agreed to AROM only and that's all I needed. I was 4 cms 2 hours later and had my first "real" contraction shortly thereafter. I went into active labor around 1 pm and was holding baby by 3:30 pm. No epi, pit, no drugs at all, not even postpartum pit! I was a second timer, as you are& that makes a world of difference. I also had intermittent monitoring and could move as needed as well as no IV fluids and ate/drank thru my labor. Really, a great birth. So it can be done mama! Best of luck!
Thank you so much for the response! So glad you chimed in It helps a bunch to hear from others who have had more positive experiences. My confidence level regarding whether I can do this without an epidural keeps increasing the more I hear of other women who have managed to do so. Thanks again for the support! I sincerely appreciate it
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#11 of 22 Old 07-03-2014, 08:51 AM
 
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I was induced, more like augmented, for PROM management with my last one. I really wasn't having any significant contractions at the time, though, so I think it was more like a full on induction. I did have a favorable cervix and was dilated 2-3 cm. I personally chose to have an epidural, but, rather than for immediate pain management, this was more because I was tired and worried about what labor *would* be like, since I'd never had pit before. I expected it to be a long process. As it was, it was really quick, and I might have gone without an epidural if I hadn't gotten worried about the experience so early. Pitocin started at about 2 a.m., contractions picked up around 6 a.m., and baby was born a little after 10 a.m. For me, that's a quick birth. The really active part (where the ctx were felt intensely despite the epidural) was only about two hours. She was delivered in less than ten minutes of pushing.

I think that everyone's experience is different, but my advice would be to go into it with an open mind, because your birth can still be great. I think that it not being your first definitely works in your favor in this regard. Good luck, and happy birthing!
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#12 of 22 Old 07-03-2014, 09:15 AM
 
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I had an induction and it was the first intervention that set off a series of them that ultimately culminated in an incredibly violent and abusive experience. I would *never* agree to induction again unless it was absolutely necessary to prevent demonstrable imminent harm (going past 41, or even 42 weeks does NOT count). Plus, as though a fake labour weren't enough, now there a studies being published showing a link between induction and autism. Do your own research, don't just blindly trust what the docs say (what a mistake that was).
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#13 of 22 Old 07-03-2014, 09:40 AM
 
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I agree with the comment to have an open mind. I was open to an epi if I needed it, especially if I needed a lot of pit. I had pit augmentation with my daughter (1st birth) and labored on pit for 13 hours & no epi. I did finally break down & get an epidural with her birth during what I now know was transition (which was silly and a bummer bc I delivered her 20 minutes after the epi got started! I didn't even get to enjoy it).

I will also say that the risk of autism from pitocin is not that much higher than the risk for autism in general (1.2/68 vs 1/68). Just to keep that in mind...(just google statistician Sam wang).
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#14 of 22 Old 07-03-2014, 09:59 AM
 
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Each must decide if they are comfortable with the purported increased risk. For me the risks of not inducing would have to be serious enough to off set *all* the risks of induction, not just autism but way increased risk of c-section and the risks that entails. Here's the original study with autism and pitocin (also dr, odent, famous obgyn, probably had stuff about this)

http://archpedi.jamanetwork.com/Mobi...icleid=1725449
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#15 of 22 Old 07-03-2014, 11:20 AM - Thread Starter
 
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Wow - interesting new information! I had an epi with my first child, which is why I'm trying to avoid it this time. It's not that I had a bad reaction, it's just that it wasn't what I had planned for - LOL, and we all know how that planning part can go though, right? This time, I am more flexible in regards to my aspirations. I believe it's important to be able to roll with things in most regards, not just including birth.

I have done my research. I believe people must be informed. I don't blindly trust anyone - doctors included.

In regards to autism, I believe the cause of autism is as complex as it might be varied from individual to individual. I am primarily concerned with having a live birth followed by having a child that is healthy - free of life threatening illness, etc. All else falls much further down on my list of current concerns.
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#16 of 22 Old 07-03-2014, 02:51 PM
 
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The issue with induction for post date is that it's a treatment that is given to prevent a possible complication not an actual one but that treatment itself carries actual risks. So of course we all want a life baby but the issue is whether or not it's worth it to take on actual risk to prevent something that may or may not happen. You know, like it would be different if the induction was used commonly to prevent actual things that were happening as it stands it's often used to prevent possible things from happening and introduces all kinds of risks on its own. Similar to iatrogenic prematurity caused by preventative cesarean sections.
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#17 of 22 Old 07-03-2014, 07:40 PM
 
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If actual things are currently happening, it is too late to prevent those things. Prevention, by definition, involves things that have not happened yet, and therefore are not absolutely certain to happen. It's a fairly common belief in obstetrics that if you wait for a crisis, you've waited too long to treat. (Having been an obstetrical crisis, I share this belief.)

Induction has risks, but there are also risks to staying pregnant past a certain point, and that exact point will vary with each pregnancy. Each person really has to decide what risks she's comfortable with.

I can think of a variety of circumstances in which I'd want to be induced, and have been glad that my friends and sisters were induced - everything from pre-e and IUGR to women with winter due dates who live far from the hospital. I've never been induced myself, although I did deliver prematurely by c-section once. The lesson I got from that, mostly, is that sometimes babies are better off out than in. We can do a lot to help a baby in a hospital, but there are serious limits on what we can do for babies having trouble in utero.

There's a recent meta-analysis that suggests the induction may actually reduce the risk of c-section (http://www.cmaj.ca/content/early/2014/04/28/cmaj.130925), so that's one thing to consider.
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#18 of 22 Old 07-03-2014, 07:47 PM
 
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If actual things are currently happening, it is too late to prevent those things. Prevention, by definition, involves things that have not happened yet, and therefore are not absolutely certain to happen. It's a fairly common belief in obstetrics that if you wait for a crisis, you've waited too long to treat. (Having been an obstetrical crisis, I share this belief.)

Induction has risks, but there are also risks to staying pregnant past a certain point, and that exact point will vary with each pregnancy. Each person really has to decide what risks she's comfortable with.

I can think of a variety of circumstances in which I'd want to be induced, and have been glad that my friends and sisters were induced - everything from pre-e and IUGR to women with winter due dates who live far from the hospital. I've never been induced myself, although I did deliver prematurely by c-section once. The lesson I got from that, mostly, is that sometimes babies are better off out than in. We can do a lot to help a baby in a hospital, but there are serious limits on what we can do for babies having trouble in utero.

There's a recent meta-analysis that suggests the induction may actually reduce the risk of c-section (http://www.cmaj.ca/content/early/2014/04/28/cmaj.130925), so that's one thing to consider.
Is that like how Angelina Jolie had both her breasts removed "just in case"? I for one am thankful that most medical treatments are saved for treating an acutal thing, not just preventing a hypothetical possibility. I guess my view is biased because I was abused for refusing cesarean section for failure to progress. Failure to progress in this case meant a possibility of something going wrong, but at the time the doctors and everyone acknowledge that there was nothing actually wrong. Obstetrics is so ass backwards it's no wonder it won the wooden spoon for least evidence-based area of medicine.

ETA:

http://www.midwiferytoday.com/articles/timely.asp

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#19 of 22 Old 07-03-2014, 08:05 PM
 
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Is that like how Angelina Jolie had both her breasts removed "just in case"?
Angie's breasts, Angie's risk, Angie's choice. (As a breast cancer survivor, I really appreciate Jolie's candor about her decisions. I've had one therapeutic and one prophylactic mastectomy myself. Jolie's editorial on her surgery has been very valuable food for thought for both cancer patients and BRCA+ cases in my age group.)

In cases involving abuse, I tend to think that the issue is the abuser(s), and not the specific procedures that comprised the medical abuse.
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#20 of 22 Old 07-03-2014, 09:17 PM
 
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Angie's breasts, Angie's risk, Angie's choice. (As a breast cancer survivor, I really appreciate Jolie's candor about her decisions. I've had one therapeutic and one prophylactic mastectomy myself. Jolie's editorial on her surgery has been very valuable food for thought for both cancer patients and BRCA+ cases in my age group.)

In cases involving abuse, I tend to think that the issue is the abuser(s), and not the specific procedures that comprised the medical abuse.
Yes, true to all that ^, though I do think there are some serious systemic issues happening with violence against women in the obstetric context.

Personally for me I bought into the whole thing the first time aroundz I was terrified of birth, all I could think about were the what ifs. I did tests to try to calm my nerves. I planned a homebirth but was ton frightened to see it through. I went to the hospital thinking they would help, obviously. That decision is still my biggest regret as a mother. The hospital did not help, it did not make things better for me and ds, it made things worse. It made us both sick. Then my second birth I refused to buy into the cultural hype that birth is a scary terrifying medical event that will probably kill someone if there's no medical help. And I had an ecstatic birth, the actual ecstatic kind that is so awsome that you want to do it again, without even wanting more children. The thing is that we all know that birth is soemthing that we do physically, but it's also a spiritual event, not just for mothers but for babies too. I wish I had known that the first time, and embraced that and done some spiritual work in anticipation and to prepare.
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#21 of 22 Old 07-09-2014, 01:48 PM
 
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I don't have experience with induction, but I'd think you'd want to give yourself plenty of time to allow it to work. Like, make sure you go in when you still have a couple days leeway so you can go home if nothing's happening or if it's going slower than desired. Just because you start an induction doesn't mean you have to continue if it's not working. And cervidil or a foley bulb is what I'd be looking into as opposed to cytocec. And I'd go to a chiropractor familiar with pregnancy.
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#22 of 22 Old 07-09-2014, 01:49 PM
 
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I see I'm a bit late to the game for the OP but I hope everything's going great and there's a newborn happily with mom. Maybe my last post will be helpful to someone else sometime.
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