Induction, Pitocin and Pain Relief - Mothering Forums
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#1 of 24 Old 06-21-2006, 11:30 AM - Thread Starter
 
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As I pass my due date with no visible progression (last week I was 2 cm and 50% effaced, had my membranes swept), I need to explore my options as the possibility of having a hospital induction looms on the horizon. For BTDT moms who've had pitocin, were you able to manage without pain relief?

I had my first dd with no drugs or interventions at 39 weeks. The thought of epidurals and c-sections gives me the willies. (Although, I do remember thinking last time I was in labor that having an epidural may not be such a bad thing.) I'm getting real mad that I need to start thinking about this.

I would VERY MUCH like to match my labor experience with my first: no drugs. But I need to consider the possibility that I'll be 42+ weeks and need to go in. Please give me some perspective with your own experience.

BTW, my doctor is VERY laid back. He's not the bullying kind. He waited until the very end before suggesting to my co-worker that she be induced. I also think it was kind of humorous as I remember him just leaning against the wall as I did my thing. All he did was catch the baby. It really drove home to me that I really only needed him for pre-natal care. I could take care of the rest.
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#2 of 24 Old 06-21-2006, 11:48 AM
 
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I would never consider an induction without medical reason. And past 40 weeks is not medical reason.

-Angela
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#3 of 24 Old 06-21-2006, 11:53 AM
 
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I went to 42 weeks with my DD and then did the hospital induction route. I beg you to wait until you absolutely MUST have the induction to do it. I know its hard being past your due date. I wish I had waited- even if it meant going past the 42 week mark.

That being said... before they start pitocin you can ask them to give you cervidil. It is a suppository they insert in your vagina. It helps "ripen" the cervix and for some (like my friend who had a babe last month) it was enough to get labor started. For me, it produced contractions that showed on the monitor but I couldn't feel them at all and it didn't produce much cervical change. Once they gave me the pitocin I was able to manage about 20 hours without relief. They ruptured my waters at about the 12 hour mark and my labor was VERY intense after that. Anyway, I took a shot of nubain at about 20 hours, because I was just so tired and kept getting tense and couldn't relax. At 24 hours they called in an OB to consult because I hadn't really progressed. At that point I was given an epidural in preparation for a c-section. Ultimately I avoided the c-section because of some good thinking on the part of my midwife, but that is a story for another time.

That was my 1st child, and when I labored with the second (which was completely natural) the labor never got as hard. I kept thinking I had hours to go because I wasn't getting contractions that were as painful as on the pitocin. Ironically, that labor was 2 hours long. In that first labor, I held out for a long time without any pain relief. The pain didn't get unbearable until I got tired. I had done about 8 hours with the cervadil before they even started the pitocin- and we entered the hospital at 6 p.m. on the day I was 42 weeks- so by the time I asked for the nubain I had been awake for nearly 2 days. The reason the labor was so long was probably due to a malpositioning problem- my daughter was born with her hand over her head. So I would say that it is do-able. It will probably be different, and possibly tougher than your natural labor. A doula would be a great resource.
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#4 of 24 Old 06-21-2006, 01:46 PM
 
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My first birth was a complete induction because my doctor scared me by saying she thought my "baby was too big." I did the whole thing without pain meds (it was a cervidil/pitocin induction that lasted 16 hours). It was hard, but women do it.

Just because there is no "visible" change in your body does not mean so much -- where there is change is with your baby. Your baby is getting closer to being ready to meet the outside world. I personally will not force another baby of mine out before he/she was ready unless something harmful to me or the baby was going on.

Wishing you speedy labor vibes!
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#5 of 24 Old 06-21-2006, 03:33 PM
 
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My midwives will do a homebirth anytime between 36 & 42 weeks. Being 39 or 40 weeks seems a 'weak' excuse to induce...yet a really, really common one too!

I was induced with baby #2 at 39 weeks. Baby #1 was a c/s and I wanted to avoid another one. There are other reasons that I agreed to an induction, but that's not relevant here.

I agree totally with PP that you should put off induction as long as possible.

Althought they kept giving me greater and greater doses of pitocin for 12 hours, they said my contractions weren't strong enough. (Yah, think that was because the baby wasn't ready to be born yet...?) After the 12 hour mark, they convinced me to have the bag broken. Up until that point, even with the pitocin, I was not in terrible pain. I could ride each wave and breath and remember to relax. After they broke my water though, it was hell. It wasn't so much the physical pain, although that was seriously worse, it was the feeling that the strength of each wave was pulling me underwater and I wasn't sure that I could find my way back to the surface. That kind of terror is not what labor should be, IMHO.

I made sure the midwives we chose are not nervous about the 40 week mark, or about breech babies or about twins...

Oh, and don't let them get near you with cervadil. It is NOT for softening the cervix, that is an off-label use and it is known to cause serious problems.

Calm, naturual labor vibes to you...

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#6 of 24 Old 06-21-2006, 03:59 PM
 
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I had Pitocin with my ds b/c I was having ctx that were not causing any change in my cervix. Hindsight....
I opted for an epidural and in our tiny hospital you take it when you can get it (our only anthes. was going to be in surgery all day). This was around 930 am. I had only been on Pit since 830am. Worked great until 5pm and just stopped (bolus back then). Of course the Pit was up pretty high but my endorphines were very low! Had ds at 907pm and didn't have any other drugs. Hurt.. but do-able.
With dd I again was induced (Pre-e this time). Cytotec at 8pmThurs (yeah, I know all about it NOW.. hindsight again). Fri I was at 4cm and put on Pit at 10am. My mom said "you better get your epidural cause you can't make it without it".. that pissed me off!!! So, I did it without and she was OP until right before crowning. That was pain.. but I am so happy knowing that I did it without pain management besides positions!
If you put it in your mind that you do not want drugs, you can do it!
HIRE A DOULA!!!! This will make all of the difference. My midwife acted as my Doula and this is what made me decide to become one full-time.
You Can Do This!
If you need any encouragement, PM me!
Happy Vibes to you!
ps.. don't be induced:
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#7 of 24 Old 06-21-2006, 04:31 PM
 
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I had pitocin and never used any pain relief. It was rough, but it can be done.

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Birth mom to M (7), O (5), & C (2). winner.jpgnovaxnoIRC.giftriadadopt.jpg

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#8 of 24 Old 06-21-2006, 04:35 PM
 
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I had pitocin with my first and the pain was unbearable compared to unmedicated birth with my second. I also got an epidural with my first and all of those interventions led to my c/s. Induction carries a big risk of c/s, fetal distress, and other issues as well. It's hard to resist when you are 'overdue', but your baby knows when it should be born.

See this link for info on induction. It's very informative and I wish I had read it before my first labor.

http://www.motherfriendly.org/Downlo...fact-sheet.pdf

Also, here is the pharmaceutical insert for pitocin:
http://www.kingpharm.com/uploads/pdf...Pitocin_PI.pdf
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#9 of 24 Old 06-21-2006, 05:29 PM
 
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I had pitocin/cervadil and no pain relief. My baby was also posterior for 14 of the 17 hours of my laboring. It wasn't the peaceful Bradley style birth I had dreamed of, but we all came through and I have quite a story to tell.

Now that I am doing this again, I know that I want to avoid induction as best I can. I was induced at what my doctor called 42 weeks 1 day and what I *knew* to be 41 weeks 2 days. My OB is wonderful but LOVES her wheel and everyone has a 28 day cycle according to the wheel! ACK!

Whatever way you go, you can do it!
Suzy

Mother of two. : 4/05 and 1/07 Wife of one. : 7/01
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#10 of 24 Old 06-21-2006, 05:42 PM
 
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I was induced with ds and it was hell--
(I was 42 wks 4 days)! No pain meds and I was out of my mind in Hell. I had dd2 with a mw standing by in case I wanted guidance ( I didn't ) and I smiled and laughed the whole time. Big difference. Knowing what I know now I would have chosen to go into labor naturally with ds- barring a real medical reason

My friend Christy was induced last year. They said her blood pressure was questionable and scheduled an induction. The pit caused her uterine to rupture and her baby girl died. She blames herself because she chose the induction. Sometimes inductions are necessary and save lives, but I think they should only be used when there is a good medical reason because sometimes they cause harm.


I completely agree with Alegna
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#11 of 24 Old 06-21-2006, 05:45 PM
 
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I was induced and it was super painful - in the RECTUM of all places (sorry if TMI). Ended up getting the epidural I would avoid induction at all costs.

Roman Goddess, mom to J (August 2004) and J (April 2009).    h20homebirth.gif signcirc1.gif
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#12 of 24 Old 06-21-2006, 05:56 PM
 
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First, hugs Your baby is still just as likely to come before 42 weeks as it ever was. Standard of care is not to induce before 42 weeks, as long as you are having biophysical profiles, careful monitoring or what not. In any case, hold out as long as possible, because inductions procede much more smoothly the closer you are to your natural birthing time.

Second, my sister and I have both been induced, and neither of us used any pain medication. I was induced on my due date for pre-e. I think I was very close to labor anyway, as I was more dialated that day than the day before, and was already having painless, erratic contractions when I arrived for the induction. I was given prostaglandin gel. Contractions started up well a couple of hours later. Several hours later my water was broken to keep labor progressing. My baby was posterior, and consequently I had a very active, very uncomfortable, rather long labor. Baby was born less than 24 hours after I reported to the hospital. It was long, and I definitely would have accepted an epidural, except that my mom and dh kept the nurse away so she couldn't offer me one! Baby was born 3 hours after my lowest point, so it wouldn't have been worth it anyway, to me.

They thought my sister was over-due, though, given how iffy her dates were, they should have known better. She was induced with pitocin. She had a 4 1/2 hour labor. The last 1 1/2 was really intense. She was not able to be as active because of the drip. I think she did some hypnosis on her own, from previous training, not birth preparations.

If I had to do it all over again, I would definitely up the monitoring and postpone induction as long as possible. When my doc and I decided together that induction was necessary (as we did the first time), I would choose methods (again) that allowed my mobility over methods that strapped me to a bed.

I definitely agree that a doula could only be a plus in this situation, and as it is becoming very common, it should be easy to find one that you click with who has lots of experience with this!

Oh yeah, and I have never had any "visible progression" until the birth day. All those braxton hicks never seem to win me any "free" centimeters. You could go into labor tomorrow and not know about it until it happens. Here's hoping you do

Rochelle
dd-00, ds-02, dd-04, ds?-due 10/06
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#13 of 24 Old 06-21-2006, 06:10 PM
 
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Get a doula. Try with cervidil first. Before that, start taking Evening Primrose Oil to soften your cervix even more. Get a doula. Did I mention that you should get a doula? It will help immensely. No, it's not ever too late to get one.

Mama to two awesome kids. Wife to a wonderful, attached, loving husband. I love my job-- I'm a Midwife, Doula and Childbirth Educator, Classes forming now!

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#14 of 24 Old 06-22-2006, 12:12 AM
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I had to be induced for medical reasons and I tried cervidil, I think (cannot recall exactly but I know they tried a few things first) and nothing worked. Pitocin was started after 24 hours of trying and I had back labor and the epidural did not work and my tailbone got broken during labor. The epidural did not work on fully half my lower body. The anesth. tried repeatedly to fix it. My body just did not like it. The pain was so unbearable I was begging them to suck my baby out or get the tongs or do anything they could. My OB (bless her) decided that taking on the demeanor of a football coach was the best way to go and she was right. She coached me with tough love through it and I did it. But, I will avoid inductions and epidurals at all costs if I have another child.
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#15 of 24 Old 06-22-2006, 12:45 AM
 
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I would not even consider induction unless I went past 43 weeks, which is where I "risk out" of a homebirth. Being 2 days past your due date is not a reason to schedule an induction.
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#16 of 24 Old 06-22-2006, 01:44 AM
 
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ITA with Dreams In Digital - AND, if your BPP are good, you know you can always tell your provider that your cycles are a little wacky, or you think your conception date was different than you first thought. I went to 43 weeks that way.

Because Pitocin induction SUCKS MONKEY BUTTS! And no, I have no idea how to get through it without an epidural. I'd take the epidural if I had to go through pit induction again, as I did with my first. It's really horrible, in comparison to natural labor. Particularly if they have you in bed to "monitor" you and your contractions and the baby's reactions. Bleh. In my case, it was absolutely medically necessary - I had severe preeclampsia at 34 weeks. But outside of that, feh. Some babies take a little longer to cook!
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#17 of 24 Old 06-22-2006, 12:25 PM
 
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I wonder sometimes if the amount of pitocin administered has anything to do with needing pain relief. I say that because I positively cannot imagine anyone going through what I did without any pain meds. On day 1 of my induction they started out with the lowest dosage of pit and slowly upped it as I was showing no progression. They turned it off to let me sleep that night and then back on at the maximum allowable dosage in the morning. Well, at the max dosage the pain was so incredible (at 2cm dilated btw) that I was passing out from it. I had to have an epi at 2cm just to stay conscious. Well, once I had the epi, I was obviously unable to move and baby's position was not a good one. Because I couldn't move to help change his position, he got stuck at 8cm and I was sectioned after 38 hours of labor.
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#18 of 24 Old 06-22-2006, 12:38 PM
 
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Quote:
Originally Posted by ckhagen
I wonder sometimes if the amount of pitocin administered has anything to do with needing pain relief.
Yes, it is commonly agreed that it does. This is the "vicious cycle" of managed labor:

1) Induction with pitocin

2) Unbearable pain

3) Epidural

4) Stalled labor as a result of Epidural

5) C-section

Homeschooling mama to 6 year old DD.

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#19 of 24 Old 06-22-2006, 12:44 PM
 
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I was induced at 39 weeks, due to pre-e. Started with prostglandin gel night before, then broke my water in the am (in lieu of pitocin - I wanted to see if that would kick in labor) after 6 hours of mild/moderate ctx and no progress, finally consented to pitocin. Did it w/out pain meds, and it was pretty hard/painful with double-peaked contractions, little break between them, etc. Being able to get in a tub saved me from needing meds. Not how I'd choose to do it, but it was doable.
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#20 of 24 Old 06-22-2006, 01:18 PM
 
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Quote:
Originally Posted by Melaya
I had pitocin and never used any pain relief. It was rough, but it can be done.
me too

it was with my first and i did not know how much "worse" it was supposed to feel.
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#21 of 24 Old 06-22-2006, 01:26 PM
 
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Quote:
me too

it was with my first and i did not know how much "worse" it was supposed to feel.
I think it helped that it was my first labor. I did not realize how much more pain I was in than I needed to be. All I knew was that it hurt, bad. But in my head, I just figured that was how labor was supposed to be.

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#22 of 24 Old 06-23-2006, 12:02 AM
 
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Induction information.

World Health Organisation’s document “Care in Normal Birth: a practical guide”
http://www.who.int/reproductive-heal...ical_guide.pdf

Suspect Diagnoses Come with Biophysical Profiling
http://www.midwiferytoday.com/articles/biophysical.asp

Elective induction of labour.
http://www.hencigoer.com/articles/elective_induction/
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#23 of 24 Old 06-25-2006, 03:35 AM
 
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Marcie - how are you doing? Hopefully you won't have to worry about an induction! I think whether ot not a person can manage without pain meds for an induction has a lot to do with how ready their body is. I was induced at 18 days past EDD with my first and I was zero dilated and not effaced at all at the start of the induction. I was not given cervidil or anything, just pitocin that gradually went up until I was maxed out on it. I wanted a NCB but eventually got the EPI. I regretted not having a doula but honestly I don't think anything could have been done to prevent me needed the EPI. My body just wasn't ready and being strapped to the bed with CFM was a requirement with the induction.

I do understand considering induction after 42 weeks because of the increased risk of stillbirth. I'm very anti induction but I couldn't sleep at night if I encouraged someone to refuse an induction at or beyond 42 weeks. With my 2nd I did refused induction and signed an AMA but had my baby on my own at 42 weeks. This time I had a doula and never layed in bed and had the NCB of my dreams. Still if I had gone much further I definitely would have considered the induction again.

~Erin
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#24 of 24 Old 06-25-2006, 04:08 AM
 
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I had HELLP wth my first son and had to be induced at 38 weeks - I had gel the night before which really helped to dilate and efface but sadly didn't bring on labor....I had to labor in bed with internal/external monitors, drips, etc. I also had to have a magnesium drip, which I thought was more unpleasant than the pitocin!! My water was broken about an hour after the pit started - I didn't have any pain meds!!! I had great support - all three of my midwives came to the hospital, my mentor, my best friend, and my hubby. I think the amount of support I had was crucial for avoiding an epidural. I was also really fortunate that my labor progressed quickly - start to finish in under 8 hours.
Hoping you have a natural, easy birth, and have great support in any event!
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