Very uneasy about induction decision... - Mothering Forums

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#1 of 28 Old 02-19-2010, 07:50 PM - Thread Starter
 
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So for the last two and half weeks I have had unbelievably bad hip/butt/back pain. Could be sciatica - maybe nerve damage - its constant pain with spasms - I can hardly walk. I have a hip brace on, back brace, been to two massage therapy appts, four chiros, four physical therapy appts - nothing. As a last resort, I tried percocet (I love that we can't drink wine, but I was given a narcotic). It didn't do much for the pain, but that was an intense drug - never taking that again!! So, on the advice of my physical therapist, I am going for the induction on Wed - just a day shy of 38 weeks. To make matters trickier, we need an amnio to prove lung maturity - thats on Tues. I am not dialated at all. I am so torn up over this - I keep thinking I should shuffle through the next few weeks (last two went to 41 weeks), but the nurses and therapists are concerned over soft tissue damage to me if I keep this up, or that I won't be able to labor or push if I continue to detiorate. This is nuts. I never had this with that last two. Is my mind clouded by pain? Is induction the right decision? I am so unsure...

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#2 of 28 Old 02-19-2010, 08:03 PM
 
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That is a very tough decision but you already knew that. After two weeks of physical therapy for a neck injury I did m=not feel much comfort, but after one or two sessions of acupuncture I felt much better. So would you consider acupuncture? HTH

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#3 of 28 Old 02-19-2010, 08:03 PM
 
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Why do you need an amnio to detect lung maturity at 37w6d? My midwife is cleared to deliver at 37 weeks because it's considered full term enough... I would think that one day shy of 38 weeks wouldn't be *that* big of a concern?

What means will be used for induction? Is your cervix ripe at all yet or will you need something like Cervadil? Then after that what are the plans? Do they think they'll go with Pitocin after that?

Not to bombard you with questions... just trying to see what's happening and then trying to asses what *could* happen.

Basically, it's hard to FORCE a baby out if he's not ready. You can exhaust external means of trying to evict baby, but if he's not ready, he's not ready and that's more than likely to end up in a cesarean.

If your body does seem like it's been prepping for labor (BHs, soft/ripe cervix that's favorable), then an induction should go much more smoothly.

I can't imagine the kind of pain you must be in, mama... especially with two other young children around to keep up after!! Induction is always a tricky, tricky decision, but it certainly can be the right one in certain circumstances!!

Judy, wife to my Catholic deacon husband ... homeschooling mother to my four girls, a boy, and someone new in May '15! Forever remembering our loss (8/11) .
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#4 of 28 Old 02-19-2010, 08:04 PM
 
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I'm sorry you're in such pain. It sounds miserable.

I'd be uneasy about induction too, especially before 39 weeks. Can you hold out for one more week? http://health.msn.com/pregnancy/arti...ntid=100249741
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#5 of 28 Old 02-19-2010, 08:09 PM
 
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Oh Mama, you have such a hard decision to make. You cold probably make it another two weeks, but what are the consequences, will you have permanent damage? I wish I had an answer for you, though it sounds like all of your professionals are pushing for induction. Its the amnio that would make me crazy, did they discuss the cons to having an amnio at this stage? I can't imagine that the risk would be as high as at the beginning of pregnancy. Sending lots of good vibes your way, for whatever decision you should make.

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#6 of 28 Old 02-19-2010, 08:12 PM
 
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Of course that's a pretty personal decision. I've had the symptoms you've described for a while now and with the help of chiro, and a fantastic massage therapist who thinks my case has more to do with 'false sciatica' due to a very tense piriformis muscle and the use of tennis balls to sit on to relax the muscle I am doing OK. That and staying at home a lot and sitting around with my heating pad when I need it. If I were in your position, I would wait it out. I find the whole induction scenario too threatening and I would hate to end up with a C-sec because of it. Hopefully you have friends or family who are willing to help entertain any children you might have so that you can give your body a rest.
I'd probably try to see my massage therapist twice a week and have him/her concentrate on the muscles in your bottom. A tense piriformis can make your left leg go numb and be very painful like sciatica. My therapist suggest eating lots of greens, like kale, because they helps clear out the toxins that build up in muscles and cause pain. You might want to try an evening primrose oil suppository to help ripen your cervix to hurry things as much as possible. Good luck finding the right decision.

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#7 of 28 Old 02-19-2010, 08:16 PM
 
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I'm so sorry you are in pain. And this is a very hard decision as well.

My last month was severely painful. I was unable to move without DH assisting me (aka I couldn't even go to the bathroom, I couldn't drive, I couldn't move positions).

I tried exercises. I tried chiropractic 3x a week. Nothing worked. BUT I was able to temporarily relieve the pain by soaking in hot water. (Note: not covering my tummy, just lying my backside in hot water). It was wonderful. I turned into a prune duriing that month. DH even bought me a water pillow and one of those romantic looking book holders.

Maybe some water therapy will help you stay pregnant a few extra days. I personally would not induce for pain/discomfort. The potential risks to the baby and the cascade of interventions scares me. I stuck it out b/c I wanted an UC. (P.S. are you going to have a birth pool?? Those things are amazzzzing.)

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#8 of 28 Old 02-19-2010, 08:29 PM
 
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I'd be hesitant to induce, too. I might try finding other physical therapists or whoever. Have they mentioned TENS? My Step-mother has a lot of pain/sciatica/whatever and she uses tens and it really helps. I'd definitely consider acupuncture, as well as if you can find someone who knows anything about trigger points - they hurt like crazy when they're being released but can help SO MUCH.

Beyond that, I'd definitely do some EPO suppositories and try and get my body ready as possible so maybe baby would come earlier than expected (or an induction goes easier).

Also, if you're open to it, hypnobabies lists a lot of random single hypnosis tracks for all sorts of stuff... they have ones for hip pain, back pain, blah blah blah, and they're not the whole hypnobabies homestudy, but just single tracks. They might help you out... and I think they run around $15, so it's a cheap solution you can listen to when your going to bed and it certainly won't hurt... http://www.hypnobabies.com/mylink.php?id=4696 Like I have said a bazillion times, I am *shocked* how much the hypnosis has helped me with random stuff during my pregnancy. They've totally made a believer out of me.

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#9 of 28 Old 02-19-2010, 08:44 PM
 
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So sorry you are in mcuh pain and having to make this decision. The other Mama's have given some great advice.
Of course it's your decision to make and I would say if you are feeling uneasy, don't do it. There is a reason you are so doubtful. I think you should try some of the other suggestions and make sure you are absolutely clear on the induction before going ahead with it.

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#10 of 28 Old 02-19-2010, 08:55 PM
 
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I'm so sorry you have to make that decision! I'd like to say I wouldn't do it/recommend it, but I can't really say that without knowing more about why they think there's a potential for permanent soft tissue damage. Having a lot of pain - which doesn't sound like true sciatica, since you don't say it extends down the leg, but maybe you just didn't mention that - is not a reason I would choose to induce. However, permanent damage is a reason I would induce. I would really have to know more about why they think that might happen before I could form an opinion. If you know why they think that and are comfortable with their conclusions, then induction might be the best choice. I wouldn't want to live with permanent damage.

Of course, I'm also coming from a family where we seem to grow babies a little faster than normal, giving birth at around 38 weeks, so 37 weeks doesn't sound early to me. In fact, I'm hoping this baby comes at 37 weeks! Your history is a lot different than mine, so you might weigh things differently.
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#11 of 28 Old 02-19-2010, 09:11 PM
 
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#12 of 28 Old 02-19-2010, 11:52 PM
 
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Take it from someone who has been induced before, avoid it at ALL costs. I would try seeing a chiro, anything to avoid it. Also, start researching induction and how much it increases other interventions. I'm so sorry you are dealing with this and it's a very personal decision. Good luck hun. {{{{huuggss}}}}}

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#13 of 28 Old 02-20-2010, 09:40 AM
 
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I have been induced for both pregnancies and both went really well. With my dd I had no signs of labor or being ready but after 4hrs. she was born nice and healthy. My ds was my first and his induction was for my own health (no kidney function)and that was fine as well.
Sometimes we do have to think about ourselves and our own outcome. I too have docs paying attention to my soft tissue and the effects of this pregnancy on past surgeries. I promised hubby that I would listen to what they have to say about my own body as well as the babies. Now that I am about 37 weeks I feel like it is more about my own body and what it can handle.
Good luck!!! I know these decisions can be difficult.

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#14 of 28 Old 02-20-2010, 12:11 PM
 
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DDC crashing.
The first thing you need to evaluate is will an induction work or will I end up with a c-section because of a failed induction. Inducing before you are 'ready' has a very high failure rate, which can put the baby into distress, etc. Then you might not only have sciatica to deal with but also recovery from a c-section. Which would take a couple of weeks and put you in the same place as you might have been if you had waited it out.

The medical community uses 'the bishop score' to determine if you will have a succesful induction or not. Here is a great article written by a labor and delivery RN and doula that may help you to break down what your chances are for having a vaginal delivery with an induction.
http://holisticdoulanycblog.com/2010...-need-to-know/


Good luck mama, whatever you decide.
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#15 of 28 Old 02-20-2010, 08:15 PM - Thread Starter
 
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No no - you are all very right - it would be absurd to induce because of pain/discomfort. I will absolutely shuffle through another few weeks if that's a good idea - I think the concern is causing a big future problem. My doctor and physical therapist do not believe this is sciatica - if it is, it is very unusual - no pain below the hip/in legs, no numbness, etc - just constant ache, sharp shooting pains, and muscle spasms in hip and back- and with me pregs there are no other diagnostics to do for now. It could be nothing - it could be more severe nerve damage...
To be honest, you are all a million times more educated on this subject than I am - it never occurred to me I would need any of this and never bothered to learn a thing about any of it - I just looked up how an amnio is performed. That's how behind I am.

Can someone who has been induced explain how you labor connected to an IV? I can't walk well anyway, but how do I labor without even trying to move? I don't understand the logistics of this. Does anyone with pain issues have recommendations on how to push? What is a good position? My physical therapist says to do what works - how do I find that position?

Wife to wonderful DH, SAHM to DS1 (3/05), DS2(11/06), and baby boy #3 coming (3/11/10)!
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#16 of 28 Old 02-20-2010, 08:30 PM
 
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How does one labor while connected to an IV? ... it all depends... and with your issues being mobile, it can really be a tricky thing, I'd think.

I guess I didn't mention it before, but I have been induced three times before (hospital births.. and I was at 42 weeks or just about 42 weeks). With the first two, I'd never repeat the experience, though I'm happy I had no lasting complications and or complications that led to a cesarean.

All three times I did have an IV. With the first two (and sadly, I wasn't super educated on birthing and certainly not natural birthing) I wasn't encouraged to walk or even move around. I sat in the bed and hoped things would get going. (ugh... I shudder at that now because it's kind of pathetic!). I had cytotec one time and cervadil the other (cytotec is NOT what you want though.. gosh.. I've heard such terrible things about it on here now and I thank my lucky stars I got through it all fine). They were administered to ripen the cervix in hopes that would kickstart things. They did, but because I wasn't encouraged to move and I didn't know of any pain-coping techniques or anything, it hurt... oh, and I also had pitocin to get things moving as well (which made the contractions one on top of the other and they HURT). So.. I did get an epidural both times. Then.. it was just sitting in bed and/or resting until it was time to push.

With dd3, though I did have an IV, I had made my intentions clear that I wanted no pain medication (or pitocin).. and I walked... and walked and walked and walked... and then took a shower to relax myself (I was getting stressed about things 'not moving fast enough' -- aka, not fast enough for hospital timelines -- .. ). Then, dried my hair (in between crazy contractions) and suddenly needed to push and dd3 was born in two short contractions

As for a good position.... gosh.. it's hard not knowing your *exact* situation and mobility levels. I think your physical therapist is right though! I know you don't know what works now, but that might just have to be something you find during labor! Sometimes you can plan all you want, but things will simply come naturally to you when it happens!! Be open to those possibilities...

In the mean time, you can explore options (looking around on the net and such) for various birthing positions. Then, try to see if you can physically do them. Just so you have a bit of an idea ahead of time whether they *might* work for you.

Please do continue to educate yourself on everything from the amnio to what the bishop's scale is (and then be sure to know where you fall on it).. and find out what induction methods your care provider might use (cervadil, pitocin, breaking your bag of waters, etc) and find out what those things can do.

Judy, wife to my Catholic deacon husband ... homeschooling mother to my four girls, a boy, and someone new in May '15! Forever remembering our loss (8/11) .
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#17 of 28 Old 02-20-2010, 08:32 PM
 
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When I was induced, they had the IV on one of those things that I could walk with it. Dh followed me around with the IV... it was a pain in the butt and I kept bumping the needle which was (I swear) the worst part of my labor... but I'm needle averse. You're also connected to a fetal monitor for induction (because of the risks for fetal distress)- mine was a telemetry unity because I told the midwife that I wanted to be able to move, so she made sure it was available to me.

Honestly, I think for most people who are induced, they just get the epidural when it starts to hurt and they labor in bed... by just sitting there (assuming the epidural kicks in properly). I imagine a number of them are forced to because there's no availability of a telemetry unit or because hospital policy says you have to be in bed the whole time, and yeah, definitely not easy to labor when you're stuck in bed. I'd ask about what the options are for that kind of stuff before agreeing to an induction.

As for pushing - would you be able to push on your side, maybe? or in a birthing chair? seems like a birthing chair/stool would be easiest because you don't have to hold your leg up or anything, and gravity could help you out. Just a thought.

ETA... ooh... a supported squat might work (like, where your birth partner is behind you, holding you up and you squat how you can) it might take pressure off your hips/nerve issues...

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#18 of 28 Old 02-20-2010, 08:39 PM
 
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No no - you are all very right - it would be absurd to induce because of pain/discomfort. I will absolutely shuffle through another few weeks if that's a good idea - I think the concern is causing a big future problem. My doctor and physical therapist do not believe this is sciatica - if it is, it is very unusual - no pain below the hip/in legs, no numbness, etc - just constant ache, sharp shooting pains, and muscle spasms in hip and back- and with me pregs there are no other diagnostics to do for now. It could be nothing - it could be more severe nerve damage...
To be honest, you are all a million times more educated on this subject than I am - it never occurred to me I would need any of this and never bothered to learn a thing about any of it - I just looked up how an amnio is performed. That's how behind I am.

Can someone who has been induced explain how you labor connected to an IV? I can't walk well anyway, but how do I labor without even trying to move? I don't understand the logistics of this. Does anyone with pain issues have recommendations on how to push? What is a good position? My physical therapist says to do what works - how do I find that position?
Not knowing anything specifically about your pain, it sounds a bit like mine - I get horrible sacroiliac joint pain in pregnancy, and it's not relieved very well by anything I've tried. It sounds like what you have is worse than mine - I can still get around even if I have to limp and shuffle and wince, and I'm not worried about long-term damage.

I AM worried about inducing too early though. Not that I can tell you what to do, not being in your shoes. I induced with DS, but I was 3 cm dilated and contracting regularly (though painlessly), so I wasn't too worried about failure to progress, which would be a huge concern for me. If you're not ready, the induction is less likely to take. Also, 37 weeks may be considered "full-term", but recent research has suggested strongly that babies who are induced even one week early have a much greater risk of asthma and lung problems, so I think it WOULD be a good idea to find out if you can whether the baby's lungs are ready.

Good luck in whatever you choose.

Oh, as for laboring with an IV - I had no problem. Just dragged my equipment around with me. It was an attachment I didn't want, but it didn't affect my ability to concentrate on the contractions either. I forgot about it, if you want to know the truth.
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#19 of 28 Old 02-20-2010, 08:40 PM
 
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Does anyone with pain issues have recommendations on how to push? What is a good position? My physical therapist says to do what works - how do I find that position?
I don't have any pain issues and haven't been in birth before, but I think a good idea is to have as many things at your disposal as possible.
Is a tub or shower possible where you will be birthing? With back issues, I'm thinking this would work great for you.
Also a birth(exercise) ball and birthing stool.
These things will give you lot's of different position options to try while laboring to see what works for you and lessens your discomfort.
I think your physical therapist is right. You really won't know until you start laboring and find good position for yourself.
HTH!

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#20 of 28 Old 02-20-2010, 09:21 PM
 
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sacroiliac joint dysfunction is something someone else mentioned in this thread. Have those words come up with your doctor/therapists?

All fours has always been a helpful position for me to be in during late pregnancy because of my lower back and hip pain. It also helps turn a posterior baby (and a posterior positioned baby will aggravate lower back pain, so that's something to consider.) I also labored on all fours because of back pain/back labor. I haven't pushed in that position, but it is something for you to consider. Have you looked at the book, "Active Birth" (I think the author is JAnet Balaskas? I'm to lazy to check whether I've got that right).

A balance ball might also be helpful. Check with the physical therapist about how you might want to use it.
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#21 of 28 Old 02-20-2010, 09:37 PM
 
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When I was induced, they had the IV on one of those things that I could walk with it. Dh followed me around with the IV... it was a pain in the butt and I kept bumping the needle which was (I swear) the worst part of my labor... but I'm needle averse. You're also connected to a fetal monitor for induction (because of the risks for fetal distress)- mine was a telemetry unity because I told the midwife that I wanted to be able to move, so she made sure it was available to me.
Uggg... I was induced with cytotec, then pit. Because it was a medical induction for my DD's sake, and the risks of the cytotec, they required continuous monitoring. Even though my hospital HAD a telemetry unit, they "couldn't find it" for me. I think they were trying to punish me This means that I was not allowed in the tub or shower AT ALL, I was not allowed to walk around, I labored for 24 hours flat on my back in "bed." I put bed in quotations because their labor beds had removable pads to make them delivery tables... and the one I was in already had all the pads removed.

The IV and the monitors made it very difficult for me to get up to go to the bathroom, but I did as often as I could, so I could get off that damn table. I can imagine that it would be a lot easier without the extra cables for the monitors. I didn't end up getting any pain meds, but I came very close.

Anyway, the whole experiece convinced me not to go back to the hospital if at all possible (even though I had midwives co-managing with the high-risk OB's). I doubt that I would have labored that long if I had been upright. On a side note, I also doubt I would have labored that long if the midwives hadn't been there. (where's the cut-me-open smiley??? LOL).
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#22 of 28 Old 02-20-2010, 10:27 PM
 
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Uggg... I was induced with cytotec, then pit. Because it was a medical induction for my DD's sake, and the risks of the cytotec, they required continuous monitoring. Even though my hospital HAD a telemetry unit, they "couldn't find it" for me. I think they were trying to punish me This means that I was not allowed in the tub or shower AT ALL, I was not allowed to walk around, I labored for 24 hours flat on my back in "bed." I put bed in quotations because their labor beds had removable pads to make them delivery tables... and the one I was in already had all the pads removed.

The IV and the monitors made it very difficult for me to get up to go to the bathroom, but I did as often as I could, so I could get off that damn table. I can imagine that it would be a lot easier without the extra cables for the monitors. I didn't end up getting any pain meds, but I came very close.

Anyway, the whole experiece convinced me not to go back to the hospital if at all possible (even though I had midwives co-managing with the high-risk OB's). I doubt that I would have labored that long if I had been upright. On a side note, I also doubt I would have labored that long if the midwives hadn't been there. (where's the cut-me-open smiley??? LOL).
OMG. You're my new hero. They made me sit in bed for half an hour, at 6 cm (b/c they kept losing baby's heart beat since the monitor kept slipping, I guess) with the pitocin going and I was CRAWLING OUT OF MY SKIN. I can't imagine trying to do that for hours. Longest half hour of my LIFE. Then I kept asking when I could get up over and over, and they kept patronizing me with "soon" then as soon as they'd "let" me (man, am I glad I'm homebirthing again this time...) I got in the tub and went from 6-10 cm over the course of 20 minutes, right after they'd TOLD me I was looking at 4 more hours because each cm is normally an hour. In my transition haze I was thinking "omg, there's NO way I can do 4 more hours of THIS" and kept promising myself that when I got out of the tub I could ask for drugs... but when I got out they checked me and told me I was ready to push and all the pain went away.

Anyway, sitting in bed for hours while the pit is kicking you? Yeah, I'd be begging for the epidural - and the whole idea of a catheter going into my spine makes me shudder, but I could see doing it in that case.

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#23 of 28 Old 02-20-2010, 11:04 PM
 
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I got in the tub and went from 6-10 cm over the course of 20 minutes, right after they'd TOLD me I was looking at 4 more hours because each cm is normally an hour. In my transition haze I was thinking "omg, there's NO way I can do 4 more hours of THIS"....
That's about what happened to me! They checked me, and I was 4, but apparently unbeknownst to anyone, I was already in transition. The contrax were one on top of the other and the mw told me it was going to be several more hours, and all I could think was the same thing you thought: "I'll never make it without drugs, because there's no way I can do THIS for several more hours!" Then 30 minutes later, I was at 10.
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#24 of 28 Old 02-20-2010, 11:07 PM
 
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That's about what happened to me! They checked me, and I was 4, but apparently unbeknownst to anyone, I was already in transition. The contrax were one on top of the other and the mw told me it was going to be several more hours, and all I could think was the same thing you thought: "I'll never make it without drugs, because there's no way I can do THIS for several more hours!" Then 30 minutes later, I was at 10.
I'm just glad I held off on asking for the drugs until they checked me... because I could have been in the position later of saying "wow, the drugs really helped me dilate" when that might not have been true at all.

Still took me 2 hrs to push her out, though But the pushing was shockingly pain free, for me, with that one (not so much w/the second baby...)

Jenna ~ mommy to Sophia Elise idea.gif  (1/06), Oliver Matthew  blahblah.gif (7/07) and Avery Michael fly-by-nursing1.gif(3/10)

 

dizzy.gif Wading slowly and nervously into this homeschooling thing.

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#25 of 28 Old 02-21-2010, 12:04 AM - Thread Starter
 
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This has all been seriously helpful - I am so afraid of looking online for more info for the all the inaccuracies and horror stories out there. But it time to pull my head out of the sand and stop wringing my hands over this. I have complied a long list of questions for my doctor and PT to answer. I will feel much better when I understand more I think... I really appreciate the weighing in!

Wife to wonderful DH, SAHM to DS1 (3/05), DS2(11/06), and baby boy #3 coming (3/11/10)!
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#26 of 28 Old 02-21-2010, 12:43 AM
 
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This has all been seriously helpful - I am so afraid of looking online for more info for the all the inaccuracies and horror stories out there. But it time to pull my head out of the sand and stop wringing my hands over this. I have complied a long list of questions for my doctor and PT to answer. I will feel much better when I understand more I think... I really appreciate the weighing in!
A book that I find useful on the ins and outs of obstetric procedures, etc is "the thinking woman's guide to better birth" by henci goer. Might be worth seeing if you can look at it for the section on induction. She talks about the basics and also when it's medically indicated (or not) and how to make sure you get a "good" one... same with things like epidural... Could be helpful in your decision making process.

Jenna ~ mommy to Sophia Elise idea.gif  (1/06), Oliver Matthew  blahblah.gif (7/07) and Avery Michael fly-by-nursing1.gif(3/10)

 

dizzy.gif Wading slowly and nervously into this homeschooling thing.

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#27 of 28 Old 02-21-2010, 01:13 AM
 
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This has all been seriously helpful - I am so afraid of looking online for more info for the all the inaccuracies and horror stories out there. But it time to pull my head out of the sand and stop wringing my hands over this. I have complied a long list of questions for my doctor and PT to answer. I will feel much better when I understand more I think... I really appreciate the weighing in!
Good! I think as long as they have a good reason to believe there might be permanent damage, then you will be more confident in the decision, because obviously even if you did wind up with a c-section, that's better than being permanently disabled by a pregnancy (IMO, of course).
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#28 of 28 Old 02-21-2010, 01:04 PM
 
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Good! I think as long as they have a good reason to believe there might be permanent damage, then you will be more confident in the decision, because obviously even if you did wind up with a c-section, that's better than being permanently disabled by a pregnancy (IMO, of course).
I agree.
If it were only the pain (which I understand sounds completely awful ) that you were weighing induction against I think I would try to do everything I could to hold off until 39 weeks, then do everything to ripen the cervix and induce *naturally* at home. Black and blue cohosh, EPO internally, sex if it weren't too painful, talking to you baby, birth art, and castor oil if the cervix was ripening.
But if they do say it is going to cause permanent damage that is a whole other thing IMO. You will need to physically take care of you baby outside of the womb too.
I hope you get some clear answers that make your decision easier.

Kelcey... in love with DH, and DD born 10/13/07, and a little DS born 2/23/10!
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