Induction: Your thoughts.

[Mildly]

I was kinda hoping that I wouldn't have to think about this but as I'm now almost a week overdue and have an appointment on Friday to discuss induction at the hospital, I'm interested in other people's thoughts too. Please don't think I am trying to judge other people whether they have had inductions or not, I just wanted to talk through some of the research that I have found on the internet.

I never realised that the last part of your baby to develop is the lungs and when they are fully developed, they send out hormones which kickstart labour. This got me thinking about the effects of having labour started artificially on LO. I know the chances are that the lungs will be pretty much developed by this point in the pregnancy but levels of asthma and other lung conditions have increased since the medical profession has increased its rates of induction.

Then I came across this analogy

What does induced labour feel like?

Someone once told me how to imagine and compare a normal labour with an induced labour like this:

‘Normal Labour’:

1. Hold your hand out flat, like you would to receive money from someone.

2. Clench your fist and hold it closed for a second

3. Release your fist back into a flat position again.

If you repeat the above over several times, this is how a normal labour would be to the uterus. You can see how it’s not so bad and the circulating blood, hence oxygen, would be restricted but the uterus has time to recover. Now for the ‘induced’ analogy.

‘Induced Labour’:

1. Hold your hand out, clench, out, clench, out clench, out, clench, out, clench, out, clench, out, clench, out, clench, out – keep going for a minute or so – is your fist tired or sore yet? Imagine how this would feel for your uterus to do this for hours on end and what difference this could make during your labour and for your baby.

Now don't get me wrong, there are plenty of cases where induction is better for both mother and baby and not being a doctor I have limited knowledge on the risks of certain conditions. I will be listening to whatever medical professional I have for my appointment on Friday and taking their advice on board. I think my problem is that, looking back through my notes, apart from PGP, I have had a textbook pregnancy. No problems whatsoever, no measuring excessively small or big, no diabetes, no blood pressure or urine problems and because of that, I know the only reason they are going to suggest induction is because I am over on my dates. The other factor is that because I charted my temperature when TTC I know the exact date of ovulation which changes my official due date from the 3rd Sept to the 6th Sept, so I have three days in hand.

On the other hand, I am so fed up with being pregnant. I am huge, everything is painful, I hate going outside the house because people stare at me. I am sick to death of people asking whether I have had it yet. So I can understand completely the desire to be induced and get this horrible phase over and done with. Not to mention, during my research I found that often women will only release the hormone oxytocin (the main labour starter) when they are calm and in a safe place. It is thought that this relates back to our oldest ancestors who would only birth when in complete safety (i.e. not being chased by large animals and in their own caves etc.). I found this quite interesting because it seems to me that in this day and age, what with due dates and social pressure, it is actually quite difficult to remain calm when everyone is expecting you to have had your baby.

Anyway that is my current rambling thought pattern, I would really like it if anyone had any advice or thoughts too. At this point I am not ruling anything out be that refusing induction or going with it. Thanks

 

[Cixes]

I was induced with my 3rd child at 38 weeks due to SPD, i felt that it was the best thing for me because i couldn't cope being pregnant any longer. I had the pesary once and labour started gently but within about an hour or so, i walked about and used a birthing ball until it got too much i used gas and air and then felt that i couldn't cope and asked for an epidural but as they were trying to put a canula in my hand i pushed the nurse away and said that it was too late my baby was coming, my midwife took a look and couldn't believe that the baby's head was there! It took me 1min to push him out with no intervention or tears.
For me induction worked really well, labour is tough no matter what and each is different, if i could have another induction i would probably because all my babies came quite fast and i would prefer to be in the hospital and safe than risk delivering in the back of my car!!!
I suppose for some people it is worse because its more intense but then again those powerful contractions get the baby out!

 

[kerryp]

im not sure about this as its not something i have had to think about yet but doesnt the placenta start to break down after a certain time so it becomes unsafe for baby to be inside for much longer? My aunt said she got shown both my cousins placentas & the difference between "on time" & "overdue" was unreal (in her words) as the placenta that was from overdue baby was breaking down... just a thought.

 

[elliej]

i might have to be induced due to high blood pressure, and although i dont really want it to start that way i would much rather be induced and have a healthy baby and be ok myself than wait and risk having more complications. at the end of the day in my view you can only do whats best for you both. if your doc thinks that inducing you is the best option then there is a reason for that, the fact it might be more of a difficult birth IMO is niether here nore there, the baby has got to come out some how and it'll hurt whatever , as long as they arrive healthy thats all that matters.

 

[Mildly]

Thanks for your comments

I think the difficult thing is that it is such a personal decision based on individual circumstances that it is really difficult to figure out what is the right thing for the individual to do.

I think there are certain aspects of induction that I am ok with but I am a bit worried about having a oxytocin drip throughout my whole labour, not least because I would be unable to have the water birth that appeals to me but also because of the increased hormone levels.

As far as the placenta deterioration goes, I understand that provided you are monitored if you go against their advice, they would be able to tell you when things get dangerous for your baby. However it does worry me what the effect of the placenta not working so well is and what kind of criteria do the medical profession have for saying 'right now we really need to induce based on teh condition of your placenta'.

Elliej, I think that certainly induction due to high blood pressure is very important. Like you say it is going to hurt regardless. I think I just wonder why there is a tendency to induce in ladies that have no particular problems. Is it convenience? Is it to protect a woman's mental state? Is it funding related?

Anyway thanks again for the comments

 

[kerryp]

i dont think all inductions necessarily include a drip... danni only had pessaries didnt she? i could be wrong though....

 

[Mildly]

Yeah I'm pretty sure from what I've read that they'll only put you on the drip if things don't start to progress quickly enough on their own, so it is almost a last resort type thing.

 

[Laura_James&Amber]

I don't really have any advice as I haven't been in this position and I've not really thought about it if I do end up in this position! But didn't like to read and run so giving you loads of hugs and hope you are able to make a descion you are happy with

 

[babymad]

With my 2nd baby I had gestional diabetes and had to go onto insulin at 20 weeks.I was induced at 38 weeks and 5 days as the baby can get really big and the placenta is not as good as in a healthy pregnancy.I couldn't wait to be induced as I was so scared for my baby,in fact everything was great,his blood sugars were perfect and he was healthy and we went home the next day. i only had tablets inserted twice at 10.00am and again at 4.30 pm. My labour started at 11.00pm and he was born at 11.53pm, less than an hour later.I was happy to be induced and if I had been lucky enough to have another baby I would have done it again.

 

[Mildly]

Please don't think I'm trying to say that induction is wrong or criticise anybody's choices on induction. In light of medical conditions that warrant induction I am completely in favour of the process.

What I am really trying to establish is whether the NHS is pushing this process without due regard to the risks of the procedure itself. And by that, I mean in cases where there is no medical condition which requires induction i.e. going overdue. I think that most women would agree that given a choice between labour starting naturally and labour starting via induction most women would chose a natural starting labour, although obviously most don't get that choice.

 

[MummyJess]

My first daughter was induced at 36 weeks due to pre-eclampsia and it was my worst labour, mainly because the drip made my contractions so intense and I couldn't be mobile due to constant monitoring. However, she needed no special care and her lungs were strong enough even then. The placenta already showed a lot of deterioration, which is apparently caused by the pre-eclampsia. She hadn't shown any distress before or during labour but I'm sure she would have soon been in trouble. I guess they can't always tell the state of the placenta

I understand your view on this, why rush baby if they're not ready? But sometimes things may just need a helping hand. If you are physically not ready, then even a pessary isn't going to get things started so I guess it doesn't hurt to consider having this, but possibly putting your foot down about a drip? Not sure if this is even allowed?!

I hope that you will still be allowed a water birth if you have the pessary. I had 2 and highly recommend it! But it's worth asking if this is still allowed after 42 weeks. Have a funny feeling it's not cos you're more high risk.

I don't know if I would have your patience to refuse an induction at this stage! Have you been doing anything to get things started?

 

[Laur_250]

Hi mildly, My only knowledge is that my friend was induced at +9 and she was a text book pregnancy like you, she hated being pregnant so agreed but later regretted it as her labour was so intense cos she went from nothing at all to strong contractions that she couldnt cope with too quickly. She swore to never have any more children and still does and wishes she'd just been more patient and said no. I'm not saying that means everyone should refuse it, if you need it medically then do it but personally if i'd been late, based on her experience i'd of waited for my body to do it naturally. Hope you find a descision you're happy with. xxx

 

[Redshoes]

Having had both I can honestly say;
Induction by sweep or gel, yes
Induction by drip (synthetic Oxytocin), no

 

[nickilubs]

I had pessaries, i only neded the one though and my body and me wanting it to work mde it. I have really seen now though being in hospital how for some people it does and some it doesnt work.

I went straight down stairs and started walking about after 40mins (you have to be monitored) and dancing about running up and down starirs and doing general me stuff and it took 4hours then all of a suden I started to feel like I really needed to fart so I went to the toilet and thats when I cleared out but I couldnt really move because it wasnt that it hurt its just it was so hard to walk. They monitored me when i got back to bed but really they were offering so much pain relif becaue the contractions were so strong and just 80% of the time it was constant pain with no breaks that must of been me reacting to it. A little later when they had calmed more painful but with more gaps) 1 every minuet I got up and danced around and walked about the ward some more. I know It sounds mad but es it id hurt but if you can think through that pain and just reallycarry on then i think it helps. I think you need to be really prepared forit and be determind that it will work I didnt want to keep having that first stage over aagain so i think I MADE it work for me.

But there was other ladies who had it and it started to work but I feel the inital pain for them was too much and they gave up before it got strong enough. They were pushing pain relif too me and refusing others it.

As for the lungs I do think you need to consider the placenta breaking down. Really just have it when you are asked if you want it theres a reason why they wait and why some people they dont. I had the pessaries knowing that if I didnt it could harm me and her and I trustthat although I dont like it here it was the best thing for me. I think you just have to go for whats best for you xxx

 

[ninjawomble]

TBH I think whatever it takes to get the baby out safely , I will do.

But my birth plan consists of " whatever pain relief you can throw at me and sticks..I will have. And I want a hospital birth, coz I know there plenty of doctors and drugs if I need them" my midwife actually laughed at me

I dont have a specific birth plan, coz I know it will go out the window starightaway! So if I need to be induced..I will be.

 

[taika]

This is a really interesting thread (thanks Mildly!) - I'm also very keen to hear everyone's advice/thoughts on this.

I was quite adamant that I'd refuse an induction (unless there's a valid medical reason) if it's just based on dates. This felt right for me - I wanted things to be natural, I think compared to a lot of people I've had an "easy" pregnancy (but what pregnancy is ever completely easy? ), and basically I was just ready to wait it out until LO was ready. Obviously I'd want to do this with medical support and monitoring - if there were any signs LO needs to be brought out sooner then of course I'd not put her at risk.

Now I'm starting to have doubts. After being quite small throughout I've started to put on quite a lot of weight in the last few weeks and I'm getting quite uncomfortable. Suddenly I know what most of you have been going through for months! I'm also really wanting to start this next phase of my life and meet my daughter and be a Mummy. I feel like I'm stuck in a limbo between my old life and my new one and to be honest it's made me feel quite depressed at times.

I've also read some worrying things about placenta deterioration and health problems in post-term babies - obviously I don't want my LO at any risk at all. How to know what's best for her? Logically it seems that it must be best to wait for her to be ready and come out naturally, with medical supervision to check she's ok until that happens. But then why are so many women induced purely based on dates if there's no medical reason?

Sorry for rambling... I guess what I'm trying to say is I don't know what to think anymore! Hopefully she'll decide to arrive before I have to make the decision, but to be honest I expect to still be pregnant when I'm 40+9 and then I'll have to make my mind up.

The needing to feel calm and safe in your own cave thing is really interesting... maybe it's time to get a massage and have a cuddle with the OH tonight

(Oh, and P.S., like Mildly I really think this sort of thing is personal choice and I definitely don't judge anyone else for what they've decided, especially if there's been a medical reason!)

 

[nutcase109]

My personal experience was that induction was not the most pleasant thing, but was necessary for me and bubbas health. My birth story is up in the new arrivals if you wanna get an idea of what it was like.

It really wasnt that bad, and anyway, first time birth is always gonna be exciting and scary no matter how you do it, I reckon!

I was able to make the decision of only being induced if there was a health risk, so you could always book the induction, and decline it on the day if all is well and healthy with baby? That would give you both options perhaps.

I think going into natural labour would have been an amazing experience, and perhaps a bit easier to mentally deal with (what with the building up of contractions slowly instead of nothing to full-on in 60 seconds!) but hey, I can honestly say it was still all fine, and once little one is out, it wont matter if you had to fly to the moon and back to deliver them xx

I really hope it goes well for you, keep us posted as to what you decide?

Emily xx

 

[mandspice]

I was induced at 41 weeks and it was an easy choice for me - firstly I knew that little man was fully ready and didn't want to risk the placenta declining and secondly I was so desperate to give birth by this point that I was really excited when they booked me in. My consultant said, to put it bluntly, once baby's at term it's much better for them to be out than in! for mum and baby.....and until I get my medical degree I'm inclined to agree with her.

Still, I can understand some people prefer a more natural process.....it's a personal choice. I never had a birth plan and never refused any pain relief - in fact I enjoyed all they offered me and I just surrendered myself to the professionals almost in an ignorance is bliss kind of way . Labour and delivery were never an issue for me or something I thought about in depth, I spent pregnancy thinking about the aftermath and how to care for my lil munchkin.

Anyway, that's me, everyone's different. Good luck with whatever you decide Mildy, can't wait to hear news of your arrival

 

[flowergirl]

I had a fantastic experience being induced

I was induced at 40 + 2 due to high bp but am convinced I was actually over a week late by this point according to my own dates.

I had one dose of the prostin pessary and it kick started a natural labour within 9 hours with no other interventions needed. It didn't seem massively intense until I was fully dilated at which point I had gas and air to push baby out. I was lucky that my waters didn't break until moments before Kathryn was born which allowed me to stretch and helped cushion sensations I think.

I would only discourage induction if you are pre term (but often you have no choice but to be induced due to medical issues) as the girls I saw having inductions before their due date had a much tougher time- the pessary had little effect and they needed several interventions from ARM and sintocin drip to forceps or ventouse and episiotomy. The Sintocin drip is thought to give you very strong contractions and very suddenly without the milder ones to ease you into labour (so to speak!). I would try to avoid this at all costs!

If you are induced you have the fact that you are past your due date going for you- your body will be ready to go into labour (hopefully). To increase your chances of helping nature along make sure that after the pessary is inserted and your half hour of enforced bed rest has passed, get up and get moving! Go out for a walk or get up and down those stairs! And most of all- don't fear the induction- relax and go with it and you should make things easier for yourself. You are doing the right thing getting to know your options and being informed. Good luck xxx

 

[AnDi]

Personally I feel it is done way way too much, considering we aren't even 'overdue' until 42 weeks, and theres so much pressure piled on from 41 weeks.

I've had three so far and am pretty sure I'll probably end up having another this time. Saying that my consultant wants me booked in for induction at 10 days over at the local cattle market, whereas my midwife is fully supportive over waiting as long as it takes for a home birth.

I've been looking in reasons why my body won't do it naturally and there does seem to be alot in the theory of mums needing to feel safe and secure, the fight/flight reflex seems to be a monkey for stopping labour. I'm 40 weeks tomorrow and have been having on/off contractions for a few days now

My placenta failed in my last pregnancy and my baby needed a transfusion 2 days after birth. Different area though now, and placental scans are the norm 10 days over, as well as monitoring every over day, so I'm pretty happy to wait.

Personally I'm pretty sick of being told what I can and cannot do, if I do decide on an induction this time, it will be because either my placenta is failing again, or I'm just bleedin sick of being preggers And then I'll leave the hospital if they want to break my waters or 'threaten' me with a drip again.