WWYD? Castor oil or pitocin? (facing pre-e induction)

kindacrunchy

Hi ladies, I need some advice. I'm facing induction due to mild pre-e. I had gestational hypertension with both previous pregnancies but it never progressed to pre-e, this time it has but as of now it's still mild so my midwife is giving me the weekend to hopefully go into labor before we discuss a pitocin induction on Monday (assuming my pre-e doesn't worsen before then).

Here's the info: I had my membranes stripped on Wednesday, I was 2cm and soft. Since then I've had a lot of contractions including them every 3-4 minutes for about 4 hours only for them to space out. I lost my mucus plug and have had bloody show.

My midwife recommended trying castor oil tomorrow. She recommended mixing it with scrambled eggs to make it gentler. I'm not liloving the idea of castor oil but also don't want to deal with a pitocin induction and be stuck in bed to labor. So I'm very torn. WWYD? And if you've done the castor oil thing what was your experience?

soulcupcake

*I* would and have chosen castor oil. Hands down. It's what my midwife and I chose to use when we induced at home with my 4th, and while there was a very, very delayed response and start before the "effects" kicked in, it (and perhaps it and the cohoshes) were effective. However, given my history we knew the effects were going to be short lived, and there wouldn't have been much concern of dehydration since OOH settings encourage eating and drinking throughout the labor process, and my "labor" would have been long over before such side effects had time to kick in.

My current midwife prefers the cohoshes because they have fewer icky side effects (I only had very mild diarrhea, which didn't last very long, and wasn't bad at all, and no other side effects). However, that's what I'd choose for myself, based on my own history and experiences.

Depending on the hospital, they may have you on CEFM, and you'll definitely have to be on an IV drip, all of which do not appeal to me. I'd also absolutely avoid AROM, as it carries its own set of risks and draw backs.

kindacrunchy

theresat858 said:

I would go for the pit.

Why does pit mean being stuck in bed? I was able to labor next to the bed (wired monitors and iv hooked up) for hours during my induction. Generally, you are only confined to the bed if you get an epidural.

Because this hospital is not natural birth friendly, it's my only choice though.

JCWhitey

I would try some other options before castor oil, personally.  Sex, nipple stimulation, and Evening Primrose Oil.  For me EPO is what worked and didn't even intend for it to!  My midwife had told me I could start it at 38 weeks to help soften things up, and usually after a week of internal use it'll start softening your cervix.  I decided to start swallowing it at 38 and week, and I waited until halfway through the 38th week to start internally because it made me nervous and my water broke that night!  I will totally use EPO again this time around when I'm nearing my due date.  

  

soulcupcake

EPO isn't oxytocic, and sex, while it can induce contractions in some women, isn't known to be effective for inducing in a large portion of women.

EPO and RRL are only meant to prepare the body for labor, and EPO only has the properties the body needs to make prostaglandins. If labor starts shortly after starting the protocol, it's mere coincidence. I start EPO orally at 35 weeks, and vaginally at 36. And I begin drinking RRL mid-second trimester.

I've seen CO encouraged in moms who have a history of precipitous births, mostly due to the fact that the side effects would be short-lived. Nausea, stomach pains, diarrhea, etc., if they're going to happen, is better if it lasts for a short duration/labor than a longer one.

jennypolkadots

Everything JCWhitey said. There are other methods to try before using pitocin, especially in a non-NB friendly hospital. Nipple stimulation and sex/orgasm would be my first choice. And planning a nice fun day to relax (sometimes this really does make labor jump start). Then EOP or castor oil. You can also do another membrane strip. I'm surprised a hospital that is not NB friendly has a delivering midwife though, most don't. 

Just remember at the hospital they can not force you to do anything you don't want to, you just have to sign a release form. They can't force you to use constant fetal monitoring or stay in bed. Your midwife should also be really supportive of you laboring next to the bed if you are on pitocin so I don't see how the nurses would have any say so. Maybe I am confused on the situation. Best of luck, either way you should be meeting your child soon so this is so exciting!! 

mandi195

I'm anti pitocin, since it's not actually oxitocin, and makes contractions much more intense/ 

soulcupcake

And it's even trickier in a situation involving a non-NCB/med-free hospital. The standard protocol is often AROM followed by cervidil, cytotec or pitocin. OP, there are moms that opt for a low dose pit drip while insisting they keep their membranes intact, but it may be more difficult to advocate for this if they're not low intervention-friendly.

If they go the more routine route, I'd definitely consider membrane sweeps, acupuncture, lots of walking, and possibly foley bulb, but a lot of hospitals don't routinely use this method (mechanical), before trying the pharmaceutical methods.

kindacrunchy

Okay so here is an update... Once my midwife consulted with the ob (she has to) I was told Saturday morning that both the midwife and doctor recommended I try the castor oil that day because they really didn't like how my labs were coming back and if that didn't work I would need to be induced Sunday, or I could have went in on Saturday and just been induced without trying the castor oil.

So I took the castor oil and it sucked. The side effects were worse than I imagined and it didn't work.

Went in on Sunday and requested them to break my water first to hopefully get labor going. Normally I wouldn't have done this but I was going to be on the clock anyway with the pre-e. Since contractions didn't start within a couple hours pit was started. Took a few hours for things to pick up then I went from 3cm dilated to baby being out in 2.5 hours. I managed to have a pain med free birth even with the pitocin and the hospital was better than I expected (and had been told) and let me use a ball, walk around the bed, lean etc as long as the monitor stayed on, I had a small space to work with.

However, I had a retained placenta and ended up having to get a spinal for surgery. The surgery went well and I am extra sore but doing well. Baby is perfect and my pre-e is cleared up. Certainly wasn't the birth I envisioned but sometimes things happen.
I tried everything I could before having to have a medical induction and my midwife was amazing as was the doctor that did my surgery.

kindacrunchy

Oh and I meant to add that while I appreciate the suggestions for other things to try first we were already doing them (sex, nipple stimulation, membranes swept, etc). They weren't getting the job done and we needed to try something more aggressive with the fact that I had pre-e so that's why it came down to just castor oil and or pitocin for options.

mandi195

Congrats to you on the arrival of your LO. Glad to hear you're doing well!

JCWhitey

Congrats on the birth of your baby!  I'm sorry the castor oil was such a bad experience.  

2junebabies

Congratulations! Honestly, that is one of the best induction stories I have ever heard! It sounds like it went extremely well, even if it wasn't your dream birth. 

Kristil2014

Thank you for sharing this @kindacrunchy‌. I am glad your LO arrived safely.

I am facing the exact samething. I have an OB consult in less than 2 hours. I am hoping I just have high bp and no other preeclampsia markers.

I am happy to hear that a pitocin induction can result in a med free birth. (Other than the pitocin) if the OB wants me induced ASAP.

emwithpeanuts

My first was a pitocin induced labor with no pain meds. It was rough. 10 hours of titanic contractions. I have had 2 successful castor oil induced labors. Even though I am permanently scarred by castor oil, it seems by time I need it I'm up to doing it again. I would recommend it before pitocin. My midwifes had me take some tinctures and sublinguals with the castor oil that I would do too if they can tell you what they are.

jessinaround

I am so happy to read of these positive pit inductions. Due to pre-e my doctor wants to induce me next week. He's carefully monitoring me and trying to give me as much time as possible. Unfortunately my labs keep slowly creeping up. I've been 3cm and 90% effaced for a week and half. He's offered to break my water as a first measure and go from there. I'm thinking of asking him to sweep my membranes tomorrow. But then I'm afraid that's too soon. (I'm only 37 weeks.) At the same time I don't want a hospital induction My first was a home birth!