Baby size and induction

ayeshaohara

sorry for starting a new thread, I couldn't recall if this has been discussed or not. 

So im just over 35 weeks today, had an ultrasound to check growth as I'm high risk and found out baby is measuring small and showing signs of delayed growth likely due to poor placental delivery of nutrients/blood flow. She's just over 4lbs and 20th percentile. Her head is above average but her body is below average. 

Anyway the discussion came up about if I would be induced and it's very likely I will be but we will just be tracked more closely for now. My husband asked me about being induced and I realised I know nothing about it. Any STMs want to shed some light? My husband was under the impression you labour faster when you're induced which I didn't think was the case...more that the drugs just start the process for you. 

Love to hear your induction stories please, both good and bad! 

lalala2004

I'm a FTM, so no induction stories, although I'm under the impression it generally speeds things up.

I just wanted to reassure you that they get size wrong a LOT. They had been telling me LO was measuring big all pregnancy, and then today my doctor said "He's not too big, I'd guess he'll be 7 1/2 pounds." God only knows how big he will really be.

ayeshaohara

lalala2004 said:

I'm a FTM, so no induction stories, although I'm under the impression it generally speeds things up.

I just wanted to reassure you that they get size wrong a LOT. They had been telling me LO was measuring big all pregnancy, and then today my doctor said "He's not too big, I'd guess he'll be 7 1/2 pounds." God only knows how big he will really be.

Thank you. The issue here is my underlying medical stuff which we knew could delay growth and that she's already showing the discrepancy between head and body size. So even if the size itself is not completely accurate they're pretty solid signs she's not growing as she should be. 

hellogoodbye2

I was induced after 40 weeks. There are many different methods of induction so that's something you'll have to ask your doc specifically. As for how long it will take, I don't think anyone can say it will take longer or shorter than a natural start to labor as every woman and every L&D is different. 

My L&D was 24 hours in total and I thought I had a very good induction. My doc started me out on Cytotec (a vaginal pill that helps soften the cervix). Then a low dose of Pitocin. Then my water was broken and I was ready to push about an hour after that. 

I'm glad that my hospital didn't push the drugs on me hard and fast. They were okay with taking things slow. I dilated slowly, but at a consistent pace (until my water broke, then I dilated super fast). 

Good of luck to you! 

AmmyBelle

FTM here too, so grain of salt, but my understanding is that induction starts the process of labour (and can lead to more powerfully felt contractions in the case of pitocin, since it has no endorphins to go along with it like naturally-occurring oxytocin that is produced when your body goes into labour on its own) not that it speeds it up necessarily. The childbirth class I've been attending covered induction last night and that's what I walked away with. 

Keep in mind, there are several different ways to induce (break waters, strip membranes, drugs, etc) and you should totally ask your OB about the risks/benefits to each before you go ahead and consent to an particular one, just in case. It never hurts to ask  

ayeshaohara

Thank you both. I didn't realise there were so many ways to be induced! I will definitely have lots of questions once the decision to induce has been made

slfezz

I was induced with both my kids. 

For DD1, I was just given pitocin and started contractions right away but were manageable. Then Dr broke my water a few hours later when I had gotten to 5cm and I then things really started to HURT and I got an epi. Overall, things went great and I had my baby 8 hrs later

DD2 was similar except they started with a foley bulb since I hadn't started dialating yet since she was laying transverse until that morning. It felt weird but didn't hurt. Started the pitocin after the foley fell out at 4cm and it was similar to DD1 after than. Foley to baby was 16 hours. 

ETA: Also be skeptical about ultrasound size measurements. DD1 was measured to be 9.5 lbs and 3 days later came out at 8lbs 1oz

mumbolino

I am a FTM as well, but we spoke about induction at length at our course. I would be very reluctant to opt for an induction. HOWEVER, i am only talking about people to chose this to "speed this up". (which it often doesn't. It can prolong labour, it can make it more painful and it can lead to more interventions). 
Of course, you are in a very different position, as you might have to be induced, and you might not have much choice at all. 

I would just try to inform myself as best as I can so that you know what the various induction methods mean and entail. 

A hospital just tried to pressure a good friend of mine to get induced because she was 3 days (!!!!) "overdue".... I am very glad that she did not cave (there was no medical risk to herself or baby!) and let things take their own course (beautiful baby is born now, 5 days after the due date. Anything up to 42 weeks if full term, but the hospitals seem to freak out once the magic 40 week mark is reached, which I find outrageous. 

Here are some links for you, and - of course, talk to your docs / midwives about it, and about what methods etc they would chose, so you can make the best decision for yourself and feel happy and empowered with your choice :-) 


https://midwifethinking.com/2011/07/17/induction-a-step-by-step-guide/

https://www.easybabylife.com/induced-labor.html

https://www.wombworldbeyond.com/stretch-sweep-mean/

https://www.bellybelly.com.au/birth/induction-of-labour-to-induce-or-not-induce/

https://www.babycenter.com/0_inducing-labor_173.bc

mcb2016

I'm glad to see this thread. My dr plans on inducing me early because of medical issues as well.

KidShrink

I think it'd 'speed things up' in comparison to a stalled labour where things are not progressing and a decision to add pitocin to increase contractions is made. My sister went in labour naturally at 37 weeks (she was going to be induced 2 days later because of cholestasis), and ended up needing pitocin to keep things going. And then took the epidural because the contractions became unbearable. She ended up being in labour for about 24hrs. A friend got induced one week after her due date, and gave birth within 9 hrs. So really, I think the length of labour has more to do with what your body is doing than the induction itself. 

Are they suspecting IUGR? 20th percentile is not that low. Or is it just the difference between head and body that bothers them? 

ayeshaohara

KidShrink said:

I think it'd 'speed things up' in comparison to a stalled labour where things are not progressing and a decision to add pitocin to increase contractions is made. My sister went in labour naturally at 37 weeks (she was going to be induced 2 days later because of cholestasis), and ended up needing pitocin to keep things going. And then took the epidural because the contractions became unbearable. She ended up being in labour for about 24hrs. A friend got induced one week after her due date, and gave birth within 9 hrs. So really, I think the length of labour has more to do with what your body is doing than the induction itself. 

Are they suspecting IUGR? 20th percentile is not that low. Or is it just the difference between head and body that bothers them? 

What is IUGR? 
They didn't give me too much info get because like you're saying she's not that low yet. But just for some perspective at my last ultrasound she was 38th percentile. My understanding is its the discrepancy that is more the cause for concern

ayeshaohara

I googled. No it's not IUGR. I have thrombocytosis (too many platelets) which can affect placental blood flow. That's the cause 

TXmamatobe

I was induced at 39 weeks with pitocin and the doc broke my water straight away because I had excess amniotic fluid (the whole reason for me being induced). Pitocin *can* make contractions more intense but that was not the case for me. Regardless, I did have an epidural once I was at 5cm - contractions were painful but not unbearable. I had DD within 8 hours and all went well. Good luck! 

KidShrink

IUGR could be the result of a number of things, for the baby. I used to train in a feeding clinic where we saw a number of kids who had a history of IUGR, and the causes all differed (and were often unknown). Does your condition usually lead to a discrepancy between head and body measurement, or smaller babies overall? 
What we often found is that women who were quite petite would end up with an 'IUGR' or failure to thrive baby, but then when you actually looked at their own stats, you couldn't really expect them to push a 90th percentile baby. So I've always taken those with a grain of salt, especially when we know how inaccurate ultrasounds are in estimating birth weight. 

helleebellee

I was induced with my IUGR baby at 38.4 weeks.  He was estimated to be about 4 lbs and ended up being 6 lbs.  The induction went smoothly, up until pit was introduced, and then all hell broke loose.  My dr starts an induction by breaking my water.  That did nothing. So we did the pit. It was instantly painful, and I went from 3cm to birth in 42 minutes. No time for an epi and the dr barely made it.  

My second pit induction was not as pleasant. I elected to have an induction because I was GBS+ and I've had plenty of fast labors. We didn't want to chance me not making it in time to get the antibiotics, and honestly, I was tried of being pregnant.  Horrible excuse on my part, I should have just waited.  We got the antibiotics in and then the dr broke my water.  Labor stalled at 6cm and it was decided that pit would be used to "speed things up." I told the nurse that I wouldn't allow the pit until I had an epi.  She told me that there was no way that pit could work that quick and started it even though I'd told her no.  The second that first drop was in I was crawling the walls.  It was one long, extremely intense and painful contraction. It literally never stopped. I couldn't even breathe because the pain was so unbearable.  This put the baby in distress and they had to push the fluid for the epi. It took them a full hour to get it done, all the while, a c section seemed likely because of how baby was reacting to what was going on.  I opted for the walking epi because it's instant and wears off quickly so you're not stuck in bed as long. It allowed me to calm down and breathe properly.  I then went from 6cm to birth in less than 20 minutes, which was good because the dr only gave about that much time to get baby out before he did a c section.  

I have an induction date set for this time, and I'm not sure how I feel about it.  We set it because I'm on blood thinners and I have to be off of them for 24 hours to be able to get an epi. Plus, any life saving procedures are safer without the blood thinner in my system (or something like that). The other reason is because the dh can only be home on weekends and if I go into labor during the week, I'm on my own.  My dr told me that if I think at all that I could be in labor to stop taking the blood thinners. Way easier said than done! How am I supposed to time that? I honestly don't think I'll make it to set induction date, which scares me, but I prefer spontaneous labor to induced labor. So I guess I'm just gonna deal with whatever comes my way, with the dh or not.  

All I can say is definitely research your options and make sure you're firm in what you want.  If I'd had bigger balls, I would have yelled at the nurse doing the pit. Make sure you have someone with you who will advocate for you if/when needed.  

mcb2016

I bet they will just be watching you more closely to monitor if she continues to fall % wise. I believe they get concerned around 10%. My baby's head was measuring much bigger than his abdomen and femur as well. He's gone up quite a bit since our 20 week but they will still be monitoring for possible growth issues. 

ayeshaohara

KidShrink said:

IUGR could be the result of a number of things, for the baby. I used to train in a feeding clinic where we saw a number of kids who had a history of IUGR, and the causes all differed (and were often unknown). Does your condition usually lead to a discrepancy between head and body measurement, or smaller babies overall? 
What we often found is that women who were quite petite would end up with an 'IUGR' or failure to thrive baby, but then when you actually looked at their own stats, you couldn't really expect them to push a 90th percentile baby. So I've always taken those with a grain of salt, especially when we know how inaccurate ultrasounds are in estimating birth weight. 

It's not IUGR from what I'm reading about it. The condition can slow growth. As I said before the discrepancy between head and body is a marker of slowing growth. It's very rare to see my condition in someone my age so it's all a guessing game unfortunately. Baby is definitely not failing to thrive...I could push out a 12 pounder no problems. This pelvis was made for childbirth! 

ayeshaohara

mcb2016 said:

I bet they will just be watching you more closely to monitor if she continues to fall % wise. I believe they get concerned around 10%. My baby's head was measuring much bigger than his abdomen and femur as well. He's gone up quite a bit since our 20 week but they will still be monitoring for possible growth issues. 

That's the impression I am getting too. Watch and wait sort of thing. I think the issue here is that it's slowed quite a lot in a short space of time too and she's not gaining much at a time when she should be gaining the most. 

ayeshaohara

Thank you for the induction stories! Seriously helpful stuff!! I never wanted to be induced because I had known about the stats showing increased risk of interventions. At least this way I can go in armed with some more info! 

cortney626

Here's my induction story that ended in a c section. It was after my due date, I was dilated and contracting so we set up an induction. I went to the hospital around 10pm, got the cervadil to soften the cervix at midnight. That takes 12 hours. Just before noon they broke my water. A couple hours later I got the epidural which slowed down the contractions. They gave me pitocin to speed them back up. But after another 10 hours and not progressing at all, I had a c section. In hindsight I probably would have waited a few days, but I didn't know I wouldn't progress. It may have ended the same way. But with my experience I'd be hestitant to be induced unless medically necessary. 

JessicaB0627

I would also be hesitant to induce unless your doctor feels it's truly necessary. I was induced at 37 weeks due to pre-e and I also had the never-ending contraction. My contractions literally overlapped and I ended up getting the epidural 13 hours in. (I had hoped for med-free) They broke my water after 18 hours and we're just about ready to take me for a c-section when I went from 2-10 cm in 30 minutes and had DD. 20 hours of labor total, and it was ROUGH. 

Also this is probably a completely different situation than yours, but DD has a HUGE head compared to her very petite body.

Par13

I'm only PG with my second, so I have nothing to compare my induction to, but seemed completely in line with a normal labor and delivery.
I was already 4cm dilated naturally when they started the pitocin and had relatively mild contractions after it was initiated. I was 10cm and ready to push after about 6 hours - but I'll make a long story short and just say that I didn't start pushing until about 10 hours after my induction started (nothing to do with the induction itself though). Also, I think they broke my water about 2 hours into the pitocin. I pushed for about an hour and then DS was born.

Edit: Also, I think it depends on the person, but Pitocin didn't just start my labor - it was the only thing that made it continue and progress. My body never labored on it's own; it was all drug induced.

jenbrinson07

I'm 34 weeks and last week my baby was in the 7th percentile for weight, week before 8th- so they are monitoring with weekly ultra sounds. They also mentioned inducing at 37-38 weeks. I was induced with my last baby 13 years ago. I was given Pitocin and still able to get an epidural. I had bad back pain, but other than that, it was similiar to my first baby, in which was not induced. 

jthomas2270

I was induced my first pregnancy at 38 weeks due to high blood pressure. They gave me cervadil (to soften the cervix) at night and then began pitocin around 7 am. The doctor broke my water at 10 am. Baby boy wasn't born until 1 am the following morning. It was a longer process for me but I was hardly dialated or effaced before the induction. In terms of pain management, I was able to stay pretty comfortable the whole time and got an epidural when I was around 5-6 cm. I was tired just from being up so long ( I can't slee in hospitals... Too many beeping things). But overall it was a pretty smooth induction experience.

ajh7

My doctor is planning on inducing me between 37 and 38 weeks due to high blood pressure. I had my OB check today and received a call from the nurse stating that I have to do another 24 hour urine collection due to a positive protein/creatinine ratio. Depending on the results of the 24 hour test, they may be inducing me sooner. 

WVUPetunia

I'm a lurker from July, but I was induced with my first at 38 weeks due to pre-eclampsia.  I walked in the hospital dilated to almost 5 (I'd had PTL issues since 28 weeks), had my water broken, and started Pitocin at about 6:30-7 a.m.  I got an epi around 11.  They had to turn it the Pitocin off a couple of times in the afternoon because DS wasn't handling it well (they were starting to think I'd need a c-section).  I didn't start pushing until 5:30 p.m., and he was born at 8:08 p.m...  So, it was still a pretty slow process for me given how dilated I was when I walked in.  DS was sunny side up, though, and stuck on my pubic bone, so that probably caused most of the problems!  Everyone's different...

ckcshumphrey

I got induced at 41 weeks with my first pregnancy. I was not even 2cm dialated, maybe 50% effaced. They placed cytotec at 10pm to soften my cervix and said they'd start Pitocin in the morning. Within a few hours of the cytotec I was having strong contractions and progressing. Got an epidural. Never had to start Pit. Gave birth 9 hours from Cytotec insertion. Baby was measuring 7 lbs 8 oz a few days before but came out 8lbs 12 oz. Ultrasound accuracy can definitely be off.

2.red.heads

Sorry, I didn't read any of the previous responses, but here was my experience with an induction:

I was induced with my first baby at 42 weeks.  I feel like most people's inductions are fairly fast, like ~9 hours.  Mine was 25 hours start to finish.  No one 'wants' to labor for a long time but I was sort of grateful.  I wanted to attempt to not get an epidural.  I feel like the nurses were very gentle/gradual with upping the Pitocin.  I really don't know this for a fact, but I have a feeling they would have cranked it up a little sooner if they knew the anesthesiologist was right around the corner anyway. 

I went in at 10pm to start cervadil, then Pitocin started in the morning as well as my midwife breaking my water.  I wasn't 'uncomfortable' from contractions until 4pm.  I didn't start pushing until ~10pm.  DS was born at 12:45am. 

GL to you.  I hope you have a healthy baby and you feel comfortable with your Dr's recommendations!     

mumbolino

One more thing I forgot to mention: Often people get pressured to have an induction because they supposedly have a "large" baby. As a previous poster mentioned, measurements can often be off in either direction. 
Also: In most cases, bigger babies can be born just fine as well. Just saying: If someone tries to tell you that, there's some info out there, and it doesn't seem to be a necessarily legit reason to induce. 

Cricket99

*Lurking from January 16*

I was induced at 38 weeks in January for high blood pressure and small size of baby. They were afraid my placenta wasn't giving him enough nutrients. They said he was measuring at 5lbs 10oz. I went in at 8pm and had a Foley Bulb placed at 9pm. It jump started labor as I was already 1cm dilated and 80% effaced. I was given pitocin around 3am, had my water broken at 11am and my son was born at 12:43pm. When the Dr. broke my water she said it could be 18 hrs and I basically said, "over my dead body!" All told it was 16 hours of labor, but the intense part was from 6am on. Good luck!

lalala2004

@cricket99 How big did he end up being? (Curious)