If I have to be induced, what order??

Meinschatz11

Hi ladies! I'm lurking from over on the nest. I swear I saw a post about this recently but now I can't find it, so if anyone wants to link it, that would be great. I'm 39 weeks tomorrow, planning on a natural delivery with a midwife in a very NB friendly hospital. My MW is wonderful and I trust her completely. I have declined internal exams thus far b/c I don't think they really tell you anything, plus I'm type A and tend to worry. I know full well that I could have this baby on my own, and that's what I'm hoping for. But after talking with DH last night, I realized that I don't have a real clear idea on what I would choose if I need to be induced. After we've exhausted all the natural induction methods, in what order would you choose? And please let me know if I've left any out. Thanks! I would really, really, really prefer to avoid pitocin. And I'm not doing castor oil. I was leaning towards:

Foley bulb, membrane sweep, cervadil, amniotomy, pit 

What do you think??

AmyRI

I am more afraid of a 24 hour time limit on AROM than I am of pitocin when administered correctly and slowly, and you have the chance to turn it off once you are in a good ctx pattern. I probably would agree to AROM first if the foley bulb got me to 3-4 cm so I could avoid the IV and constant monitoring that comes with pitocin... but I'd have a really hard time agreeing to AROM super early on.

Membrane sweep (as PP said, you can be sent home after this)
Cervadil (if not softening/effacing)
Foley bulb (assuming you're dilated enough to have it placed)
AROM if dilated more than a few cm
Pitocin (low-dose, increased slowly, turned off once you are in a constant ctx pattern)

Meinschatz11

AmyRI:

I am more afraid of a 24 hour time limit on AROM than I am of pitocin when administered correctly and slowly, and you have the chance to turn it off once you are in a good ctx pattern. I probably would agree to AROM first if the foley bulb got me to 3-4 cm so I could avoid the IV and constant monitoring that comes with pitocin... but I'd have a really hard time agreeing to AROM super early on.

Membrane sweep (as PP said, you can be sent home after this)
Cervadil (if not softening/effacing)
Foley bulb (assuming you're dilated enough to have it placed)
AROM if dilated more than a few cm
Pitocin (low-dose, increased slowly, turned off once you are in a constant ctx pattern)

Thanks! This is very helpful. I had forgotten that you could go home after membrane sweep. My MW is comfortable letting me go to 42 weeks as long as everything still looks ok. I'm hopeful that he will come on his own, but I wanted to have something thought out in case he doesn't. I appreciate your input!

memo9

I would do:

Membrane Sweep

Castor Oil (Never say never)

Foley Bulb

Pitocin

Membrane Rupture

Amanda&EricB

The cervadil put me into labor, within hours. I didn't need pit or anything else after that. I know it doesn't work for everybody but I never expected it to work for me either!

amandaleigh1

You can't membrane sweep or do the foley bulb if you ate not at least 1 cm dilated. That was the case with me and my induction.

I started with cytotec and moved on to lowest dose pit. I only had the pit on for two hours at the beginning and a little bit at the end.

It is good to think about this stuff if it looks like it might happen. I thought about and talked about my induction extensively with my OB. I felt like I was invested fully in the process and still had a really positive pain med free birth experience because of it.

I declined AROM during my labor as I was not sure I would like the effect it would bring and I didn't want the pressure of the clock.

Meinschatz11

Thanks again ladies. I may bring it up at my appt tomorrow, but at least I have something to go on for now.

georgi611

Amanda&EricB:

The cervadil put me into labor, within hours. I didn't need pit or anything else after that. I know it doesn't work for everybody but I never expected it to work for me either!

I was also induced with cervidil, and went into labor within hours.  It was inserted at 5:45pm on a Sunday, my water broke on it's own around 10pm, contractions started like crazy, and Miss Emelia came into the world at 2:36am on Monday. haha

My midwife said it was a good batch of cervidil...another girl on the floor had the same thing happen!  Didn't need pitocin or anything!

JoySeattle

I haven't birthed yet, but I'm a professional doula and my personal preference would be:

• Miles Circuit - https://www.milescircuit.com/
• Acupuncture
• Chiropractic
  
• Membrane sweep
  
• Nipple stimulation
• Evening Primrose Oil (orally and/or vaginally)
• Herbal Teas/Tinctures and/or Homeopathy
• Castor Oil
• Cervadil (if not softening/effacing; note: I would not do Cytotec)
• Foley or Cooks Catheter (assuming you're dilated enough to have it placed)
• AROM - only if dilated past 4cm with a well engaged baby
  
• Pitocin (low-dose, increased slowly, turned down/off once you are in a consistent contraction pattern)

Best of luck!