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Natural Birth
natural birth + induction= ??
So I had my 32 week appt. and the doc sprung on me that he plans to induce me at 38 weeks because of my hypertension and GD. Ok, wow, um... ? So we talk again about my plans for a natural birth, and he says he's all for it. He will break my water and we will forgo pitocin for the induction. Well that's a relief at least, but I still don't see how forcing a labor is condusive with a natural birth. And what if the induction doesn't "work," doesn't that increase my risk of c-section? I'm really conflicted right now. Have any of you ladies had it both ways previously? Or do you have thoughts on how the two may/may not work together?
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Re: natural birth + induction= ??
Someone here has definitely posted about being induced using pitocin but not using any pain relief meds, and the rest of her labour being intervention free.
I think it was the poster who was offended some poeple consider her birth not natural.
But so it definitely can be done.
Elizabeth 5yrs old Jane 3yrs old
I see that you are in NoVa. You're certainly right to be concerned; the c-section rate in hospitals there is 50 percent (I'm from there, too). But like pp said, hypertension and GD could be legitimate reasons to induce. (I don't know for sure, since I haven't done a lot of research on either topic.) There is a time and a place for inductions, but I understand why you're concerned. Will breaking your water force progress immediately, or will you end up on pitocin anyway? I hear many, many stories about "failure to progress" following the water breaking, which is treated by pitocin, which in turn (understandably) leads a woman to ask for an epi, which then causes the baby's heart rate to slow, and then all of a sudden you're in the OR.
I think the main question is whether the induction is truly necessary. (I don't have an answer for that.) Because by having one, you are certainly at greater risk for a c-section. But, like pitocin, c-sections have their place. And in the end, if you really need one, then you really need one, and thank goodness they are available, you know?
Ditto to this. With the GD, I can def. see why the dr wants to induce. BUT, if he is sayign he will 'just break your water' to induce labor I would be a little skeptical.
What are he C-sec rates, I wonder? as pp said this made be a 'bait and switch' "Sure you can be natural... I'll just break your water..." then when labor isn't going fast enough for him he might start talking you into pitocin- or worse yet jump right into pushing a C-section. (not saying he would, but it is possible)
More questions need to be asked- mainly timeframe questions- how long after water breaks will he let you go. If the next step is pitocin- how long on that til next step? Would that next step be a C-section?
Sounds a bit off to me. For some women, amniotomy (breaking the water) is all they need to put them into active labor, but it doesn't always work. And it's impossible to say at 32 weeks that all you'll need is an amniotomy, no Pitocin, because usually an amniotomy is successful for women who have progressed pretty well on their own, and you have no idea right now how far you'll be progressed at 38 weeks. Heck, you could still be closed up tight and your doctor might not even be able to do an amniotomy.
So in your shoes, I would definitely be prepared for Pitocin. That's not the end of the world; I was induced with Pitocin with DD and ended up having a fabulous birth experience, vaginal delivery with no pain medication.
Personally, with your risk factors, I wouldn't even question an induction at 38 weeks. Yes, inducing can increase your risk for a c-section, but in your situation, NOT inducing could increase your risk for all sorts of things FAR less pleasant than a c-section.
If you have concerns, talk to your doctor about the risks of being induced vs. the risks of NOT being induced, so you can make an informed decision on what you want to do.
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
Ditto everything all the PPs have said, but most specifically the above. You need to ask more specific questions of him- specifically about timeframe. Once your water is broken you are on the clock. Some docs/hospitals will let you go 24 hrs, some will only let you go 12 now I understand.
Induction only really works when your cervix is favorable. Are you having a lot of sex, taking evening primrose oil, walking?
I would ask if having cervadil administered is an option as well.
I was thinking this, too. It seems to make more sense that they'll get your cervix to soften, rather than just breaking your water and hoping for the best...definitely sounds like things will be on a timeframe.
I'd also ask that if you do end up with Pitocin, to have it at the lowest levels possible, and turned up really slowly, etc.
Here's a bunch of GD birth stories - and the website itself has a LOT of information about GD and pregnancy. hth
https://www.plus-size-pregnancy.org/gd/gdbirthstories.htm
DS2 - Oct 2010 (my VBAC baby!)
I agree with what everyone else said. I think you really need to ask some "what if" questions. Maybe call your OB's office and tell them you'd like more time allotted for your next appointment because you have lots of questions for your doctor. Then go through all the "what if"s, and follow them with more "what if"s. Hopefully, your doctor will respect you enough to give you honest answers and not rush through it. And it's not too late to switch OBs. I know it probably feels like it is, but if it's in the best interest of the baby, you, and your birth, it's really not.
Here are just a few questions off the top of my head that I'd ask :
-What happens if we wait for me to go into labor on my own? Best case? Worst case?
-If I allow my water to be broken, can I still walk around? Change position? Not be strapped to a bed?
-How long after my water is broken would you want to start pitocin if contractions don't start on their own? What is the absolute latest after my water is broken would you want me to deliver? If I haven't delivered by that time (and there's no sign of infection), would you be comfortable with using antibiotics to ensure there's no infection and me continuing to labor? How would you feel about me laboring at home after my water is broken? I'd ask a lot of "...and then what?" questions about ALL of this.
I'd also talk about some natural induction methods (black cohosh, blue cohosh, castor oil, nipple stimulation, etc.) even though 38 weeks might be early to consider some of them. Also Evening Primrose Oil (orally and vaginally) will start to soften your cervix (but 32 weeks might be a little early to start those). And so will sex. Lots of sex.
Both have natural prostiglandins.
Here's a site with good natural information to check out too: https://www.givingbirthnaturally.com/
Good luck!
I usually lurk but wanted to say that if you are giving birth at Inova Fairfax be prepared to have it not go well at all, I gave birth at Fairfax and had my OB (natural birth friendly) not been present during my entire labor and delivery I would have been forced into a lot of interventions that I did not want.
My nurses were not at all supportive of my natural birth plan thankfully I had my husband and my OB in my corner.
i haven't had a baby yet but there is a higher rate of c-sections with women who are induced but that doesn't necessarily mean that will be you. i think being informed about all the things that can happen and are associated with induction will be the best thing for you. hopefully he won't even need to induce you!
did you talk about what you will/ won't do as far as methods of induction? there are different things that can be done by your doctor as well as without [stripping membranes, breaking water, nipple stimulation, sex, walking, etc.] so you should make sure you know the pros/ cons/ risks of each so you can tell him what you do and don't want to try.
32 weeks seems really late to be talking about induction techniques and things like that. if you'd like to avoid starting the "chain of intervention" you could try some at-home methods first.
I definitely agree with asking those questions. How long will your OB let you labor with just the amniotomy & nipple stimulation (I add that because it definitely helped me progress without Pitocin)? That is the biggest question that comes to my mind.
I don't really know what the risks of hypertension or GD are so keep that in mind as I'm saying this, lol... but can't they just do an NST, u/s and check your blood pressure as you get closer to term before they just decide to induce you? Now seems to be really early to start talking about an automatic induction but it's a good thing he mentioned something so you have time to do your research and ask questions.
Can you ask him to calculate your Bishop score? That is a tool that can be used to see if an induction is truly necessary. It also depends on how favorable your body is. I was a fingertip dilated at 38 weeks and 50% effaced. That (the dilation) wouldn't have been enough to do an amniotomy. My midwife's original plan of action (when I was still only a fingertip at 41 weeks) was to use a foley bulb catheter to open up my cervix, which is a non-medicinal approach. I was okay with that since I didn't want my body soaking up a bunch of chemicals... I wanted any intervention to be done as "naturally" as possible. I ended up dilating enough before my induction so that I didn't need that anymore.
I had a successful induction and augmentation without any pain meds. My m/w broke my water and told me to start doing nipple stimulation a little while after. Yeah, it was a little awkward tweaking my nipples in front of her but whatever, lol. I would do anything to avoid Pit. It worked... but I was also 42 weeks pregnant and obviously favorable. I had absolutely no problems until transition. I would have considered that part of my labor a piece of cake. But then my cervix started swelling during transition so I was given Pitocin for augmentation. That is non-related to my actual induction though. It was just the biggest mental workout I've ever had, lol.
Just thought I'd share my experience with you because I went through something like what you might have to go through and an induction without drugs is definitely possible. You just have to be favorable for it to work.
Matthew Kevin
7/31/83-7/20/11
Met 1/8/00
Engaged 4/21/06
Married 9/29/07
Two beautiful legacies: Noah Matthew (2 yrs) and Chloe Marcella (8 mos)
Day Three
great advice already. my 2 cents: being in nova alone makes me wanna yell RUN. its never to late to switch practices and that bs they're giving you about PROM but with no induction drugs is really unheard of. Insurance legalese only gives an OB 12 hours from the rupture of membranes to BIRTH. Thats hardly enough for a normal progressing labor - much less a labor that hasn't even started yet.
personally i'd start shopping for a new OB. yesterday.
as for the can you still go natural....meh. yes you can. will it be as easy as a 100% natural childbirth...heeeelllz no. One student of mine likened her pit ctx to running into a brick wall over and over and over again without the time to catch her breath. They just function differently than a good ol natural ctx and from what i gather feel a lot diff.
great advice already. my 2 cents: being in nova alone makes me wanna yell RUN. its never to late to switch practices and that bs they're giving you about PROM but with no induction drugs is really unheard of. Insurance legalese only gives an OB 12 hours from the rupture of membranes to BIRTH. Thats hardly enough for a normal progressing labor - much less a labor that hasn't even started yet.
personally i'd start shopping for a new OB. yesterday.
as for the can you still go natural....meh. yes you can. will it be as easy as a 100% natural childbirth...heeeelllz no. One student of mine likened her pit ctx to running into a brick wall over and over and over again without the time to catch her breath. They just function differently than a good ol natural ctx and from what i gather feel a lot diff.
i have a feeling this response is going to be all over the place...
i had a med-free, pitocin-induced birth that went just the way i wanted it to go. BUT i also had everyone around me [hubs, midwife, hospital] totally supportive of my wishes. they started pitocin on the lowest level and upped it a little bit every hour. i was also 3 cm dialated and 80% effaced all on my own. [i had signs of pre-e] i was stalling a bit at 8cm and they broke my water after that.
wouldnt they start pitocin BEFORE they broke your water? once your water is broke most hospitals will only let you labor 24 hours before they require a c-section. it seems like they'd be setting you up.
i never realized how bad pitocin contractions were until my natural ones kicked in 12 hours later and they were able to turn the pitocin off.
my advice [which it seems like you are doing] is research your butt off! your knowledge will help save you from a lot of uneccesary interventions and switch ob's if you dont feel 100% comfortable!
good luck!
I am the poster the pp mentioned above. Anyways, I was induced (with pitocin) for medical reasons at 38 weeks in a very natural birth unfriendly hospital. I was able to have a pain med free labor. However, I was bullied a bit by one of the nurses so have your support person ready to fight for you. It is definitely possible to have an induction and natural labor . I would see if they could strip your membranes and use natural induction techniques (nipple stimulation etc) before breaking your water. If that doesn't work, then move to the cervadil and then the pitocin. I personally would not want to break my water (but I have +group
so that is a bit different for me. Breaking my water would be the absolute last thing I would want to do, but maybe a good choice for you!
GL to you; You can do it!!
9 angels in heaven-3 in my arms and 1 in the NICU
Mono/di twin girls: Josephine born to heaven and Evangeline born Earthside at 25w
The PP's have posted alot of great information. I just wanted to share that I was induced at 42 weeks. DD didn't drop due to the fact that I had quite a bit of amniotic fluid (still in the normal range but approaching polyhydramnios). I was still able to have a natural childbirth. The story is in my blog if you're interested.
I would recommend being as educated as possible when you give birth and make sure your labor companions are as well. Being able to talk intelligently with the staff will make it easier to have the birth you prefer. It will also mean that if you do accept interventions, you will be able to do so knowing that it's what's best for you and the baby in your particular situation.
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