Natural Birth

Would you rather...

I'm not quite there yet but I've seen this question posed on other boards a few times over the last couple of days so I thought I'd ask you all.

If you had to be induced for a medical reason, would you rather have it started with Pitocin or AROM?  Let's assume your cervix is already soft so no need for Cervadil, etc.  Or, school me - would there be a need for Cervadil at that point?

I'm trying to come up with the pros and cons of each in my info gathering stage :)

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Re: Would you rather...

  • My hospital required constant monitoring if you were on pit.  Plus then you're attached to the iv (unless it's just given as an injection but I don't think many ob's do that anymore). 

    But with the AROM the clock would be ticking and there is no going back.

    I'm sorry you're having to consider this.


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  • I was faced with this decision for my first.  At the time I was going to opt to have the AROM, but the induction was scheduled at 41w6d so I figured that should push me over the edge.  The more I read about pitocin the more I dislike it for inductions.  So I think I would try everything under the sun before the induction (and there better be a darn good reason for inducting) and then go with the AROM.  Actually if I wasn't already 4 cm dilated or whatever a Foley bulb gets you to I would opt for that first and see if that could push me into labor.  And I would definitely be getting my membranes stripped, having lots of sex, walking with lunges for miles and miles every day, discussing Black/blue cohash (or whatever it is) with my midwife/OB, doing evening primrose oil by mouth and cervix daily, etc.
    Mama to Lucy (7/06), Lexi (5/09), and Max (11/11) M/C 12/17/10
  • I'd rather start with Pit.  AROM puts you on the clock.  Pit can be adjusted or turned off and you can even try again another day if it's not working, assuming your membranes aren't ruptured and there is no urgent medical need to deliver.  But AROM can't be undone.  
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  • I would say it depends on the situation.  Are you dilated at all?  If not then they can't break your waters.  And breaking them could lead to them doing a lot more intervention and complications with baby.  Pit is not a great option either.  I agree with what a PP said, about sex lunges, walking, ect.  Also there is nipple stimulation do it to get contractions going, use a massage oil to do it.  As a last resort before the Pit or AROM try two tablespoons of caster oil at home.  It can be quite unpleasant to take it, but its worth a shot if you have no other choices before an induction. Good luck!
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  • We did PIT bc we didn't want to be "on the clock", not that you aren't anyway.  I did have my membranes stripped a few hours before the PIT was started...and that hurt!   Plus, the OB said that PIT was more reliable way to start labor...I was very ready though.  I have a feeling I would have gone into labor on my own that day or the next.  During the 3 hours, I was hooked to a monitor for a NST, I was having very steady, mild contrax the whole time...about 5 minutes apart....but that had been happening for a long time.
  • If it was a situation where the baby had to be born that day then I would start with AROM.  If not then I think I would start with Pit, it can always be shut off if things aren't looking favorable.
  • imageiris427:
    I'd rather start with Pit.  AROM puts you on the clock.  Pit can be adjusted or turned off and you can even try again another day if it's not working, assuming your membranes aren't ruptured and there is no urgent medical need to deliver.  But AROM can't be undone.  

    I was actually leaning towards AROM but you're right, that can't be undone.  Definitely something to think about.

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  • imagebluerevolution9:
    I would say it depends on the situation.  Are you dilated at all?  If not then they can't break your waters.  And breaking them could lead to them doing a lot more intervention and complications with baby.  Pit is not a great option either.  I agree with what a PP said, about sex lunges, walking, ect.  Also there is nipple stimulation do it to get contractions going, use a massage oil to do it.  As a last resort before the Pit or AROM try two tablespoons of caster oil at home.  It can be quite unpleasant to take it, but its worth a shot if you have no other choices before an induction. Good luck!

    I was only 1cm on Friday but I had some scar tissue on my cervix that the doc broke through (I wasn't dilated at all until she broke through it) so I'm hoping I've progressed a little more since then.  I have been anti-internal up until Friday but I'm so glad I let them do that one b/c of the scar tissue.  Not sure if I'll have another before next week.

    Other than that I've been trying everything I can think of.  Walking, nipple stim, acu, EPO, RRL tea, eggplant parm Embarrassed, etc.  I'm not ready to resort to castor oil and honestly, I'm not convinced it would work for me.  I already have bowel issues (not just pregnancy but always have) and they haven't triggered contractions yet.  Maybe I'll save it as a last resort :)

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  • It depends on how far along I am and what station the baby is at.

    If I was less than 41 weeks, I'd start with Pit and try to wean off of it once contrax were under way.

    If I was over 41 weeks and baby was not too high, I would start with an AROM.  I'm pretty sure that's the least popular choice but I'd rather take the chance of stalling out later and then needing Pit vs. starting out stuck to an IV pole.  Maybe it's just because I was induced with an AROM before and it worked out fine so I have a positive memory of that method, lol.

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  • There is also another alternative called a foley bulb induction.  A catheter and bulb is inserted into the cervix which is then blown up and puts pressure on the cervix.  The theory is that your body will pick up cues and start contracting on your own to dilate.  Then the foley bulb falls out and you're on your way.  This is a good non-chemical method of induction that also does not put you on the clock. 
  • speaking of schooling someone, could you all school me on of these drugs? Are they even necessary? If they are for inducing a late baby then would you still be able to have a natural birth? Would there be no need for a C-Section.
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  • image35baby:
    speaking of schooling someone, could you all school me on of these drugs? Are they even necessary? If they are for inducing a late baby then would you still be able to have a natural birth? Would there be no need for a C-Section.

     theoretically, there is nothing that says you must now have a c-section or something with any of these interventions.  But you need to know that they start you down a path of intervention.  If you have Pitocin you need to be on a fetal monitor, probably will be given and IV and will have you ability to move around limited.  Most likely you will be told you need to stay on the bed.  WIth Artificial Rupture of Membranes, you risk that if the baby is still too high: a cord prolapse (very rare, but serious and needs an emergency c-section).  You also have an increased risk of infection, and if it doesn't start contractions you will most likely then have to use Pit or be forced to have a c-section if after 12 hours you don't start progressing. You will also likely be given antibiotics if your waters have been broken for more than 24 hours (thats the protocol where I live at least).

    No said you can't have a natural birth if you have an induction, but you have to have a good plan and good support.  You need to be clear to the staff about what you are willing to do and what not, and always make sure they give you time to think over what they are suggesting you do.  Its YOUR BIRTH and YOUR BODY you have the right to time to make a decision.  If it is not an emergency, you have time.   

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