Has anyone gone in for an induction and had to go back the next day?

ericamanuela · June 2012

I'm scheduled for an induction later next week. My doctor said he's going to start me with pitocin since I'm 90% effaced. He said if it doesn't work then I'll have to come back again the next day and try again. I've never heard of this. I've heard of the pitocin not really working and having to go in for a c-section but I've never heard of going back the next day for another round of pitocin. Has anyone else experienced this?

xtina05 · June 2012

This has happened to a couple of my friends. Their body's just didn't respond to the pitocin first time around.

ericamanuela · June 2012

How many times did it take for it to work?

triagain2 · June 2012

Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

ericamanuela · June 2012

triagain2:
Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

Thanks, that was really helpful advice. Good to know. Is it dangerous to go home with pitocin in your system or is that if for some random reason something happened to the baby I could try to blame my doctor? It does show a good sign that he's not in a rush to go straight into a c-section. The last time I was checked by the doctor I was only dilated a 1/2 cm but I was 90% effaced and the baby was at -1 station. I will check out bishop score. Thanks again for your advice!

triagain2 · June 2012

ericamanuela:
triagain2:

Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

Thanks, that was really helpful advice. Good to know. Is it dangerous to go home with pitocin in your system or is that if for some random reason something happened to the baby I could try to blame my doctor? It does show a good sign that he's not in a rush to go straight into a c-section. The last time I was checked by the doctor I was only dilated a 1/2 cm but I was 90% effaced and the baby was at -1 station. I will check out bishop score. Thanks again for your advice!

Well pitocin has a half-life of 10 minutes so once they stop it, after 20 minutes its completely out of your system. That being said, labor can be stressful on babies. Assuming your babies umbilical cord is no where weird, and your placenta is not old/insufficent then your baby can tolerate contractions. For the most part, a doctor who is going to send you home is only doing it because you didn't really contract on pitocin all day. If you contract a lot or make any cervical change you will stay, so I'd probably choose going home over a c-section if nothing happened all day.

As a guide, if after 1-2 hours of pitocin you are not writhing in pain, very uncomfortable, your body is not responding as it should be. I've had women on max pitocin and they feel nothing, that just means your pitocin receptors are not turned on yet.

I didn't see, how far along are you? When is the induction planned for? any medical reason? Assuming I have no pre-eclampsia like I did last time, I will be induced at 41 weeks only. I am very much opposed to induction unless 41 weeks or medical reason. Too many failures, but I was induced for pre-e last time at 39 weeks and it went well for me. I was 1cm, 60% and -2 station upon arriving. Took me 22 hours to deliver.

ericamanuela · June 2012

triagain2:
ericamanuela:
triagain2:

Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

Thanks, that was really helpful advice. Good to know. Is it dangerous to go home with pitocin in your system or is that if for some random reason something happened to the baby I could try to blame my doctor? It does show a good sign that he's not in a rush to go straight into a c-section. The last time I was checked by the doctor I was only dilated a 1/2 cm but I was 90% effaced and the baby was at -1 station. I will check out bishop score. Thanks again for your advice!

Well pitocin has a half-life of 10 minutes so once they stop it, after 20 minutes its completely out of your system. That being said, labor can be stressful on babies. Assuming your babies umbilical cord is no where weird, and your placenta is not old/insufficent then your baby can tolerate contractions. For the most part, a doctor who is going to send you home is only doing it because you didn't really contract on pitocin all day. If you contract a lot or make any cervical change you will stay, so I'd probably choose going home over a c-section if nothing happened all day.

As a guide, if after 1-2 hours of pitocin you are not writhing in pain, very uncomfortable, your body is not responding as it should be. I've had women on max pitocin and they feel nothing, that just means your pitocin receptors are not turned on yet.

I didn't see, how far along are you? When is the induction planned for? any medical reason? Assuming I have no pre-eclampsia like I did last time, I will be induced at 41 weeks only. I am very much opposed to induction unless 41 weeks or medical reason. Too many failures, but I was induced for pre-e last time at 39 weeks and it went well for me. I was 1cm, 60% and -2 station upon arriving. Took me 22 hours to deliver.

All great info, thanks. I will be 40 weeks and 3 days. I'm not quite sure why he wants to induce only 3 days after my due date. This is my first pregnancy, my baby is on the large side. Last time his measurements were taken (a few days ago) they estimated 9 pounds. I realize that these ultrasound measurements are not always accurate. This baby has been measuring a week and a half ahead this entire pregnancy so maybe he's thinking my due date is off?

Also, some of my blood counts have been off for a few weeks and he's thinking I'm trying to fight off some type of virus. I feel good so maybe it's a small virus or it perhaps could just be wacky numbers from being late in my pregnancy. I don't really know. The blood counts (wbc, atypical lymps, myeltocytes) are very slightly out of range but it does make me nervous.

I know that 1/2 cm isn't great but hopefully it's changed in a week. At least I'm 90% effaced and he's at -1 station. I'm nervous but I assume I'm in good hands.

ericamanuela · June 2012

By the way, I was tested for mono, taxoplasmosis, herpes, EBV and all came back negative. I gained almost 30 pounds throughout this entire pregnancy and my blood pressure averages around 110/70. Thanks agian!!

triagain2 · June 2012

ericamanuela:
triagain2:
ericamanuela:
triagain2:

Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

Thanks, that was really helpful advice. Good to know. Is it dangerous to go home with pitocin in your system or is that if for some random reason something happened to the baby I could try to blame my doctor? It does show a good sign that he's not in a rush to go straight into a c-section. The last time I was checked by the doctor I was only dilated a 1/2 cm but I was 90% effaced and the baby was at -1 station. I will check out bishop score. Thanks again for your advice!

Well pitocin has a half-life of 10 minutes so once they stop it, after 20 minutes its completely out of your system. That being said, labor can be stressful on babies. Assuming your babies umbilical cord is no where weird, and your placenta is not old/insufficent then your baby can tolerate contractions. For the most part, a doctor who is going to send you home is only doing it because you didn't really contract on pitocin all day. If you contract a lot or make any cervical change you will stay, so I'd probably choose going home over a c-section if nothing happened all day.

As a guide, if after 1-2 hours of pitocin you are not writhing in pain, very uncomfortable, your body is not responding as it should be. I've had women on max pitocin and they feel nothing, that just means your pitocin receptors are not turned on yet.

I didn't see, how far along are you? When is the induction planned for? any medical reason? Assuming I have no pre-eclampsia like I did last time, I will be induced at 41 weeks only. I am very much opposed to induction unless 41 weeks or medical reason. Too many failures, but I was induced for pre-e last time at 39 weeks and it went well for me. I was 1cm, 60% and -2 station upon arriving. Took me 22 hours to deliver.

All great info, thanks. I will be 40 weeks and 3 days. I'm not quite sure why he wants to induce only 3 days after my due date. This is my first pregnancy, my baby is on the large side. Last time his measurements were taken (a few days ago) they estimated 9 pounds. I realize that these ultrasound measurements are not always accurate. This baby has been measuring a week and a half ahead this entire pregnancy so maybe he's thinking my due date is off?

Also, some of my blood counts have been off for a few weeks and he's thinking I'm trying to fight off some type of virus. I feel good so maybe it's a small virus or it perhaps could just be wacky numbers from being late in my pregnancy. I don't really know. The blood counts (wbc, atypical lymps, myeltocytes) are very slightly out of range but it does make me nervous.

I know that 1/2 cm isn't great but hopefully it's changed in a week. At least I'm 90% effaced and he's at -1 station. I'm nervous but I assume I'm in good hands.

well 90% effaced and -1 station are both great places to start. Effacement makes a big difference because that head has to push against a cervix that is literally paper thin versus the depth of your index finger. You should be fine! Don't worry! Its not typical to do a CBC this late in the pregnancy without reason, but I wouldn't worry about the labs so much, slight variations in WBC's are normal in a full term patient. Unless there is a great reason to do a growth ultrasound at the end of pregnancy (measuring a week ahead is not a great reason in my book) I don't agree with them. Like you said they are only as good as the person doing them and even then they are more frequently incorrect then correct. But it does sound like you have a good sized baby in there. Assuming you are not 5'2" or shorter, my guess is that you will have no problem delivering vaginally assuming baby tolerates labor.

We have a joke in obstetrics called the "short gown sign". Meaning, if the patient gown touches the floor when the patient puts it on, just sign them up for a c-section. Basically short women get sectioned. Obviously, not entirely true, but kinda funny.

ericamanuela · June 2012

triagain2:
ericamanuela:
triagain2:
ericamanuela:
triagain2:

Former labor nurse here, I have seen some doctors do this, but many will not. The theory for those that do not do it is that if you went home after a day of pitocin and something happened to the baby (God forbid) overnight, you might consider the doctor liable. I think a doctor that is willing to do it is a good doctor because they are not practicing defensive medicine and they are obviously not fast to do a c-section. Just so you know, thats why you don't hear about it too often.

GL! Also google "Bishop Score", this will tell you how "favorable" your cervix is for induction. I found a good bishop score will almost always correlate with a good induction.

Thanks, that was really helpful advice. Good to know. Is it dangerous to go home with pitocin in your system or is that if for some random reason something happened to the baby I could try to blame my doctor? It does show a good sign that he's not in a rush to go straight into a c-section. The last time I was checked by the doctor I was only dilated a 1/2 cm but I was 90% effaced and the baby was at -1 station. I will check out bishop score. Thanks again for your advice!

Well pitocin has a half-life of 10 minutes so once they stop it, after 20 minutes its completely out of your system. That being said, labor can be stressful on babies. Assuming your babies umbilical cord is no where weird, and your placenta is not old/insufficent then your baby can tolerate contractions. For the most part, a doctor who is going to send you home is only doing it because you didn't really contract on pitocin all day. If you contract a lot or make any cervical change you will stay, so I'd probably choose going home over a c-section if nothing happened all day.

As a guide, if after 1-2 hours of pitocin you are not writhing in pain, very uncomfortable, your body is not responding as it should be. I've had women on max pitocin and they feel nothing, that just means your pitocin receptors are not turned on yet.

I didn't see, how far along are you? When is the induction planned for? any medical reason? Assuming I have no pre-eclampsia like I did last time, I will be induced at 41 weeks only. I am very much opposed to induction unless 41 weeks or medical reason. Too many failures, but I was induced for pre-e last time at 39 weeks and it went well for me. I was 1cm, 60% and -2 station upon arriving. Took me 22 hours to deliver.

All great info, thanks. I will be 40 weeks and 3 days. I'm not quite sure why he wants to induce only 3 days after my due date. This is my first pregnancy, my baby is on the large side. Last time his measurements were taken (a few days ago) they estimated 9 pounds. I realize that these ultrasound measurements are not always accurate. This baby has been measuring a week and a half ahead this entire pregnancy so maybe he's thinking my due date is off?

Also, some of my blood counts have been off for a few weeks and he's thinking I'm trying to fight off some type of virus. I feel good so maybe it's a small virus or it perhaps could just be wacky numbers from being late in my pregnancy. I don't really know. The blood counts (wbc, atypical lymps, myeltocytes) are very slightly out of range but it does make me nervous.

I know that 1/2 cm isn't great but hopefully it's changed in a week. At least I'm 90% effaced and he's at -1 station. I'm nervous but I assume I'm in good hands.

well 90% effaced and -1 station are both great places to start. Effacement makes a big difference because that head has to push against a cervix that is literally paper thin versus the depth of your index finger. You should be fine! Don't worry! Its not typical to do a CBC this late in the pregnancy without reason, but I wouldn't worry about the labs so much, slight variations in WBC's are normal in a full term patient. Unless there is a great reason to do a growth ultrasound at the end of pregnancy (measuring a week ahead is not a great reason in my book) I don't agree with them. Like you said they are only as good as the person doing them and even then they are more frequently incorrect then correct. But it does sound like you have a good sized baby in there. Assuming you are not 5'2" or shorter, my guess is that you will have no problem delivering vaginally assuming baby tolerates labor.

We have a joke in obstetrics called the "short gown sign". Meaning, if the patient gown touches the floor when the patient puts it on, just sign them up for a c-section. Basically short women get sectioned. Obviously, not entirely true, but kinda funny.

You've been such a great help for me! You're right, it's really weird to do those type of blood tests late in pregnancy and I have a feeling and I'm really hoping that things are slightly off is because I'm so late in my pregnancy and that it doesn't end up being something more serious. They are going to redo my blood work about 6 weeks after the baby is born. The only reason why they ran all of those blood tests was because I had very enlarged glands on my neck. The glands ended up going back down to normal.

The only other thing that was slightly off was that my baby was having PACs for a couple of days. I ended up seeing a pediatric cardiologist at Mass General and everything is perfect and the PACs cleared up entirely on it's own.

I am a bit afraid of delivering a large baby and I'm hoping they are off with his size. I have a pretty small frame but I am 5'4" :-)

Thanks again for all your help. I really appreciate it. As you know and must be used to, first time moms are scared and have no idea what to expect. Thanks again!

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