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3rd Trimester
Induction / Epidural
I've been thinking a lot about unnecessary things like inductions.. I'm a FTM so I didn't even realize that many are done unnecessarily until reading a few things on bump and some follow-up research. I still don't understand why OB's do this, but apparently many do, so I'm planning on telling mine today that I don't want to be induced ahead of time before it even comes up. A friend told me she wasn't induced, but they gave her pitocin anyways to speed things up - but what's the point? All the conflicting views are so confusing...
I've also been rethinking getting an epidural - been reading a lot on how it can slow down labor significantly...
Thoughts on either of these would be appreciated!
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Re: Induction / Epidural
I *think* part of the problem with pitocin is it really ramps up contractions meaning you need more epidural to feel good but then you need more pitocin to keep the contractions coming. Induction when the body simply isn't ready does increase the chances of what otherwise would have been an unnecessary c-section.
I want to use a squat bar & my hospital offers them so I am not planning on getting an epidural. I'm open to change if I really don't feel well but I'm a huge fan of using gravity to help get this little lady out! I haven't discussed anything with my doctors yet, but I think at 37 weeks they go over birth plans and I will be requesting to go 10 days past my due date before an induction if that has to happen.
My sister was induced 9 days late, had an epidural with a 9lb+ baby with a great hospital staff and had a fairly easy vaginal delivery so it is possible.
https://harvardmagazine.com/2012/11/labor-interrupted - someone on Jan 2013 posted this article this morning, I thought it was interesting.
We just went over induction/epidurals/pain relief in our birthing class this week!
I also do not want to be induced, unless it is medically necessary. The nurse running our class said our hospital doesn't do unnecessary inductions, so that made me feel a whole lot better. My research on pitocin has lead me to the conclusion that it causes stronger, more painful contractions, which can cause fetal distress, and I don't want myself or my baby to go through something like that.
I'm very much considering having IV pain relief throughout most of my labor, if needed. I forget the name of the medications they said they use at my hospital, but the nurse said they're like demerol, which I had after an appendectomy this year, and that did take the majority of the pain away and made me feel a heck of a lot better. I have a pretty high tolerance for pain, and I don't want to rush to the epidural immediately if there are other options. I know the IV meds cross the placenta and the epidural meds don't, but I don't believe there is any harm to the baby. Plus, with IV meds, you can walk around, use a birthing ball, change positions, etc. With an epidural, you're confined to the bed. And, if you use IV meds, they do give you injections on either side of your vagina as you are about to deliver so you are numb and don't feel extreme pain or discomfort with the delivery.
Epidurals can either slow OR quicken the labor... it's really hit or miss what it will do to each individual person. I would just rather avoid it for as long as possible and only get it towards the end (if needed) so that I can move around during my labor.
IV Meds have more effect on the baby than an epi.
There's a huge distinction between inductions for no reason vs. medically necessary, and you could put your baby at risk if you decline a medically recommended induction.
I was induced w/ DD a few days late b/c of slightly high BP. It was not a great experience but who knows what labor would have been like in any case--I'll never know if it was truly "worse" or not. I LOVED my epidural and had no issues with it. I could still move around but didn't have pain and I don't know how I would have gotten through labor (and five hours of pushing) without it. I think I would have ended up with a c-section if I had NOT had my epi.
With DS, I was a full week overdue and water broke with no contractions. Had to start pitocin after 5 hours (risk of infection starts to go up if BAby doesn't come out) and was very nervous about it after my first experience, but things progressed really well. Got an epi again, loved it, no problems.
I guess I"m just saying that every situation is different, and you don't know how your experience will go. You need to do your own research, but remember that your doctor IS the one with training and experience. Just ask lots of questions if you get to the point of talking induction so that you can make a smart decision.
I felt very much the same way you did, and then my water broke unexpectedly at 36 weeks. 14 hours later I was not having contractions and the risk of infection was high since my water was broken, so they started me on pitocin. My nurses were SO CAUTIOUS and did not push it at all. They increased it very slowly and watched my contrax very carefully to make sure that baby was not in distress and that I wasn't progressing too fast.
I did get an epidural and it sped my labor up BIG TIME. Like, I was at 4cm, got the epi, and within 30 minutes was fully dilated and ready to push.
The point of my story- nothing went how I "planned" and I ended up getting more interventions than I expected to need, but my labor was short easy, and relatively painless. So I have no complaints.
Ugh, the Pitocin thing. Even if you're not induced a lot of moms will end up being augmented with Pitocin. There are a lot of reasons that range from being confined to a bed, which can slow down labor, most people get epidurals, which can slow down labor, lack of individualized care, which means they expect every woman to progress on a set schedule and if they don't they want to speed up the process, some doctors just really don't want to wait out a slower, naturally progressing labor, etc. The thing is, obviously the use of Pitocin comes with higher risks to mom and baby, increased chance of C/S, etc. It's definitely overused.
It sounds like you're doing research though and that's great! The best way to make sure you're getting the best care possible is to do your own research so that you're armed with knowledge.
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Most importantly- every soon to be mom should do their research, but also be open to other options as well. I wanted to have an epidural free labor with DD, and told my OB who was very supportive of my choice, until I was in active labor after being induced and she kept denying my epidural reminding me of my earlier request (finally giving in later to the epidural).
My OB also claims to not induce unless medically necessary, and so does the hospital, but the week before my DD, my OB told me she was going on vacation two days after my DD, she didn't think I would go into labor naturally by then and if I wanted her to deliver my baby we should consider induction. As a FTM I couldn't imagine anyone else delivering my baby so I obliged. But, other things happened during labor and if I wouldn't have had an epidural, I would have ended up having a c-section because there was scar tissue covering my cervix not allowing my to dilate and had to be forcefully broken (from a LEEP in the past). There was no way this was happening without an epidural- so keep in mind, it's great to have a birth plan (I had mine printed out and copies made) but sometimes plans change and don't be so opposed it clouds your judgement.
And the only reason they needed to use pitocin was because after they finally busted the scar tissue I went from a 1 to a 4, but started to have a fever.
Oh, and another comment on the IV pain meds- they were horrible for me. They knocked me out so bad all I remember from labor and delivery through about an hour before DD was born was one continuous contraction. I was knocked out, would wake up for a contraction and pass back out. Once I got the epidural I was able to sleep off some of the meds but it took about 6 hours after the last dose for me to shake the fog, and then DD was hazy when she was born and didn't BF right away. I told my OB no IV pain meds this time around, and I want to go into labor naturally (the oh crap, those are contractions/my water broke moments) but other than that I'm open to whatever.
Inducing 7 days past EDD is not medically necessary even though some practices try to institute this rule for a variety of reasons. I would encourage you to do some research on this. The average FTM goes into labor at 41+1.
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I didn't realize any of this when having DS. I was due on 12/31 and on 12/28 went to the doctor who said I was 4 cm and 80% effaced and I just needed a "push" so if I wanted to have the baby before the new year, I could go for an induction the next day... so I did.
I was induced. Water broken at 7:30am, then given pitocin. Epidural at 9am... Started pushing at noon - had him a few minutes after 1pm.
This time I am for sure waiting to go into labor on my own and I'm going to play the epidural by ear and see if I can stand going without it...