Induction Questions

zazu13 · February 2014

My dr is scheduled to induce me (twins) at 36 + 4 due to pre-eclampsia. I am not really dilated yet (0.5cm) at 34w and she said I was thinning some. She is having me come to the hospital the night before for a suppository to help soften the cervix in preparation for the induction the next day unless things change significantly before then. Has any one had experience with the suppository? How about the liklihood I will be more ready in 2.5 weeks?

Im starting to get nervous anout all this, but want what's best for me and babies. Ive read some horror stories about pitocin

DemoDoll · February 2014

I was induced at 41 weeks with the suppository and it was enough to put me into labor on my own. My doctor wanted to automatically start me on pitocin the following morning but I ask to labor on my own for awhile.

snmetz7 · February 2014

I had a suppository with my 20 week m/c and even at 20 w when everything was tight as could be it worked.

amhah09 · February 2014

No experience with the suppository but you can always try EPO to help soften your cervix between now and then as well. Or at least ask your OB about it.

Teresa1896 · February 2014

I had cytotec pills with my induction, not suppositories. I was not a good candidate for induction (not dilated/effaced) and my body didn't respond to the induction either. My doc said the suppositories could be more effective because they get applied directly to the cervix, but there could also be a slightly higher risk of complications for that reason as well (which is why you're always monitored so closely at the hospital during this process).
If I'd chosen to keep going forward with my induction we would've moved to pitocin and/or a foley bulb, but fortunately he let me go home and wait it out.

Rrrrrachel · February 2014

I have a friend who was induced around 38 weeks for pre e and all she needed was the suppository. No pit. It was a second baby.

MegJ17 · February 2014

Hopefully since you are already starting to thin and dilate you will have an easy induction. You might go on your own with 2.5 weeks left. I've been at 3cm for almost two weeks now and no other signs of labor.

acrookston · February 2014

I had cervadil and the Foley bulb for my induction due to GD at 39 weeks for my first child. I was 1cm dialated and my cervix was soft already. After the cervadil and foley bulb that night, I had menstrual like cramps in my back. They did use pit to speed things up the next day but all in all, I was in labor for twenty four hours before meeting DD.

Sometimes I wonder how I actually had a baby. My first time around I was so uneducated and did whatever the DR and nurses suggested. If I had done more homework prior to giving birth, I think I would have avoided the pit since things were going without it.

snmetz7 · February 2014

Is a labor with a suppository or cytotec "easier" than a pitocin induced labor?

snowclouds · February 2014

Induction with cytotec is dangerous. This pill is meant to be taken orally for ulcers, but doctors for a long time now have been using for induction or to induce a miscarriage for missed m/c. The makers of the drug have come out and said that they do not endorse this use of Cytotec when they got a lot of pressure because of the dangerous and adverse reactions that can happen when it is used. These side effects are very rarely mentioned to women who are given this pill for inductions.

I would go with Cervadil over Cytotec. Cervadil was enough to put my friend in labor early when she had pre-eclampsia so since you have 2 wks and you're already a dilating a tiny bit then you might be more dilated in by then.

tkseg09 · February 2014

Pay close attention to how you're reacting to the Cervidil once it's inserted. I wasn't sure what was normal/what wasn't and ended up having a really bad reaction to it. I think I had it in for about 3 hours before I couldn't take it anymore. It was really painful and made all cervical checks thereafter excruciating. I had mine inserted around 8:00 pm on a Monday night and ended up having a c-section at 6:00 pm Wednesday night. I'm not trying to scare you, it seems I'm really in the minority with this, but pay close attention to how you're feeling.

tkseg09 · February 2014

I forgot to mention that I started pitocin by 5 or 6 am Tuesday and was on it till just before the c-section Wednesday night. If I hadn't had the negative reaction to the cervidil, I'm sure my birth experience would've been much different.

selina1113 · March 2014

LaBe44a said:
It seems as though that I am in the minority here too. Neither cervidil nor the cytotec did anything for me with DS#1. He was 10 late and I still ended up with a Csection after a 5 day failed induction.

Cervadil did nothing for me, either with my first.

Cindylynnmoore · March 2014

I would really look into the use if cytotec if I were you, it is extremely dangerous and the FDA does not approve the use if it for labor induction.

https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111315.htm#.UxEpk9IsrXE.email

MamaFantastic · March 2014

This is perhaps a stupid (and admittedly very uninformed) question... and it really doesn't provide you with any helpful info, so I'm sorry for being a pain.

I was always under the impression an induction/c-section due to pre-E was more of a time sensitive reactionary decision based on a surge of dangerous symptoms and changes in the mom's body, rather than a pre-scheduled labor plan. Do you have pre-E now? How do your doctors know that exactly 2.5 weeks from now will be the best time for the babies to arrive?

Rrrrrachel · March 2014

The "off label" thing is kind of a red herring. Lots of drugs are used off label. It does mean it hasn't been through formal clinical trials, but that's partially because those are so difficult to do with pregnant women. Certainly it's something to be educated about and ask lots of questions about.

BabyBsMommy · March 2014

I had the suppository, not sure which one. I was only a fingertip dilated. It was enough to start labor. They inserted it at 6:30 am and DS was born at 1:30 pm, no pit needed.

HNRomance · March 2014

LalaMama81 said:

Teresa1896 said:

I had cytotec pills with my induction, not suppositories. I was not a good candidate for induction (not dilated/effaced) and my body didn't respond to the induction either. My doc said the suppositories could be more effective because they get applied directly to the cervix, but there could also be a slightly higher risk of complications for that reason as well (which is why you're always monitored so closely at the hospital during this process). If I'd chosen to keep going forward with my induction we would've moved to pitocin and/or a foley bulb, but fortunately he let me go home and wait it out.

That's interesting, I've always read that cytotec carried higher risks than cervadil. They are both inserted vaginally but cytotec can't be removed b/c it's a pill that dissolves whereas cervadil can be pulled out. Cervadil is a synthetic prostaglandin - semen is a prostaglandin which is why they say to have sex to induce labor. Technically (unless it's recently changed) using cytotec to induce labor is an off-lable use.

Cindylynnmoore said:

I would really look into the use if cytotec if I were you, it is extremely dangerous and the FDA does not approve the use if it for labor induction. https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111315.htm#.UxEpk9IsrXE.email

Ditto. Exerpt from WebMD: "Do not take this medication if you think that you may be pregnant. It may causeabortion, premature birth, or birth defects. In rare cases, serious complications (e.g., uterine rupture) have occurred when misoprostol was used to start labor or when used in combination with another drug to cause abortion after the eighth week of pregnancy. These complications have resulted in harm to the unborn baby and mother."

snmetz7 · March 2014

MamaFantastic said:
This is perhaps a stupid (and admittedly very uninformed) question... and it really doesn't provide you with any helpful info, so I'm sorry for being a pain.

I was always under the impression an induction/c-section due to pre-E was more of a time sensitive reactionary decision based on a surge of dangerous symptoms and changes in the mom's body, rather than a pre-scheduled labor plan. Do you have pre-E now? How do your doctors know that exactly 2.5 weeks from now will be the best time for the babies to arrive?

In my situation, I do not have pre-e but I do have naturally high blood pressure. So my drs did not want me going past due date since the chances of placenta abruption go up considerably after the 40 w mark for patients with high bp. They wanted to schedule induction for 38 weeks but I was able to push them back to 40 +1 since I want every opportunity to go natural.

Since op is having twins her timeline is probably shorter on what is "best". This is just a guess.

amhah09 · March 2014

I don't know about cytotec or cervadil but pitocin contractions are fucking hell. Avoid that drug if at all possible.

AND know that you can have them shut it off if it gets to be too much. That seems like such a simple thing but I didn't think about it with DD and it cost me my sanity and epidural-free delivery. I couldn't handle it after my water broke.

My midwife (muh more like an OB and why I switched practices this time) told me I couldn't get out of the bed while I was on it because I needed to be on the fetal monitor. My friend needed a bump of pitocin after her water broke and she wasn't having contractions after like 12 hours. When she got to the point she was asking for an epidural her midwife had them shut it off and she let her get up and labor in the tub and whatnot. And I couldn't believe I hadn't been presented with that option or thought of it myself. Just a PSA if anyone finds themself in that position.

zazu13 · March 2014

MamaFantastic said:

This is perhaps a stupid (and admittedly very uninformed) question... and it really doesn't provide you with any helpful info, so I'm sorry for being a pain. I was always under the impression an induction/c-section due to pre-E was more of a time sensitive reactionary decision based on a surge of dangerous symptoms and changes in the mom's body, rather than a pre-scheduled labor plan. Do you have pre-E now? How do your doctors know that exactly 2.5 weeks from now will be the best time for the babies to arrive?

My dr said I have "mild" pre-E which could become severe at any point. Honestly this is a good question. I wish I had medical training

I know that protein in the urine is a sign of kidney stress and if symptoms worsen then it can damage the brain and liver too as we'll as limit nutrients to the babies. The plan was always to deliver between 37-38 weeks due to twins, but the pre-E complicates things even more, I guess. I want what is best for the girls and me. The dr said it was a balancing act. Luckily I have 3 appts a week so there is plenty of opportunity to ask all the questions I didn't think about initially and for the plan to change based on how my symptoms improve or worsen. Thanks for all the info, ladies. I'm off to consult Dr. Gogle and hopefully not freak myself out more.

KatieKim0815 · March 2014

Cervadil does elp get thigs soft! I went in the day before my induction and it want fine!

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