Questions of induction/Cervadil

RKSnyder · June 2014

Okay, I haven't seen this posted and I'm on mobile. If it is already answered, then flame me for being obnoxious...

I am wondering about general induction stories. Just found out I'll be induced later this week (at 37 weeks) due to BP and crazy edema.

I'm wondering if contractions usually start while on Cervadil or if they only start once on Pitocin/having water broken? Is the Cervadil painful to put in? In general, is there anything I should really be prepared for that would be different from a typical labor?

Can you feel my anxiety, ladies? Haha! Thanks for any help you can give me.

LyndseylovesHugh · June 2014

I think they can, but for me they didn't start until I had a balloon catheter inserted. They started about half an hour after that and became stronger and closer together until my water broke about 5 hours later, at which point I got my epidural. They never used pitocin to induce me.

rboisvert · June 2014

I was induced at 41 weeks so different circumstances but I only had cervadil. I was contracting within minutes and was able to keep going without pit. Clearly my body was ready to get the show on the road but munchkin wasn't cooperating and getting her head down. Good luck.

mrscurlygurl · June 2014

I was induced with Cervadil with DS with the plan to start pitocin after 12 hours. After about 9 1/2 hours, my water broke on its own and the contractions started immediately. If I'd been having any contractions prior to that, I wasn't really feeling them. I never needed the pitocin because I progressed very quickly once my water broke. I don't recall it being painful to have the Cervadil put in and I'm pretty sure I was only about 1 cm at that time.

Good luck!

mhooks23 · June 2014

I have no experience with this but will experience this at the end of the week also. They are talking about a balloon with me also. Can you get up and walk around with that in or with Pitocin? At some point do you become confined to a bed. I am sure they will have me on monitors for my BP because of my hypertension so I will be restricted somewhat.

LyndseylovesHugh · June 2014

mhooks23 said:
I have no experience with this but will experience this at the end of the week also. They are talking about a balloon with me also. Can you get up and walk around with that in or with Pitocin? At some point do you become confined to a bed. I am sure they will have me on monitors for my BP because of my hypertension so I will be restricted somewhat.

With the balloon you can still get up and walk around, it's not attached to anything. The part that sticks out they tape to your leg (they did for me at least). The balloon was all I needed to really jump start labor, if that's an option for you I would go that route first; it's uncomfortable when they insert it but, for me at least, labor came on in a more natural way (contractions built up over time).

iris427 · June 2014

mhooks23 said:
I have no experience with this but will experience this at the end of the week also. They are talking about a balloon with me also. Can you get up and walk around with that in or with Pitocin? At some point do you become confined to a bed. I am sure they will have me on monitors for my BP because of my hypertension so I will be restricted somewhat.

Pit is an IV drip, so you can walk around with an IV pole as long as you also have telemetry monitors. You need continuous monitoring with Pitocin, so if they don't have telemetry units, you'll be stuck on the regular monitors and only able to move around in your room as much as the cords allow.

INmommy871278 · June 2014

I had light contractions that were not painful with cervadil. My water broke on its own after 12ish hours on cervadil and that's when the painful contractions started. The cervadil didn't hurt to be put in.

I was induced due to high bp and was confined to my bed because of the increased bp. Not sure if that is common with all docs and hospitals or just mine, but they wouldn't let me walk the halls because they didn't want to risk my bp going up any higher. I was only allowed out of bed to go to the bathroom. Good luck!

RKSnyder · June 2014

Thanks, ladies for the great info! I doubt I'll be up since I've been on bed rest due to elevated BP. Was on hospital bedrest for awhile and showed some light contractions on the monitor but nothing was painful. Just nervous about the whole induction process! Thanks for giving me a little more of what to expect.

argonne · June 2014

With DS, I was induced with Cervadil at 41w4d. They inserted the Cervadil around 9AM and I had regular, timeable contractions for about 3 hours before they tailed off. My MW gave me a second dose around 3PM and that got things going. I was in active labor about an hour later and starting transition (at 7cm) by 8PM. I didn't need pitocin to get labor going, but I did need it when my labor stalled at about 1AM at 9.5cm. They started the pitocin and I was complete within an hour and pushed for 2 hours (that sucked). DS was born at 4:22AM.

So, yes, labor can be initiated by Cervadil alone. I will say that my MW really worked it in. I don't know if what she did was a membrane strip while inserting it, or what, but it got things going. It also may have helped that I was fairly overdue and I was already at 1.5cm and 50% effaced when I went in for my induction.

BPer · June 2014

The placement of the Cervadil was painful for me, but that's because DD's head was so low that it was pushing the opening of my cervix back toward my tailbone, making it hard for the nurses to "gain access" so to speak.

I started contractions within an hour or so, they were mild, but irritating enough to keep me awake all night.

Pitocin was started about 12 hours later, and contractions became more painful, but they didn't get OMG intense until after my OB broke my water.

HairBossMama · June 2014

@RKSnyder‌ I'm having the same issues and being monitored closely but have not set a date to be induced yet. How high is your bp?

pfeilele · June 2014

I had two doses at 4 hours apart. Doesn't hurt to put in. I started cramping near the end of the first dose. Contractions ended up being back to back without a break halfway through the second dose. I got the epi after a few hours of that and they started pitocin just to keep things moving so I have no idea what those contractions felt like.

RKSnyder · June 2014

@ashbozso‌ my BP was pretty bad. My doc is watching for the top number to be above 140 and/or the bottom to be above 90. My other complication is severe fluid retention/edema, which gives them lots of cause for concern too. Fluid was moving into my abdomen making it hard to see baby. I'm getting induced at exactly 37 weeks but today at my appointment was 1cm dilated, 50% effaced, and baby is stationed at -2.

eortman · June 2014

You can ask for a cervadil only induction attempt. For me, contractions started within an hour or so of having the cervadil inserted and I was in full on progressive labor within a few hours. I had a full induction with the pitocin with my son and it was horrendous. I refused pitocin with my daughter and had a great birth experience. Both times I had the cervadil. I felt like having the cervadil only induction was much more similar to a non-induced birth experience. Please consider advocating for yourself and making the case to try just cervadil first. Even if it doesn't work right away you can go home and come back and try again. I am assuming I'll be induced again this time, since my babies seem to think the womb is a permanent home, but I will be refusing pitocin until after delivery.

HairBossMama · June 2014

Thanks for the info. That is what my doctor is looking for as well.
My bp has been elevated above that and swelling but no fluid in my abdomen. I hope everything goes well for you.
Good luck with your induction. T&Ps for smooth delivery!

argonne · June 2014

eortman said:

You can ask for a cervadil only induction attempt. For me, contractions started within an hour or so of having the cervadil inserted and I was in full on progressive labor within a few hours. I had a full induction with the pitocin with my son and it was horrendous. I refused pitocin with my daughter and had a great birth experience. Both times I had the cervadil. I felt like having the cervadil only induction was much more similar to a non-induced birth experience. Please consider advocating for yourself and making the case to try just cervadil first. Even if it doesn't work right away you can go home and come back and try again. I am assuming I'll be induced again this time, since my babies seem to think the womb is a permanent home, but I will be refusing pitocin until after delivery.

This is what I did. I asked my MW if we could just try the induction with Cervadil, rather than moving onto Pitocin right away. She was very on board with that plan. Even though I had to have Pitocin later on, I was very happy with the way my induction went. I was able to labor and deliver without pain meds, which was a goal of mine.

RKSnyder · June 2014

Such good info! My fear lies much more with Pitocin, especially with Pitocin after water has been broken (I've just heard it makes delivery even more of a devil!) I am not able to have an epidural due to previous back surgeries so I want to do anything I can to keep myself in control of my birth experience, otherwise (though obviously I'm ready to roll with the punches). I will ask to try with just Cervadil first!

eortman · June 2014

Alot of hospitals/doctors are quick to push pitocin to hurry labor along, but I would much rather have a longer labor without pitocin than a shorter labor with it.

mhooks23 · June 2014

Thanks so much for the great information ladies and thanks for the initial topic @RK Snyder. I think my MW intends to stay away from Pitocin so I can advocate for avoiding it as long as possible.

TwizzyG · June 2014

At our hospital, Cervidil is placed and left in place for 12 hours unless you begin contracting too frequently or baby does not tolerate it (not usually the case, but it can happen). Placing it is as simple as a cervical check, uncomfortable, but manageable. I've seen patients deliver after only a Cervidil..I've seen them need a few placed and followed up with other induction/augmentation methods.

Another option you might get is Cytotec (small pill, placed the same...rechecks every 4 hours instead of 12).
With any induction method, you'll need to be monitored to make sure baby is tolerating the medicine and to make sure you are contracting too much. If your hospital has mobile monitors, it shouldn't be an issue for you to get up and walk/be in a birthing ball/etc...as long as they can pick up baby's heartbeat and your contractions.

Another option might be a foley balloon/mechanical dilator. You can move around with that too, but most people find them uncomfortable and don't want to. I personally think they're a little barbaric, but every once in a while, they seem to work. I'd keep that as a last resort (personally).

Pitocin is what is going to make you contract stronger and more frequently. (aka ... Makes them hurt more). Pit usually isn't used until your cervix is "ripened" (aka...softened and preferably thinning out (>50% effaced). Same deal, as long as you can stay monitored, you should be able to move as you wish.
The only thing that really keeps you in bed is an epidural.

Hope this helps!!!

Hoosier722 · June 2014

Cervidil made me to into labor with both my previous pregnancies. With my first, it was inserted around 8 pm and I delivered about 12 hours later. With my second, it was much faster - inserted at 10pm, delivered at 2 am. It helps if you are already somewhat dialated. I don't remember the insertion being painful.

RKSnyder · June 2014

@TwizzyG‌ thank you for explaining each! I realized I'm not sure whether my doc is using Cyotec or Cervadil. I had heard of the balloon thing and asked him and he said he would def not do that; that the medicine tends to work better and cause more of a true dilation in his personal experience (not that I know what is meant by true vs not true but the balloon kinda scared me...). I think I'm just so nervous for the unexpected!!

TwizzyG · June 2014

You're welcome! I agree with your doc that the medicine works better. The balloons are mechanical dilators that go in and force your cervix to open (the pressure the balloon puts on your cervix forces it open). Whereas medicines cause changes in your body that make your body do the work to ripen and dilate your cervix (which I think is what he meant by "true" dilation).
Either way, sounds like you're in good hands! I'm a FTM, but see deliveries every day at work and I'm still nervous! It's natural. Good luck!

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