Induction planning/timing

soulcupcake · October 2014

As early December approaches I've been thinking about the logistics of labor and all that jazz. I was induced with #1, 2 and 4 largely due to my history of very precipitous births and my provider wanting to avoid an unassisted birth. My midwife with #3 also discussed doing a controlled ROM induction (due to severely polyhydramnios, to reduce the risks of cord prolapse) for the same reasons, because she lived an hour away from me and there was a good chance she wouldn't have made it.

My primary midwife lives a mere five minutes from me, which is great. My other midwife is about 20 minutes away. As much as I'd like to wait and see when I'll go into spontaneous labor, a big part of me is anxious about that due to possibly not being able to control where I am when it does start. Given my history, I don't want to be out running errands, grocery shopping or whatever, and then BAM! something is happening and a baby shoots out. Typically, my midwife doesn't come over until mom, multips, are contracting 3-1-1, but that isn't how I "labor." I basically start labor in transition, or skip the entire process and a baby shoots out, literally.

So, if you were planning to induce to avoid an unassisted birth or birth in an undesired location, at what point would you be comfortable with it? We could wait until closer to 40 or right around that point. (I doubt I'll go earlier than 39).

mandi195 · October 2014

I would say 39 weeks if I was doing an elective induction.

Cheekers2010 · October 2014

Given your history, I would go around 39ish weeks. How early was your earliest?

soulcupcake · October 2014

@Cheekers2010

I was induced with all of them. I haven't gone past 39w2d. I doubt she'll come before 39 weeks. I had my first at 38, but I was induced to avoid a precipitous birth outside the hospital. But I might have made it to 39.

I see my primary midwife tomorrow. 39-40 weeks makes sense. I guess it depends on how I'm feeling up to that point and how "ripe" I am.

jennypolkadots · October 2014

I think I am a little confused. You were induced with your first baby because of the possibility of having a fast labor? How fast were your labors with your other children? Like lightening fast (20 minutes) or just faster than usual (2-6 hours)?

My solution would be to stop working (if you work) by 39 weeks and plan to be at home. Don't run errands and those things. I mean your alternative is going into the hospital where errands won't be being run so there can't be anything too pressing lol Keep your phone charged and husband and childcare providers on stand by. I wouldn't personally induce for this reason but it's your call to make. Are you delivering at home or a hospital? I've never heard of a medical induction for a home delivery but since you gave the distance your MW is away from you I thought you must be planning a home birth.

Considering you have had children before and know your labor patterns are different than expected, the midwives should trust your judgement on when to come over. There is a history of precipitous labor in my family on both sides. My mom had her first in 4 hours and me in 2. This is my first and there is no telling - it could be fast or just normal 12+ hours. My midwife has also had fast labors and so once I told her that she said she will err on the side of caution and just come whenever I call her, no biggie. It's what she's paid for. Have you asked your midwife? I seriously doubt she will wait until you are 3-1-1 if you tell her that is not how you labor.

soulcupcake · October 2014

@jennypolkadots

My labor with my first was 3 hours. My midwife sent me to L&D after a visit with her because she worried that I would precip. I was 5 cm and 80% effaced with a bulging bag. I had been that way for a week. The midwife I saw the week before was surprised, but was convinced I'd go into labor within a couple days. I was induced later that night, and didn't begin labor until heading into transition. (precipitous labor is a labor that lasts three hours or less)

My second "labor" was 47 minutes from the start of labor, and I was induced at 6 cm with her, but contractions didn't start until transition. For the same reasons, L&D staff weren't comfortable with sending me home knowing my first came in 3 hours. Had I gone home she likely would have been born there, which would have been fine, but we weren't planning a UC.

The circumstances were a bit different with my third due to issues related to severe polyhydramnios and uterine overdistension. I was induced for other reasons, and labor was 1 hour 40 minutes. I was 5 cm when labor started.

And with my fourth baby, just like with my first, I was 5 cm and 80% effaced with a bulging bag for about a week. Just like with my second, I got to 6 cm, but wasn't in labor. We spent a good deal of time waiting for things to start, and then it did, and I went from 6 cm to birth in one minute. We figured "labor" would be quick, anywhere from 30-45 minutes, but not *that* experience. I never actually labored.

If the pattern is similar this time, I'm 5-6 cm at 39+ weeks, I'll want to consider inducing to avoid a "surprise" and abrupt birth, and to ensure she actually makes it. My midwife knows I precip, and hopes that getting in the birth tub will help. That's assuming we'll have time to prep and fill it up. I visited with her colleague at my last visit. I'm going to go over more details at tomorrow's visit.

ETA: I'm planning another homebirth. Induction isn't that uncommon in OOH births. It just depends on the circumstances. My last homebirth was induced for partly the same reason.

jennypolkadots · October 2014

Thanks for all the info, that is really interesting! Like I said there have been very many fast labors in my family so it is something I am worried about have talked to my midwife about.

It sounds like you know what's best for your family and definitely have the experience to form the decision

With all that said, a planned induction with midwives present seems like a great option, especially if you end up being 5 cm and bulging bag like your last.

Since I've never given birth before, our plan is to head to the birth house early on and call our midwives to join us when things start to feel intense. DH has also taken a neonatal resuscitation course and learned quite a bit about birth just in case we end up with an unattended birth. But I don't see that happening at all, I will probably end up being like everyone else with a 8-12 hr first labor and worrying for no reason!

Cheekers2010 · October 2014

aeonlux said:

@Cheekers2010

I was induced with all of them. I haven't gone past 39w2d. I doubt she'll come before 39 weeks. I had my first at 38, but I was induced to avoid a precipitous birth outside the hospital. But I might have made it to 39.

I see my primary midwife tomorrow. 39-40 weeks makes sense. I guess it depends on how I'm feeling up to that point and how "ripe" I am.

ok. Yes. Obviously if you can hold out until 39 weeks minimum that's probably best. And since they were all inductions you don't know if you're someone who might typically go beyond 40 (doesn't sound like it considering the advanced dilation prior to labor).

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