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11-29-2012 at 11:10 AM
lakreuz
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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!

 
11-29-2012 at 11:17 AM
BLPL101
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I'm planning on having a natural birth for the same reasons. I actually just switched from my OB to a CNM due to him not being on the same page as me.

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11-29-2012 at 11:19 AM
this decaf...
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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. 

 

http://harvardmagazine.com/2012/11/labor-interrupted - someone on Jan 2013 posted this article this morning, I thought it was interesting.

11-29-2012 at 11:21 AM
JBos82
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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.

11-29-2012 at 11:23 AM
PatsyGK21
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I dont know why some practices schedule inductions before due dates. My practice will only induce if you're 7 days past your due date, because they worry about the merconium (i know for sure I'm spelling that wrong hah) can get into the baby's lungs. I didn't even know early induction were a thing until I read it on here. Seems medically unnessasary to me.

 
11-29-2012 at 11:32 AM
NicoleWI
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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. 


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11-29-2012 at 11:54 AM
IncogNeato
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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. 


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11-29-2012 at 12:03 PM
pamiva1
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I think it's great to do your research before hand and know all of the different options available to you, but the truth is that until you are in labor you won't know what's best for you or your baby. With both my DD and DS my water broke and I did not go into active labor. So, I had to be "induced" with pitocin because I was approaching 24 hours and they needed to get the babies out. As much as I thought my births would go one way, they ended up being completely different. In the end, my babies & I were healthy which is all I care about. So, continue to read up on everything but don't be disappointed if things don't work out exactly as planned. I think the most important thing you can do is find a DR you trust 100% and know that what he/she recommends at the time is the best thing for you & baby.

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11-29-2012 at 12:05 PM
sbevmc09
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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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11-29-2012 at 12:19 PM
TMWarren85
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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.


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11-29-2012 at 12:20 PM
sbevmc09
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PatsyGK21:
I dont know why some practices schedule inductions before due dates. My practice will only induce if you're 7 days past your due date, because they worry about the merconium (i know for sure I'm spelling that wrong hah) can get into the baby's lungs. I didn't even know early induction were a thing until I read it on here. Seems medically unnessasary to me.

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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11-29-2012 at 1:06 PM
mabenner1
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Before I delivered, I wanted to go med-free. I had terrible back labor, and went in at 6 cm, so I went ahead and got the epi because the pain was so bad I couldn't stop throwing up. I progressed to 9 cm pretty quickly, then stalled. They ended up augmenting me with Pitocin to try to get me to 10, which happened quickly, but DS wouldn't descend, so I ended up with a c-section. The moral of my story?  While not for everyone or every situation, epidurals and pitocin do have a legitimate, medical role in many women's deliveries.

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11-29-2012 at 9:40 PM
Kingston54
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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...


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11-30-2012 at 4:40 AM
Kimbus22
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Inductions are done for a lot of reasons.  I personally had one due to GD and concerns that the placenta was deteriorating.  Plus I had been in early labor with contractions every 5 minutes for two solid weeks.

Many times pitocin is given when a woman's water breaks but she isn't progressing on her own.  Typically you're given 24 hours after the water breaks to get the baby out due to the increased risk of infection after that point.

And for some, epidurals do slow progression.  For others, it speeds it up.  In my case, I was in active labor from the induction for two days but only progressed one cm because I was tense and afraid and in pain.  They gave me an epi and I went from 2cm to 10 in a few hours.  It helped me relax and rest, which was needed since I pushed for 3 hours.  That wasn't due to the epi.  That had worn off before I began pushing and I could feel everything at that point and was pushing fine.  But I have a small pelvis and a bowling ball-headed kid who was insisting on trying to come out face up no matter how many times we changed positions or the nurse stuck her hand up there trying to turn him.

If you don't want to do either, you don't have to.  Unless obviously you need to be induced due to some medical issue that is threatening the health of your baby.  It's best to educate yourself, form a plan for your ideal birth and then go in accepting the fact that it may go according to your plan or it may be completely different. Really, the baby dictates how labor and delivery will go more than you do.  So it's best to be informed and open to all of your options.

ETA:  RE: pitocin contractions. I did fine with strong pitocin contractions for two days until my water broke.  Then I begged them to kill me and let my DH raise the baby.  They gave me the epi instead.


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11-30-2012 at 10:13 AM
lakreuz
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Great info ladies thank you!!
 
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