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Questions about induction - answers and advice gratefully recieved :)

(13 Posts)
stripeymummy Thu 08-Sep-11 12:54:17

I am being induced, with my first, at 38+5 for medical reasons. The plan of action is to give me a pessary, wait 24hrs then be reassessed, if my cervix is soft enough they will break my waters, then put me on a drip and an epidural at the same time (I am having the epidural as I have a congenital heart defect and need to keep strain down to a minimum).

Having read a couple of other threads on induction, some people get set off with just the pessary. What is the chance of this happening? Or because I'm being induced before I hit the 40wk mark it is less likely to happen?
And will the drip bring on labour much harder and faster than other forms of induction? I have been allocated only half an hour for pushing to stop excess strain - then it's foreceps - and I am not allowed to push until the baby's head has dropped into the cervix - I am assuming that this will add extra time on?
Plus, what is an epidural like? Will I be able to read/watch telly/do other distractions whilst I'm waiting for the baby to drop?

I understand that everyone's experiences will be different, but I would love to hear people's stories to help prepare myself a wee bit more mentally. Many thanks, cluelessly yours smile

verybusybear Thu 08-Sep-11 14:22:43

Hi stripeymummy.

I guess my situation and a lot of other peoples would have been different to you due to the time limits they are putting on for you.

I was 13 days overdue when my waters went of their own accord. About 16 hours later was in hospital having a pessary (which I don't think really did anything) and so another 8 hours after that I was on the drip. After 8 hours or so on the drip (and in immense pain!) I had an epidural. Unfortunately soon after that I was in for an EMCS due to fetal distress, so I can't really say whether I would definitely have been up for reading / watching telly etc. However I think I probably would have been? Certainly only a few minutes after it was in I went from feeling like I was in a black tunnel (couldn't really focus on anything or talk because of the pain) to being able to have a brief joke and smile with my husband, before the other problems started.

I think the drip does bring on faster and painful contractions, but if you've got an epidural from the start I wouldn't worry about that.

You say that after the first pessary they will break your waters if your cervix is soft enough. Have they said what they will do if it isn't? Because my waters had already gone the induction process was probably a lot quicker for me than some other people. My best friend for example went in to be induced on a Sunday evening and didn't have her little girl until the early hours of Thursday morning. That was after 2 pessaries (or perhaps it was 3...?), breaking of waters and then finaly the drip. I think a lot of people are quite often not prepared for how very long it can take.

Good luck and best wishes!

issynoko Thu 08-Sep-11 14:53:59

I was about to post on this too. Have developed gestational diabetes and am likely to be induced at 38 weeks it seems - depending on how it all goes. Having had 3 spontaneous, natural births - 2 at home being fully active - am dreading the whole idea of being wired up and immobile. So have no advice but will join you in your clueless state and wait for stories! Any positive induction stories very welcome - must be some!

pinkhyena Thu 08-Sep-11 16:57:59

Hi,
I was induced at 39+2 for gestational diabetes. I was fortunate that I went into labour about an hour after the pessary was given and my waters were broken a few hours after that. I had an epidural because the pain was too much but it was fab! Before I wasn't very coherant and not in control but afterwards I had a little sleep, watched TV (Jamies 30 Minute Meals IIRC) and chatted with the midwives. They told me when it was time to push and I was much more calm that perhaps I would've been had I not had it. You can still feel when the contraction comes but it's more like a braxton hicks than a proper labour one. At least it was for me.
HTH and good luck!
x

Bet01 Thu 08-Sep-11 18:25:35

Hi,
I was induced at 41+1 as my waters broke, I had mild contractions but then nothing more, so after 36 hours they had to induce me due to risk of infection. I think having the epidural straight away is an excellent idea. I stupidly waited until I was in a lot of pain before having mine, but all of a sudden it got much worse and I wasn't really expecting it, so not my fault I guess. That part was just awful, i remember it vividly. The epi didn't hurt at all going in and was brilliant.
I had the drip because I was already 3cm dilated when I got there, too far along for pessary.
I pushed DS out in 20mins and he was 9lbs, so it can be done! I found the pushing easy, just follow the midwife's instructions.
The worst thing about induction IMHO is being stuck on a bed with a needle in each hand ( hormone drip in one and IV in other) for hours and hours. Couldn't even go to the loo (catheter-yum!)
Try and insist on being allowed to get up, if you have a 'walking' epidural. It'll make all the difference.
Good luck!

Hgirl1974 Thu 08-Sep-11 19:36:34

I was induced at 39 + 2 for the same reasons as Bet. I had the pessary first - my impression was that they didn't expect it to kick-start labour, it was simply to soften up the cervix. Was sent off for a walk and to get lunch (if they make you do that, for goodness sake don't do what I did and waddle all the way up a massive hill and back down again!) and they started the drip in the afternoon. Active labour was 13 hours of which I did 5 with gas and air and then had the epidural. The epidural was brilliant - I was a shivering, vomiting, incoherent mess before it and as soon as it kicked in, everything was fine. Was able to chat to husband and midwives, listen to the IPod and even sleep a bit before pushing. The midwife was really good in helping me change positions whilst pushing and telling me when the contractions were coming (I couldn't feel much at all until the baby was almost out). Took me 90 mins of pushing and they were almost going for the forceps when DS made his entrance, but that was mainly because he'd turned back to back using labour.

So in summary, don't worry - in many ways, the fact that you'll have access to an epidural from the outset and without having to fight to get it might be a very good thing! It didn't in any way harm my experience of childbirth and in many ways it made me feel more in control of myself and my surroundings.

stripeymummy Thu 08-Sep-11 20:30:28

Thanks for all the advice and info guys. And I'm very glad to hear about the epidural effects (best start saving up those crosswords wink)! Was kinda dreading it, but after your stories feeling a lot better. I would love to have a walking epidural, but I think that I'll be hooked up to a million machines, so I doubt I'll have much of a chance. I've already warned DH that he'll have to wiggle my legs and rub my back for me smile

Verybusy, good question as regards if the pessary doesn't work, didn't think of asking that one - doh! I'm in pretty early on the day for some pre-induction check-ups so I shall ask then. Though I'm assuming that they'll give me another.

Hgirl what positions did your MW put you into? That is another aspect I haven't asked about yet, and I really really don't want to end up flat on my back. What position did you end up delivering in?

Thanks again xx

sleepevader Thu 08-Sep-11 20:38:16

I want to know if they are likely to want to put me on a monitor and if do can I sit on my birthing ball. Being sat up in a bed in uncomfortable at the best of times.

hartgem Thu 08-Sep-11 23:02:29

Sleepevader- When I was induced, just over 11 weeks ago, the pessary didn't work so I had to have the hormone drip. As soon as this was up the contractions were quickly very intense and regular...could not even consider moving to a birthing ball. Also I was strapped to a monitor, for baby's heartbeat and contractions (normal practice I believe for inductions). They make moving around even more difficult as they have a tendency to slip all the time.
Hope this helps smile

Hgirl1974 Fri 09-Sep-11 07:52:06

Stripey - I ended up delivering on my back, but prior to that I alternated between being on my back and kneeling up against the back of the bed (a friend of mine who was induced also did this) - kneeling up was quite comfortable and obviously lets gravity do its thing! I also did the first two or three hours with a birthing ball although I can't remember whether the heartbeat monitor was on at that stage. I have a feeling that it might not have been on the whole time. The midwives where I was were very supportive of me being as active as possible in the circumstances, so I recommend that you just explain what you want and see what they say - you may be pleasantly surprised by how much you can actually move around.

katiegirl Fri 09-Sep-11 09:29:06

Hi Stripeymummy, it sounds like the drug they will be using for the first part of the induction is something called propress if they plan on leaving it for 24 hours before breaking your waters - this is on a string similar to a tampon so if you start to have contractions they can remove to prevent over stimulating of the uterus. The alternative which I am more familiar with is prostin which is given 6 hours apart, and most women with their first baby have at least 2 and tend not o have their waters broken until the next day; I always tell women to expect the induction process to last a 2-3 days and if it happens quicker (which it certainly can do) then that's a bonus. Unfortunately I think women aren't told enough about induction before they come into hospital so a lot aren't mentally prepared for how long of a haul it can be and that's hard. I'm not sure how propress compares to prostin, but I would definitely have in your head that you are quite likely going to require a second dose of medication used to soften the cervix (it may be after 24 hours of propress they move onto prostin). With prostin some people get into established labour, but the majority will require a drip (some having had no pain at all until this point others having had regular tightenings/cramps).

You will have the epidural in place before the drip is started, and if it is a good epidural (which 8-9 out 10 are) you will feel no pain- so certainly able to concentrate on other things, although if you've had a long couple of days with the first part of the induction you might just want to rest. You might be aware of contractions and you might feel pressure and sometimes still even the urge to push as the baby moves down.

It sounds like they plan on giving you a decent length 'passive second stage' - so that is when your cervix is fully dilated but you aren't pushing, to allow the baby to move down and into a good position with contractions and give you the best chance of pushing your baby out without assistance. This could be 1-3 hours. Even if your epidural isn't a mobile one, so you are unable to get off the bed it is still a very good idea to be mobile on the bed, some women are able to kneel depending on how dense the block is, but even moving from your left side, to right, to sitting up etc can help the baby navigate the pelvis.

It is definitely possible to push a baby out in 30 minutes if they are in a good position and the contractions are good.

Sleepevader, there is no reason you can't be mobile with a syntocinon drip and a CTG monitor on, it just might take a little bit more effort (for you and the midwife!). If you're attatched to the CTG with wires (although there may be telemetric monitors available - so no wires, which is even better) the midwife will not want to be having frequent gaps where you are off the monitor (as this prevents her from interpreting the baby's heart rate accurately) so you will need to stay fairly close to it. Sometimes when you are mobile it can be more difficult to monitor the baby's heartrate, so the midwife may need to reposition the monitor when you move, or she might ask that you avoid a certain position (remember the monitor is on for a reason). If your waters have broken and there is loss of contact on the CTG the midwife might suggest (or you can) putting a fetal scalp electrode on, this is a little clip the goes just under the baby's skin on the scalp (does not cause any harm but depending on how much hair they have you may see a little mark from it when they are born), it allows direct contact with the baby so movement/changing position does not affect the CTG.

Good luck all of you going for induction, my advice - be prepared for a long few days, but try and remember it is only a few days, it won't go on forever and you are going to meet your baby soon! Oh and be as mobile as possible, sleep when you can, eat and drink regularly while you can.

stripeymummy Fri 09-Sep-11 20:26:57

Hi katiegirl thanks ever so much for the info. I think you're probably right about the type of pessary they plan to use, I think my obs mentioned a string. Sounds like I might be in for the long haul sad oh well, I'm sure it'll be ok, I'll keep the DH on entertainment/massage duty wink. It's really useful to know this stuff, especially when I haven't got a scooby as to what to expect - and therefore not being able to ask the right questions. You're a star, thanks again grin

sleepevader Sat 10-Sep-11 20:19:02

Thank you got the info. I will discuss with specialist midwife when I see her this week. They may have discouraged me from the birth centre but I am keen to avoid the consultant led norm of what is easiest for the staff. Lying or sitting on bed will be so uncomfortable!

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