Induction - any experts out there?

[IngridFletcher]

I have just been reading the NICE guidelines on induction (don't ask!) and I am confused. I thought with induction they would try a sweep first, then prostaglandin gel/pessary and then if that did not work oxytocin drip. The guidelines make no mention of the drip though I am sure this is what my local hospital use if the gel/pessary fails. Is this wrong?

The guidelines say that artificial rupture of membranes should not be used alone so is ARM just used to augment labour?

Can anyone shed any light?

Hi Ingrid, I dont have anything to add but ill be watching this thread closely. My baby is due next week but if he decides not to make an appearance I want to be clear of NICE guidelines. Hopefully somebody will come along to shed some light on this.

Bump!

okay IME having had 4 inductions......

The midwives will give you sweeps when you are past your due date, then if you still haven't delivered you go into hospital to be induced. They give you 3 lots of gel/pessary 6 hours apart. If this dilates you enough but labour is not progressing they will perform ARM.

So the drip is not standard I think that is used if your contractions start to decline, your waters went days earlier and nothing happening etc etc - it's not a routine part of induction as such.

PS. The ARM is unpleasant and if it makes your contracts speed up they are painful!

I'm not a medical expert - but was induced.
My waters broke but I didn't go into labour - I had a sweep a few days previous, but the MW said my cervix wasn't ready yet and she couldn't reach it.
The hospital did try the pessary but still no action, so I was then put on the drip.
Labour was slow and in the end I had a c-section - mostly down to time really, it had been 48hrs+ since my waters broke and the hospital policy was to deliver the baby after 2 days of waters breaking to reduce the risk of infection.
It sounds a bit medical and full one (I also had pethidine and an epidural in the end too) but whilst it was painful it was ok and my baby was fine. Huge baby too - just short of 10lb. Probably a good thing to have had a section!

Your hospital will have it's own policy and it won't be the same as the NICE guidelines.
It will be dependant whether this is your first baby and how favourable your cervix is as well.
Ask your midwife or obs what the policy is at your hospital.

(by the way, my hospital's policy was straight to ARM if possible, then 3 hours wait and see if things start up, if nothing then straight to drip)

Thank you guys. Im reaalllyyyy scared of the drip. On Monday Im seeing my MW and will ask what is their policy in terms of induction.

If they want you to have the drip just insist they fit you up with an epidural first

Is it your first baby? As far as I understand, they will be more keen just to break your waters if it's a second or subsequent baby.
If it's your first then the prosglandin gels or pessary is the way.

The drip isn't much fun, I'll be honest! But I found moving around did help, although this was a challenge with a baby monitor strapped to me.

But, despite all this, I was in the painful bit of labour for only a few hours - you get used to the rhythm of the contractions and there is complete respite inbetween.

thanks. I have done lots more research and understand it better now.