Induction - any advice and what's involved?

[Minstrelsaremarvellous]

I'm booked in to be induced on Sunday. Am a bit clueless as this is no.2 and DD popped out on her due date. I naively expected no.2 to appear of own accord too! Anyhow, what will happen and does it take ages?

It's different for every woman.

Has your MW not given you any information (if not, that's a bit poor)

What are you being induced for (medical reasons or protocol as you're X days over?) as this can affect what path is followed.

Hello - I was induced with my first, I had some tablets inserted, waited a couple of hours then had some more. I then had my waters broken as they didn't go on their own - none of this hurt. Then about 2 hrs later contractions started and it took 6 hours from then on. The sintosin in the drugs they use apparently makes contractions more intense, and I did have some pethadine and an epidural, but the whole process was fairly uneventful. I might be a bit hazy (pethadine) but I would say in my case it was all quite plain sailing. Before hand I was already 1cm dilated as I was 10 days late. As it is your second, it may not take as long as normal??? I would write a list of questions and ask the MW - good luck, hope all goes well xx

They may try and break your waters first, they then may have to insert the pessaries or use a drip, I've been induced twice both were born within 12 hours, ds1 was a 3 hour labour and ds2 20 mins! It was fine.

Flisspaps - I'm currently 9 days late and will 12 on Sunday - maybe baby will put in appearance beforehand (especially as it's just started snowing! ). My midwife is quite a character and not the chattiest - quite abrupt but I can live with that and I'm happy doing my own research really. I had an epidural with DD and episiotomy - was hoping to avoid episiotomy this time as it caused a few issues. Am fairly laid back about pain relief options - prepared to go with the flow.
Good idea to call midwife and find out what happens. I saw her today thinking I was getting a sweep but she couldn't do it (only 1cm dilated) so hadn't thought of questions about induction - just got booked in and then was out before I even thought about it!

I was induced when I was 12 days overdue with DS1. The hospital was really really busy so I spent quite a lot of time waiting around so I would advise you to take lots of magazines etc!
I had a pessary in the evening (you can have this up to 3 times) and then DH went home. I slept, but by the next morning was having what they called 'tightenings' (don't know how this is different to contractions) and spent the day bouncing on a birth ball, walking round the hospital (really slowly!) and having a bath and waiting for a labour room and midwife. Mid-afternoon I went to a room to have my waters broken and after this my body kicked straight into labour with contractions about 2 minutes apart, so I never had to have a drip. It was quite a shock to the system to begin with, but I coped fine with TENS and gas and air and about 5 hours later I gave birth.

I found it very difficult to get information about what an induction would be like other than a few horror stories and lots of warnings about how much more likely it was to lead to more interventions! However, in the end my son's birth was absolutely fine and positive. Hope that helps.

I was induced on my due date with DD (DC3) due to low fluid.
pessary to start (10am I think) - did v. little. (on antenatal ward)
waited....waited....waited...
had a few period type pains. DH went home (9pm)
Another pessary overnight. would have slept but for dreadful snoring lady on ward
Waters broke early hours. period pains.
waited...waited...waited (getting the theme here?)
Couldn't go down to delivery suite to have a drip cos they were too busy. Waited.
pains all went away.
finally went down to delivery at about 9pm. Very bored.
I wanted epidural before drip (had epis with DC1&2) and they said I might have to wait another day cos Anesthetist busy. :(
Finally got epi at about 10pm, then drip in.
all started going - epi was best yet - no pain, slept a bit. At around 4am felt a bit odd - told m/w I wanted to go home - & wanted to wee - baby coming!
breathed her out (didnt really believe this was possible - pushed DC1 for 2 hours, Dc2 for 1 hour) and could feel it all, but no pain - AMAZING!
Of my 3 births, this was the best. Boring, slow at first but overall best. Had 2nd (almost 3rd) degree tear with DC1, 1st degree with DC2, nothing with this one.
I know some people find induction awful, but wanted to tell you something positive!
my advice - take a book!

Ok. In that case, if you're still 1cm dilated when you go in, they'll probably start with a pessary or gel - this helps the cervix to open and encourages contractions.

Then once you're 2-3cm, they will probably try to break your waters (ARM) which they do in the hope of strengthening contractions and establishing labour.

If this doesn't happen, you'll be encouraged to have a syntocinon drip. The contractions from syntocinon can be really strong and whilst your uterus contracts as it would in spontaneous abour, there's no gradual build up of contractions, and your brain doesn't release endorphins so they can feel more painful than they otherwise would, which is why a lot of women request an epidural is sited before the drip is started.

As I always say on threads about induction for 'going overdue' - you're not actually overdue until 42 weeks (normal pregnancy is between 37 and 42 weeks, for some women it is a bit more, others a bit less) and you don't have to accept the induction - it is an offer that should be made to you rather than presented as a fait accomplit, and if you don't want induction then you should be offered expectant management. It sounds as though this didn't happen in your case.

Thanks Flisspaps, that's great info. I appreciate it wasn't exactly 'offered' but am happy with this step. it's only 2 more sleeps now (well…… I say sleep but I think sleep is overrated!) so just waiting for the snow/ice to throw all the best plans awry!

If you're happy with it, then that's great.

It can take days to get going (or even for them to actually do anything) so make sure you take an ipod or something for entertainment. A newspaper would be nice, a big fat one.

You won't get past the first page in a few days

Best of luck (and here's hoping that you don't actually need it at all!) :)

I was induced and my DS born at 42+15. I due have an epidural (it seemed like a wise move as he was back tO back, as well as the syntocin drip!) but he was born exactly 23 hours after the first lot of gel was applied, and I wasn't even slightly engaged when I went in!

Does your hospital or PCT have a website? If so, they may have something on there about what will happen in an induction. Mine does... although the mainly ignored it!
My top tips would be:

• turn up a bit early. They told us to be there for 11 and I was there at 10.55. I was the last to arrive of the 6 women being induced that day and they did us by order of when we arrived. Due to other things going on on the ward (it was a bit chaotic & ante-natal & post-natal were mixed in together which I don't think is usual), I had my pessary 2.5 hours after the first lady had had hers. She reacted pretty quickly to hers so was already having quite regular contracts whilst I was still there reading trashy magazines & waiting to be dealt with;

• realise that women turning up in the labour ward having gone into labour naturally take precedence over you. So, even though it may be 8 hours since you had the first pessary and you have had no reaction and clearly need another and its protocol to give it within 6 - 8 hours, if the labour ward is full and with women still turning up, they will not do anything to try & progress you. If 14 hours after your pessary you are found to be 2-3cm dilated and your waters are "ripe for breaking" they will not do anything about it if the labour ward is still full. Indeed, you may have to wait another 8 hours for the labour ward to be sufficiently quiet for them to have room for you. So, yes, there were 28 hours between me having my first pessary & finally getting down to the labour ward. This was a very boring 28 hours. Obviously if I had had more of a reaction to the pessary and needed to go down to the labour ward, they would have taken me down but they certainly weren't going to do anything to get my labour to progress any faster. Once I was down there, they broke my waters, left me for an hour to see if that kick started anything (I was still 2 -3 cm), it didn't so they gave me the drip & offered me an epidural then (which I took), I dilated at the expected 1cm an hour, was left fully dilated to see if DD was make an appearance, she didn't so I pushed for 2 hours by which time it became apparent that DD was pretty wedged so they got the forceps out & there she was. So, DD arrived 41 hours after I'd arrived at the hospital but for 2 of those I'd been hanging around & for the next 28 I was bored & uncomfortable due to being stuck on a narrow bed or in a saggy chair in an over heated hospital & for most of the remainder I was pretty unaware of any pain as I had an epidural. Who knows when DD would have bothered to make an appearance if she'd been left to her own devices. And it wasn't a question of getting dates wrong or anything, she was well & truly cooked!

Hello! I had an induction, probably the most straightforward one you can think of so a good one to read!

Got to the labour ward at 9pm, had pessaries inserted and took paracetemol & sleeping tablets. Went to the nurses desk at 11pm with big cramps and was told to go back to bed as I've had all the pain killers I need, went back 20 mins later kind of bent over walking and was taken straight to a delivery room. Started with some gas and air and an examination (3cm dilated) my waters went during the examination, ahhh that was lovely!! I was monitored on and off every hour, had some pethidine which meant I slept through inbetween my contractions which I thought was amazing. 4 1/2 hours later I had my second lot of pethidine and thought I needed an epidural which is when the midwife looked a tad confused and examined me (10cm dilated) pushed for 14 mins and dd was born, no tears! woo!

I hope it goes well for you! The only thing I found uncomfortable about labour was having the pessary inserted, the rest was strangely enjoyable.

Like Murtette says, those who arrive in spontaneous labour will take precedence. I arrived at the hospital for induction 2-3cm dilated at about 10am on the Thursday, so no prostaglandin was given and I just had to wait for a labour room to become free so they could do ARM.

The day was boring and long, and the night was even bloody longer.

One finally became free at 8am on the Friday, so having spent a night twiddling my thumbs and being kept awake on one of the busiest nights they'd had for a while with women coming in and out and there being NO reason for me to have actually stayed in I was not really well rested for the day ahead!

DD was finally born at 6.39am on Saturday - like Murtette almost two full days after having turned up at the hospital.

This is my second baby (DD was pretty straightforward birth) so the idea of loitering around for hours (days!?) is a bit frustrating. I think that might be the Sunday papers, magazines, books etc.. My mum is around for DD which helps. Baby is on borrowed time to make a normal appearance as I'm booked in for 8am (I've been advised to call at 7am to see if they have a bed). Appreciate all the advice and suggestions - all of which I will adopt!

I was induced last week (17 days late!). I think the best thing is to keep an open mind about the whole thing. I really worked myself up over it, and in hindsight it was all just silly of me.

We went in for 9am, but induction didnt start til 1130am, and baby born at 845pm:
As i was already 2-3 cm dilated (from previous births) they broke my waters. I had to have lots of monitoring as baby was really active and kept kicking the monitor off. That was really frustrating for me (and boring!). Breaking the waters didnt hurt at all, but i didnt get the 'gush' and nothing seemed to come out so they couldnt check for meconium. I was told I had 2 hours to start contractions or id go on the drip. 2 hours later nothing but i wasnt ready for the drip (scared of having to be strapped to bed for labour). So i had to keep coming back every half an hour to check baby's heart beat (we kept running off up and down stairs around the hospital). This started at 1130am. By 5pm still nothing so they said they were going to start at 6 with the drip after i calmed down and had some tea/toast.
Drip in at 630 (did not enjoy having that in, big needle phobia). Contractions started about an hour later. TBH my last labour started so fast and the contractions so intense, for me this wasnt any different. She started off on the lowest dose of the drip and every half hour increased it slightly. Contractions did start small but then quickly got intense, and baby was born just over an hour later with G+A. Only the last 3 contractions really hurt, the rest were OK and i didnt even need G+A for.
The only issues I had were: they had to put a monitor on babys head which was not the nicest of experiences, and i didnt deliver the placenta for another 2 hours (whether that was due to drip or not i dont know). But it was all fine in the end and not nearly as bad as I made out to be! And we went home a few hours after my drip had finished. AND silver lining of the drip is you dont bleed as much after as your uterus has done all the contracting. One week on and I am hardly bleeding at all.
Good luck!!

preggo I just wanted to comment on the bleeding - induction (and other interventions which usually come with that) is a risk factor for increased risk of PPH and retained placenta - just to balance out your silver lining comment

It's still rare though. And I was induced and bled for about 4 weeks, I think you're very lucky

I have to dispute the bleeding as well I'm afraid. I had over 24hrs of the drip I had a PPH of 1.3ltrs and am still bleeding 6 weeks after the birth which ended in a CS where they supposedly clean you out a fair bit. I stayed on some concoction of the drip for a few hours post birth due to the blood loss.

ayearoverdue The bleeding post-birth is mainly from the wound that is left where the placenta was attached. If you imagine the size of the placenta and the fact that it's covered in tiny blood vessels, that's a large area that needs to stop bleeding and heal up, even when the uterus contracts right down. Even with a CS, the wound size will be the same - I'm not sure it's got anything to do with being 'cleaned out'. Anything that's left in the uterus post birth poses an infection risk which is why they make sure the placenta and membranes have all come out (in a CS or vaginal birth)

We are all different - regardless of the interventions that we may have or not have, some women will bleed for a week and others for maybe 8.