induction before EDD

[pugoff]

Hi, I'm quite likely to be induced tomorrow at 37 weeks due to poss pre eclampsia. What will they do? Start with pessary, sweep or drip. What are my pain relief options?

Any advice or things / options I should be thinking about? Bit scared as this was totally off my radar...

don't be scared.

pessary with cervix softening gel is the likely thing they start with, possibly 2 rounds of this. (they wait for a few hours after each so you might have to wait 2-6 hours before contractions start, do take things to entertain yourself!)

then onto drips

when you've dilated to 2-3 cms they can brake the waters to speed things up, you can ask for this.

pain relief - gas and air, Tense machine, Pethidine injections will be available as well as my best friend Mr Epidural, midwives will talk you through pros an cons at each stage.

once you are dilated to 8cm epidural is usually not an option, so if you are on the hormone drip and you want and epidural ask for it asap, they will administer it as soon as you are over 3cms dilated.
don't let them talk you out of it, hormone drips cause contractions that are so much worse....I experienced both as I was induced with DS1 and DS2, but DS3, DS5 and DD started off naturally. (DS4 was ELSC as he was a footling breech)

if there is no progress or there are any complications you might end up with a C-section, if you have a spinal you'll be awake for the birth.
It is very unlikely that you'd miss the birth due to being under general anaesthetic, but if needs to be done it will be to save lives (yours and/or baby's). I'm only saying this so you know, but please don't worry or obsess about it!

hope this helps already. any other questions? I'll be checking back soon!

Thank you. I'm still secretly hoping its all a mistake and I get to go home. If you're on the drip, how much can you move around? Or are u totally bed bound? I just feel so unprepared, physically and mentally. Never even got around to renting my tens machine . Will the hospital have one I wonder? Glad I never wasted the time to write a birth plan, seems it will be a case if que sera sera anyway.

haha re birthplan, never had one either, but we had prenatal classes with DS1 and when the health visitor showed us the forceps I thought, yep, I bet I will need these - and we did, so I was actually grateful I'd been explained what they were for !

actually with my DD (6th) I wrote " I want an epidural" on every single page on my maternity records, with capital letters...when on labour ward the midwife looked at my notes then looked at me and grinned saying " so what are your thoughts on having an epidural?"

with the drip you can move around a bit, walking or sitting on birthing ball for example, but if they are monitoring baby - which is likely - your movements might be more restricted.

can you call the hospital if they can reserve one for you. I never used one, so no idea if it is any good, some say it's useless, some love it... but they tend to be people with natural labours, not induced!

If you end up with hormone drips I really vote for an epidural...those contractions are bastards - feeling better?

I know you don't feel ready, but see it from the positive side, you might be a mum tomorrow! how exciting!

all of mine (apart from C-section) were late, DS2 topping the charts at 14 days overdue, so I'm not going to feel sorry for you!

Thanks again. I'm pretty sure ill be bessie mates with Mr epidural as I've heard induced contractions can be worse and thono wimp, I'm not one to suffer needlessly either.

Just to balance things with a different view, I was induced at 38 weeks with dts, and 37 weeks with dd3 and had 2 lots of gel with each with labour (6 hours apart).

It was my 3rd and 4th pgs, which may have made a difference in it getting going more easily and the choice of gel. I was monitored off and on and until things got going I had the opportunity for a walk around etc.

Once started the labours were very quick and very intense.

That level of intensity of pain and frequency of contractions is quite hard to cope with, but I'm on the other side of the fence than the pp as far as epidural goes and preferred not to have them. I couldn't have had an epidural anyway if I had wanted one as the labours progressed too quickly, so for me it was all about focusing and keeping calm and getting in the 'zone' which is my way of coping. And a bit of gas and air!!

Being able to feel contractions can be really productive and empowering, and actually I enjoyed my labours from that respect, but it's different for everybody, so keep a very open mind. You don't know how you will feel or cope until it's happening.

Good luck!

Thank you. That's a really good balance. Someone did say to me that with pre-e you can labour a lot quicker as the body wants rid of the baby to make everything better. I like the word intense better than painful tho.

Let's see what / who today will bring.

It might still be worth having a birth plan of sorts OP, even if it just deals with practicalities such as whether you wish to breastfeed, whether you want the baby to have vitamin K and if so by what method, whether you want baby cleaned up or passed straight to you as soon as possible, whether you want the option of a physiological third stage if possible, whether you want the screen lowered for delivery if a c section, who your birth partners are, who will cut the cord if not an emergency - and any other preferences.

I was induced at 38 weeks with pre-e. be prepared for a long pre-labour as your body may not be ready. I had three pessaries over 24 hours, they made me very uncomfortable but the midwives called it pristine pain and it wasn't contractions. After 36 hours I was 1cm and they broke my waters which is a pretty painful experience itself. Big contractions started but after another 4 hours I was still 1cm and so we started the drip.

I initially refused an epi on the drip. I regret that now, chemical contractions are a bastard. After a few hours I lost it compleley and had to have epi while intense and frequent contractions made it near impossible to keep still for the insertion.

14 hours after I started on the drip, 18 hous after my waters were broken and 54 hours after the start of the induction DD was born. I was too exhausted to push properly so needed forceps and an episiotomy.

It's not a great story but lessons I learned were: sleep and rest after the pessaries, don't get excited that its all imminent, you must conserve energy. I wish I'd resisted the drip and seen if I could progress naturally. Take an epidural with the drip, don't delay.

In all honesty I would ask for an elective c-section if back in your position ( presuming your cervix is not showing any signs of readiness on its own). Ask for your Bishops Score before they start anything. If its v low then your chance off intervention is v high.

I hope it all goes better for you. I have read much more positive induction stories. Good luck!

Hats off to foot! I have had 3 of these for medical reasons. The midwives etc are generally much more amenable to early epidurals for drip induction as it is supposed to be more painful. I have no idea myself as only ever been induced. My top tip would be that if you think you want an epidural ask for one early on. Aneasthetists get called in to do emergencies and you can find they are unavailable when you need them which is no fun. With my last, I asked almost as soon as the drip went in and the aneasthetists were grateful as they find it stressful being bleeped when in theatre.

I had pre eclampsia with my first pgcy (twins). I was told that they would use pessary first.

You are examined and given a Bishop's score to see how favourable for induction you are. That determines the when and how it's done.

In the end I didn't have pessary, just waters broken as I was 3cm dilated and having contractions - although I didn't know it was labour as I had lots of BH contractions. I was 35 weeks and my pre eclampsia had suddenly just got lots worse and I felt awful.

Contractions can become very powerful very quickly when you are induced, or it could take ages to get going. You will be monitored closely. As I was high risk (twins and pre e) they set up epidural straight away and I didn't move off the bed, but I felt so ill I didn't care. My labour was quite quick, with no augmentation at all and the midwife stayed with me throughout.

I stayed in transitional care for two weeks afterwards as my BP was yoyoing and I still felt ill.

Second pgcy was fine - no pre eclampsia or induction!

Best of luck, hope it goes well for you. X

Ps you can have any pain relief you like. :)

Just wanted to update on what actually ended up happening. Pessary put in at 3pm ish, was told would prob be 24 hrs and then hopefully could burst my waters. Hubby and I warned it may take a while. Actuality - contractions started with 10 mins, hyper contracting with barely any breaks which was exhausting, over reaction so had to take pessary out at 7ish. Contractions continued a pace, wanted to push but told not ready. When doc actually looked at 9 I was fully dilated. Baby born at 11pm.

Apparently this does tend to happen with pre-eclampsia babies as yr body needs them out. Why weren't we warned!! All in all, very intense, v painful but also v quick!! Not too much damage or intervention so I guess a good result!?

Congrats on your baby pugoff! Glad it was over quickly - are you feeling better now? Enjoy your little one!

Congratulations! Thanks for the update. Enjoy your new baby.

fantastic news, well done mummy!

How wonderful! Enjoy every moment.

Congratulations