The I word ?! Inductions…

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They can be intense, if you don’t know how to navigate them. Im here to tell you the process, the options, the side effects and when they are necessary or not.

“Inducing labor is the artificial start of the birth process through medical interventions or other methods.”(1) Inductions can start many different ways and end many different ways. The one thing that is the same at every labor and induction is, you have options. Know your options, ask questions and remember to use your BRAIN: Benefits, Risks, Alternatives, Intuition, and No or Nothing. Some times decisions need to be made quickly though. So knowing your options before anything happens is key. As a doula and child birth educator I know there are times inductions are necessary and other times they are not.

Necessary: 

  • High blood pressure
  • Hypertension
  • Bleeding in pregnancy
  • Preeclampsia
  • Gestational diabetes
  • Water broken longer than 24 hours
  • A pregnancy past 42 weeks
  • A uterine infection known as chorioamnionitis

Unnecessary:

  • “Big baby”
  • Timing for Drs benefit

Q 107 BRAIN-001The process:                                                                                                                                          Most hospitals have you arrive in the morning, depending on the circumstances with your induction they may start by inserting a prostaglandin into your vagina. A prostaglandin is a suppository, it’s  inserted into the vagina. It can help the cervix soften and efface. Your prostaglandin may kick start your labor starting regular contractions, if this happens it is possible you may not need pitocin. Pitocin is a synthetic form of oxytocin which the body produces naturally during labor. Depending on how you labor is going thus far and how you and baby are tolerating the medication, you may be able to wait and see  if your labor pattern picks up before starting pitocin. If pitocin is needed you will be hooked up to an iv if you don’t already have one, your pitocin will drip with your iv fluids.  Pitocin helps your contractions become more frequent and regular. It can make your contractions become so intense that they are too much for you to handle without pain relief. Most of the time, after pitocin is started, your dosage increases every 30 min.

Pitocin side effects (2)

  • redness or irritation at the injection site
  • loss of appetite
  • nausea
  • vomiting
  • cramping
  • stomach pain
  • more intense or more frequent contractions (this is an expected effect of oxytocin)
  • runny nose
  • sinus pain or irritation
  • memory problems

Tell your doctor if you experience serious side effects of Pitocin including:

  • fast, slow, or uneven heart rate;
  • excessive bleeding long after childbirth;
  • headache
  • confusion
  • slurred speech
  • hallucinations
  • severe vomiting
  • severe weakness
  • muscle cramps
  • loss of coordination
  • feeling unsteady
  • seizure (convulsions)
  • fainting
  • shallow breathing or breathing that stops
  • dangerously high blood pressure (severe headache, blurred vision, buzzing in your ears, anxiety, confusion, chest pain, shortness of breath, uneven heartbeats, seizure).

Another option for your induction is a foley/cooks catheter. Foley/Cooks catheter(3): a catheter with a ballon at one end and a bag of saline at the other end. The balloon is placed just inside of your cervix to help dilate your cervix. The balloon is slowly filled with saline. Sometimes your nurse will place a string around the catheter with an additional bag of saline attached to it for added traction to help more with dilation and effacement.

Catheter Side effects(3)

  • acute transient febrile reaction
  • non-reassuring FHR tracing
  • vaginal bleeding
  •  pain necessitating removal of catheter
  •  altered fetal presentation from vertex to breech

Inductions can be quick or they can be long. It’s a coin toss.

During your induction to help your labor further along with the least interventions make sure you stay hydrated, and you move around as much as possible. If you cannot be up and moving stay as upright as possible. When prostaglandins are administered you may have to stay reclined for a period of time. The birth ball and peanut ball can be your best friend in labor, Both can help your hips stay wide so baby has a chance to move lower to further along your labor. Your birth team can help you relax and remember to breathe. I often see my clients during a contraction holding their breath. I promise you the easiest way to try to avoid the annoying oxygen mask is to remember to breathe. Talk with your birth team well before your induction, about what pain relief you would like. What ever your choice is remember its your choice, not theirs, not the nurses, not the Dr’s, and not your families, Its YOUR choice. What ever happens during your labor and delivery, remember to breath and use your BRAIN. I hope you have a wonderful labor and delivery. If you would like more information on preparing for your labor, delivery and bringing your newest addition home contact The Nurturing Doula:

The Nurturing Doula, LLC                                                                                                            Katy Schmidt
thenurturingdoula@hotmail.com
805-791-8325

facebook.com/KSThe.Nurturing.Doula

* The Nurturing Doula is not a Doctor, please consult your Dr for further information on benefits and risks.

 

(1)http://americanpregnancy.org/labor-and-birth/inducing-labor/                                         (2)https://www.rxlist.com/pitocin-side-effects-drug-center.htm                                                (3) http://contemporaryobgyn.modernmedicine.com/contemporary-obgyn/content/tags/foley-balloon/transcervical-foley-balloon

Epidural vs No Pain Medication

As a doula I get the feeling most women believe just because I help women cope with the pain I think they should avoid pain medication. This is an incorrect fact! As a doula I believe and know all births are different and all birthing women are different. Some feel they can cope with the pain without pain medication, some don’t, and some want to try to cope without it but are open to it. I do not care which you choose, as long as it is YOUR decision not someone else’s that they forced upon you.

Did you know that more then 50% of laboring mothers use an epidural?

Some Pros and cons of epidurals vs no pain medication:

Epidural Pros

  • allows you to rest from the pain, sometimes you may even be able to sleep
  • with the pain relief some women have a more positive birth experience
  • may give you the extra strength needed to move forward with delivery
  • with the epidural in place you may stay awake if a cesarean is necessary
  • can help you deal with exhaustion and fatigue

Epidural Cons

  • can cause your blood pressure to suddenly drop
  • may get a severe headache
  • slowed or stopped labor
  • the following are side effects from the epidural: shivering, ringing in ears, backache, soreness where needle was placed, nausea, or difficulty urinating.
  • some women find the epidural makes pushing more difficult
  • in rare cases permanent nerve damage may happen where the catheter was inserted
  • baby may have trouble latching on
  • baby might experience respiratory depression, fetal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries and episiotomies. *1

For a few hours after the birth, the lower half of your body may feel numb. Numbness will require you to walk with assistance.

“Natural” Pros

  •  freedom to move around during labor
  • allows you to work with your contractions which can speed up labor and delivery
  • during pushing you can choose which position to birth in
  • faster recovery
  • no pain medication can make the birthing woman feel more empowered

“Natural” Cons

  • more fatigue during labor
  • possible increase in blood loss
  • breathing and position changes only provide some pain relief

When deciding pain relief for your labor a delivery remember its YOUR birth, make an informed decision. Do your research, check out americanpregnancy.org for more information.

If you would like help creating a birth wish list, please contact The Nurturing Doula, LLC

~ Katy Schmidt

The Nurturing Doula, LLC

805-791-8325

thenurturingdoula@hotmail.comScreen Shot 2017-09-12 at 2.45.55 PM

 

-Please note I am not a medical provider, talk to your Dr regarding your decisions.-

 

*1 reference- americanpregnancy.org