This post is to clarify the general nature of labor induction and is not medical advise nor designed to persuade people to allow or not allow a labor induction on their body.
Spontaneous labor almost always is the safest means to birth. The likelihood that labor, birth, and postpartum will be physically, emotionally, and spiritual healthy for the birthing person + baby greatly increases with spontaneous labor. Birth with both spontaneous labor and minimal or zero cervical exams very rarely causes fetal distress. Infection, c-sections, breastfeeding challenges, and postpartum depression happen more often with induction than with spontaneous labor.
Labor induction is common in southeast Wisconsin. It happens about 50 to 70% of the time in first births. Hospital and doctor protocol determine this percentage, so an individual’s likelihood of being induced is predominantly determined by which hospital they plan to birth in and their medical manager’s protocol.
You can say “no” to induction.
Under Wisconsin law, if you come to a hospital in active labor you must be “treated.” To my knowledge the legal and ethical rules about patient’s rights such as the right to informed consent and the right to be respected still apply when you come to a hospital in active labor.
Doula Woman has about a 32% induction rate. 90% of my clients are offered induction, or have an induction date set. Of these over half have spontaneous labor prior to the induction date and some of my clients say “no” to induction, often multiple times.
I wrote up the following summary of induction techniques.
This is a summary of what I have learned and is NOT a substitute for medical advise.
1- AT HOME
NIPPLE STIMULATION:
This releases hormones, so it somewhat resembles what happens naturally. Suggest 10 or so minutes on each side for one hour at least. You can use a pump. If contractions start and then feel too strong or just wrong, you may want to contact your medical provider.
SEX: Prostaglandin release can help. So intercourse here. Also female orgasm.
Raspberry leaf tea: Some swear by this.
Evening primrose oil: Some providers will give you a script. I am pretty sure Outpost usually carries this.
Walk-rest combo. So you walk quite a bit and you also treat yourself to an extra good night’s sleep when possible.
Snuggle with your partner and create a spa atmosphere at home!
Acupressure: Look up and you can do the “bring baby down” points too. Pinky toe a good one and press hard!
Castor oil or black or blue cobash: Obgyns say “no”to this. These are commonly recommended by out-of –hospital or holistic providers and not by in-hospital providers. FYI castor oil will cause you to poop up a storm. Castor oil has been used in many cultures historically.
2-IN HOSPITAL
Hospital grade breast pump: This can cause contractions and sometimes put you into labor.
Foley: A catheter is inserted vaginally to open and soften your cervix. Usually done at night prior to a morning Pitocin induction. This is the most gentle way to soften the cervix. Sometimes the Foley causes contractions for awhile, then these contractions stop. Rarely, the Foley alone can cause your active labor to begin.
AROM: One of your medical managers breaks your water by inserting a rod into your vagina. This could kick you into labor, strengthen labor, or do nothing. Baby may have a harder time moving down in your body. You will probably feel contractions get suddenly very harsh. You may be on shorter time clock than with other induction methods. Suggest ask provider about potential negative side effects and how much time you have to give birth vaginally should you agree to AROM. Generally best to do when baby already low in your pelvis. Especially with a first baby this can lead to csection because baby cannot make the spontaneous moves needed to come down.
CYTOTEC:
Cytotec (Misoprostol) is commonly used to induce labor. It is used to make the cervix “ripe.” It is a synthetic prostaglandin. The med is off label and it’s intended use is to treat ulcers. The Cytotec label states that it is NOT to be used by pregnant women. Cytotec can cause severely abnormal strong-long contractions and hyperstimulate your uterus though only rarely. Cytotec can cause fetal distress on moniter leading to csection. Cytotec is strictly prohibited for vbac because it can cause uterine rupture. It is used to cause planned abortions. Once in your system, cytotec cannot be “turned off.” Time to work out of your system actually varies among women and the effects can last 6 +hours. Sometimes cytotec can kick you into natural labor and you may be able to skip pitocin. Most of the time cytotec ripens your cervix but does not cause labor to start. Usually given vaginally-can be given orally. Cytotec is commonly used in most southeast Wi. hospitals. Suggest ask your medical manager to go over potential side effects and alternatives.
CERVADIL: Mimics hormone dinoprostone in a hydrogel insert. Used to ripen the cervix. You may need to lie still for 12 hours. May stimulate natural labor OR ripen you for Pit OR do nothing.
PITOCIN:
Artificial oxytocin. Pit can be turned down and it can be turned off. I suggest ask the nurses to tell when they are turning the Pit up or down. Pit causes your uterus to contract but does not mimic your unique natural labor pattern. You are on a time clock for cervical dilation. Medical staff wants contractions every X number of minutes (usually 3 minutes from start to start).
If Pitocin causes your cervix to swell you can ask that it be turned/off down and that something be done to reduce swelling prior to going directly to a c-seciton.
When you have an epidural and your medical manager gives you x amount of time to push your baby out and if you fail to do so next step is csection, you may ask that the epidural be turned off so you push your baby out in spontaneous positions, thus allowing for vaginal birth.
Pit contractions are harsher than spontaneous contractions and you and baby give up the“love hormone” benefit from spontaneous labor as well as many other mechanisms that help you and baby physiologically.
The vast majority of hospital inductions involve Pitocin.
Hospital inductions include continuous fetal monitoring because these chemicals are dangerous.
Suggest ask that if induction does start natural labor, could you switch to intermittent monitoring.
Also-if you agree to induction you can ask for your Bishop score….this gives an idea of both how to start the induction and the likelihood of a successful induction.
Oh, and if you agree to a night time arrival, you may look up benefits of a sleeping pill…Inductions can kick in AFTER you have already missed one to three nights sleep.
Peace
Martha at Doula Woman