|collected wisdom on induction
||[Aug. 30th, 2006|12:09 pm]
I'm still waiting for baby (40w 6d, I think) so the induction question is something that's on my mind. |
In response to a post by girlinaroom, I found myself neatly summarising my conclusions about induction, which I am going to repeat back here in my journal so that I have a record of them.
Here is the result of my current collected wisdon and research on induction:
Induction is just another type of birth. It's a "compromise" option that you resort to when there is a need, and not an equal "choice". But once we acknowledge that it's not an equal choice, we don't have to stress over it and make it any harder ;-)
There are many different induction techniques. If I end up needing induction, I will go for a pattern of techniques in this sort of order.
1) Stripping the membranes. This leaves your options open, and doesn't put you on the clock, but is quite effective for lots of women.
2) Prostoglandin gel on the cervix every 6 hours. This is the gentlest of the actual induction techniques. Bring along lots of entertainment (crossword puzzels, books to read, music, conversation) as it can be long and boring.
If my doctor recomends induction, I will want to talk to her about exactly *what* techniques we can use, and write myself up a special induction birth plan! If a doctor suggests inducing for the sake of their precious scheduling, then they won't want me taking up a bed for 24 hours while waiting for a nice gentle prostoglandin gel to work. If there's a legitimate reason for the induction, they'll be fine with starting this way.
If labour does not "take" after these first two techniques, they still have the option of calling it a "failed induction" and sending me home to rest for a while. That's what I like about starting this way - we're not on the clock yet, and it doesn't mean I'll necessarily be forced to either have an induced birth or an emergency c-section.
3) Breaking the waters. Once I've given the other techniques a decent amount of time to work, the next option is using the hook to manually break the bag of waters. This does put you on the clock, as the risk of infection goes up sharply after 24 hours of having the waters broken, so they try to have baby out by then.
4) Pitocin. I include this for the sake of completeness, but to my mind, it really is the *last* induction technique to consider. It's very effective, so many hospitals use it as their first technique, but I am quite against this philosophy.
By the time I'm seriously considering the pitocin, I would also be seriously considering the c-section! Any legitimate medical reason for getting the baby out early would surely not be helped by pitocin. Any posserbility of fetal distress is going to be so much worse if baby is subjected to pitocin contractions.
5) Epi-dural. OK, so the epidural is a pain relief option, not an induction technique, but if I'm having pitocin, the epidural becomes an automatic part of that for me, and not a separate choice. I would want the anaesthatist called when they put the pitocin drip in.
I would like to completely avoid any IV drugs which make baby dopey (yes, they cross the placenta), and make mother too loopy to make further decisions, and as such they interfere with both mother and baby's ability to have a first go at breastfeeding within an hour of the birth.
I do realise that the epidural means I can't walk around any more, but that's part of why I don't consider an induction to be an equal choice. If I choose to go to induction, I'm not going to also separately worry myself about whether or not I should be having an epidural ;-)