This is the birth story of the Birth I was Meant to be at.

As a doula I am always a bit wary of inductions.  You just never know how they will go, fast and easy or long and complicated.   I have been to both.  So I was unsure what would happen when Natalie called to tell me she was getting induced that afternoon.  It wasn’t really a surprise as she was past 41 weeks and I knew she was going in for a NST.

They discovered her fluid levels were about 4.  Natalie also had a feeling like it was time for her baby boy Eli to be born, so it was decided to head to the hospital for an induction.

She called me around 3:30 and I said I would be to the hospital by 6. I got there around 5:40 and she was answering TONS of questions.  It seems like they add more each week.  Her first nurse was Pam, mom to 7 kids!

Around 6:30 Natalie started listening to the Fear Clearing CD, the pitocin was on and her Pressure Waves were picking up.

Her pitocin pump started beeping 3 different times and that was distracting.  We finally got that figured out.   Natalie got a new nurse, Tammy at 7:30 and Dr. Tran came in and suggested breaking her water and doing an amnio-infusion, where they pump saline solution into the uterus.

Natalie agreed to that and by  8:30 she was on the birth ball and her pressure waves were getting longer and stonger and closer together.

By 9:00 she asked the pit to be turned down a bit, as the pressure waves were coming about every 2-4 minutes and pretty intense.  Tammy turned it down a explained it may slow things down and they were where they wanted them to be.  We said, “Let’s turn it town and see what happens”  So she turned it down to 4ml.

At 10 Natalie tried hands and knees and then 10:20 she started dancing with Ben through each pressure wave. Her pressure waves had stayed about 4 minutes apart and were still intense.  She asked to have it turned down again at 10:40 and Tammy turned it down to 3ml.  Natalie was doing great, relaxing through the pressure waves!

At 11:15 Natalie wanted to be checked. But she didn’t want to know where she was at.  Tammy checked her and I made the mistake of watching when she typed the info in.  8cm 0 station 90% effaced.  I was thrilled!  Pitocin and all and Natalie was doing great.

Her pressure waves stayed consistent.  She laid on her side for awhile and then started dancing with Ben again.  She also started chanting something through each pressure wave. It was hard to tell what it was.  But Ben finally figured it out.  “Big Warm Hug”

They stated setting the room up and Dr. Tran came.  Natalie asked if I knew where she was at.  I made the mistake of telling her 8cm.

When Natalie still didn’t feel like pushing an hour later, Tammy had someone else check her, because she wasn’t sure if her last check was right.  The new nurse figured she was 5cm.  So Dr. Tran came to check her as she had originally checked her when she started.  Indeed at 12:30 Dr. Tran checked her and found she was 5cm and her cervix was still very posterior.  She tried pulling it forward after she checked her.

When Natalie figured out she was at 5cm.  She lost her focus.  At 12:45 she decided she wanted an epidural. She was very tired and now maybe a bit frustrated as well.   (I really wish I hadn’t of told her she was at an

She got her epidural by 1:10 and we all took a short nap.  She started laying on her left side.  But at some point she was starting to feel uncomfortable and wanted a bolus.  The nurse checked her around 2:00 and she was still at 5cm, but her cervix was anterior!  She decided no bolus yet.

I suggested she lay on her other side, so we switched her to her right side.  About 40 minutes later she asked to be checked again.  2:40 She was complete! Dr. Tran was at a birth at the other hospital, so Natalie tried not to push (she was feeling a lot of pressure) during her pressure waves.  I reassured her there were other Dr’s that could catch so to just let her body do what it knew how to do.

Dr. Tran arrived at 3:10 and Natalie started to push.    Dr. Tran started out with directed pushing, but Natalie told her that she could really feel what was going on, so didn’t want directed pushing.   Natalie would breathe down and out and was making slow and steady progress.  At 3:29 her sweet Eli was born!

(The AWESOME thing is, she had a 4th degree tear with her first baby and that is one reason she wanted to do mother directed pushing, this time she had a 1st degree tear, which was so great!!!)

He had a little trouble breathing at first so they had to take him to the warmer, but once the nurse cleared out his throat he gave some nice big cries.  After a few minutes he was back in his moms arms!  Once Natalie was all situated she started nursing him.  He had a nice latch, on the first side he would latch on and suck a minute and fall asleep.  After about 15 mintues, we switched sides and he got SO mad.  It was like he was saying, “I was comfy and happy, why are you messing with me?”

On the other side he latched on and nursed very consistently for a good 20 minutes.

I am so glad that it worked out that I could be at their birth!   It was lovely and Natalie did awesome!  I really think if she hadn’t had pitocin, she could have done it without an epidural.  Pitocin can make it like you are in Transformation for hours!  However she did awesome and I think that this is one of those times when epidurals can be a good choice.  Let mom rest and gather strength for pushing.  It was a really good epidural, light enough to let her feel to push!

I have seen more and more moms who are going in for inductions for low fluid.

Once there was even a mom who was told after a fluid check she needed to go to get induced for low fluid.  She went home and got stuff together and went back.  The hospital said she was late.  She had been on the schedule for an induction for 10 am, which was an hour before she even got her fluid measured. Hmmmm, seems oddly suspicious to me.

I think if a mom is going for a non-stress test or a fluid level check or a basic ultrasound, she should have these questions handy, in case they are told they have “low fluid”.

Ask questions!

• What level is my fluid?
• What is considered normal?  Between 5 and 10 should be watched more closely, but it is in the normal range.
• Is baby doing ok?
• If you look at more then just the fluid, how is the baby doing?
• Can I go home and rest and drink a lot and come back tomorrow and get my fluid measured again?

(It is amazing how different levels can be measured by different people within a short period of time. )

There was a very interesting post by a L&D nurse about an induction for just this reason.

Here is another thought provoking post regarding low fluid by Gloria Lemay.

I also love this story of a mom who follows her intuition when care providers tried to scare her about low fluid.

As usual this is not meant as medical advice. This is just information with a lot of links so you can do more research!

Ask LOTS of questions, and then make the best decision for yourself!

Watch my Induction Video

I have created an informational video on inductions!

Induction Information

These will give you great ideas of questions to ask before an induction!

Inductions Part 1 Here you will find: 5 Risks of induction, 5 Ways to Avoid an induction, 5 Thing to ask/do if you get induced, 5 things they may USE during an induction

Inductions part 2 Here you will find: 5 Good reasons for an Induction, 5 Questionable Reasons for Induction, 5 NO risk alternatives to inductions and 5 more good links about inductions

Natural Induction Ideas

Here are some tips for natural induction!

Acupressure is a natural way to induce birthing time. Here is a great book you can download with a lot of information and instructions.

What To Do During an Induction

If you do choose get induced, I would start listening to CDs as soon as you get checked into the hospital. A lot of times you spend time waiting around for things to get started, so go ahead and relax and listen to cds. This will help you get into a hypnotic state before your birthing time starts as well as feel calm and confident about your upcoming birth. Sometimes with inductions pressure waves start harder and faster than if they started on their own. If you can get into a hypnotic state before your pressure waves start, that can help you handle the intensity of the waves.

I would start with listening to the fear release cd and then deepening or any of your other favorite CDs… but you may want to save your birth guide until you are in your active birthing time, when your pressure waves are coming on a regular basis. (Unless things aren’t seeming to start with the different things being tried, then go ahead and listen to it, sometimes it can help with getting pressure waves going or getting them into a good pattern.)

You can of course use your finger drop, peace cue, relax cue and all your other tools once your pressure waves start.

I think a good way to have a positive induction is understanding and discussing what your choices are during an induction are and having a basic plan ahead of time, then you will be able to know what to expect and the choices you will be making during your birth. Also remembering to use your tools maybe even before your pressure waves start (by listening to cds) so that when they do start you are relaxed and ready to embrace the pressure waves! Welcome each one, they are bringing your baby into your arms!

ALSO, be very aware of how often they are turning up the pitocin. You have the power to insist it be turned up SLOWLY! Here is an interesting post about “pit to distress” If a mom chooses to get pitocin, she should view it as a tool she is using to help her birth her baby.

Positive Induction Stories

Here are some positive birth stories to help Mom’s who are choosing to be induced. If you have chosen to get induced, you hopefully have a good medical reason. So move forward with a positive attitude! Positive Birth Stories of moms using Hypnobabies who were induced

It can be risky to have an Early Elective Induction, especially before 39 weeks.  Often because “due dates” are inaccurate, this practice can lead to problems with the babies after they are born.  Not to mention the risks of induction!

I was excited to see this post by Birthing Beautiful Ideas where she gave some great information on elective inductions (meaning not medically indicated).  She also mentioned a new resource at The Leapfrog Group, where they have a list of hospitals and what the rate of their early elective births are.  They say the target should be 12% or less.

I have listed the rates at the hospitals I have been a doula at.  (South Orange County).

• Kaiser Permanente Orange County – 7.1%
• Mission Hospital – Declined to respond
• Hoag Memorial Hospital 7.3%
• Saddleback Memorial Medical Center- 4.0%
• St. Joseph Hospital – 6.9%

While the hospital rates are good to know – I think that it is equally important to know your care providers rates! However I know some hospitals, such as Saddleback have a rule that no inductions before 40 weeks unless medically indicated.  So this helps to have lower rates among all the OBs working there.

For more information on Inductions – early or not – see my Free Induction Video.

I am excited to participate in another Birth Blog Carnival. This one from Giving Birth with Confidence, where we get to report how we incorporate the Healthy Birth Practices into our birthing support for moms.  My favorite one is:
Let Labor Begin on It’s Own!

It is no surprise to me that this is the #1 Healthy Birth Practice.  If more moms let their birth start on it’s own, then there would be a lot more normal births going on.  It amazes me to hear that moms often get induced without even knowing why.

Induction is such an important topic for moms to understand, but often they are given very little information about the pros and cons of induction from their care providers.  This inspired me to create an informational video about inductions.

I would love it if moms would inform themselves on this choice early in their pregnancy.  If they knew their care provider likes to induce all first time moms, then they would have time to change.

However the video is also useful for moms who are in the position where they are being told they should induce.  A mom posted on Facebook that she was going in for an induction in a few days.  I asked why and she said, “The OB said we might as well schedule it.”  I gave her the link to my video.  She watched it, called her OB and had a good discussion and canceled the induction.  She had her baby on his own schedule a few days after which ended up being after the induction was scheduled for.  She e-mailed me to thank me later.

It is amazing how empowering information can be to moms.  I love the power of the internet which allows us to easily share this information with moms everywhere!

Click here to see the links mentioned in the video above.

• the baby is almost 10 pounds
• The placenta and amniotic fluid are fine
• but you need to have this baby by 40 weeks or sooner because the possiblity of shoulder dystocia is real.
• He said he “won’t” let me go past 40 weeks anyway b/c of my age and the probability of placental failure at that point.

I’ve had 3 babies

• the largest was 7lbs 3 oz.
• I don’t have gestational diabetes
• and although I’ve measured large this entire pregnancy, I find it hard to believe I’m carrying a whale (although admittedly I look like it).

So my natural inclination is to still resist scheduling an induction and see if I can get things going naturally.  Also, I know ultrasounds can be wrong and since I’ve had 3 kids already-can’t this one just shoot out my VJJ like the other ones did even if she is huge?

I’m just worried if my OB sees:

• AMA (advanced maternal age)
• baby measuring over 9 pounds at 39 week visit
• my health insurance card
• long induction
• he will automatically slip into C-section mode.

My inductions took 4ever and I don’t see an OB waiting around.  In contrast, my 1 natural labor was 4 hrs.  A better way to go if possible.

Friends say I’m being stupid and risking a still born.  These same friends love c-sections and inductions.  I need an opinion from a different crowd.  What do you guys think?  (I’ll probably go into labor just walking to whole foods today in 95 degree weather from work to pick up some red rasberry leaf tea at lunch today.)  I don’t own the baby come out track-unless it is on the birthing day CD that I haven’t listened to yet but was supposed to (I know).  Plus my doula is out of town this Saturday-so I’d prefer not to get things started unless I know she can come.

photo credit: Lars PlougmannI found this SCARY yet very telling page on an OB’s website about her Induction Policies.

Here are some highlights and my thoughts.

Induction of Labor

Many patients will opt to have an induction of labor for the following reasons: discomfort at the end of pregnancy, a desire to have family present, a desire to have me present at the delivery, or concerns about planning ahead for childcare or work responsibilities. If you choose to have an induction, the following information will help you understand the process.

These reasons are all about convenience, nothing about medical need. I am curious about what her induction rate is?

Will induction increase my risk for C-Section?

Because I make sure you have cervical dilation that is favorable for a vaginal delivery, most studies show this will not increase your risk for C-Section. Since I feel that induction affords a delivery that will occur with a baby that hasn’t had time to overgrow, we have a greater chance to achieve a vaginal delivery. My C-section rate has traditionally been below the national C-section rate of 25%. I do not feel that induction of labor in a properly selected patient will increase the risk for C-section.

It sounds like she does take the Bishop’s Score into account.  It is pretty apparent she uses the Big Baby Scare Tactic.   She needs to update her statistics.  The national rate is way above 25%.

Some other random comments in her FAQ section.

Most women in spontaneous labor will usually need additional IV pitocin to achieve adequate contractions to deliver vaginally.

Seriously?  How did women ever manage to have babies before IV pitocin?  Amazing that mankind has survived!  Maybe care providers just like to speed things up!

CYTOTEC INDUCTION:

If you are a first time Mom, achieving a delivery whether through natural or induction methods takes a longer time. Therefore, I have all first time Mothers arrive at the hospital the night before your delivery day to ready your cervix for labor.

Nice, every first time mom gets to be induced!  There is no mention at all of the risks of cytotec!

Procedure:

Arrive at The Hospital at 6:00 pm the night before your delivery day.

You will receive 1-3 doses of oral cytotec starting at 7:00 pm to 1:00 am.

At 5:00 am, pitocin will be started thru the IV.

Between 7:30 and 8:30 am, I will arrive to rupture your water. (This is not more uncomfortable than a vaginal exam, except you will feel as though you have urinated on yourself afterwards.)

Most first time moms will deliver between 2:00 and 5:00 pm on the day of delivery.

How convenient that the baby is born by 5 pm the next day.  What if it takes longer?  What if the baby shows signs of distress along the way?  Any mention to mom of the risks of induction for her and the baby?  No, just reassurances every step of the way.

For second time moms, they only need pitocin and again, “Delivery usually occurs prior to 5:00pm on the day of delivery.”

This is actually great that she puts this all out there.  Moms can ask, “What are your thoughts on induction?”  She can send them here and they can see what they are up against if they want a low intervention birth.

ALL pregnant moms should ask their care providers at their NEXT appointment.

• What are your thoughts on inductions?
• What reasons do you like to induce?
• What cervical ripeners do you use?
• I would like to be able to go to 42 weeks if me and the baby are OK.  What are your thoughts on that?

This is part of my Wondering About Series. Feel free to e-mail any questions you are wondering about to sheridan AT enjoybirth DOT com.

My question is in regards to Pitocin. I want the truth, preferably from a mom who has experienced both types of labors- induced and spontaneous.

With my first son, I was induced at 41 weeks, 4 days (not by choice, but my midwives threatened they wouldn’t be able to deliver me and I would have to have the random on-call OB, what’s a girl to do?). I was on Pitocin for 5 hours before I got the epidural and it was torture. The pain was so intense, I really did think I was dying. The contractions didn’t build up, they seemed to peak instantly and then hold it for 60 seconds before relaxing, but never all the way.

I tried everything (walking, massage, birth ball, tub) but everytime I relaxed and got comfortable the contractions would slow down, and they would increase the pitocin. I really, really wanted a natural birth and felt so much guilt over getting the epidural, especially after all the midwives in the practice promised me that pitocin labor is the same as spontaneous labor and they have seen plenty of women do it without the epidural.

But other sources I have read promise that it is different. I am pregnant again and would really like a natural birth this time, but I’m worried I won’t be able to handle it and that it will hurt just as bad, even if I am not induced. I really feel like a failure.

What do you think? Is there really a difference between induced labor and spontaneous labor or am I just a huge wimp?

I am sorry your first birth did not go the way you had hoped.  I would like to add please do not feel bad that you got an epidural.  You made the best choice for you in the situation you were in.  So that is ok!

especially after all the midwives in the practice promised me that pitocin labor is the same as spontaneous labor and they have seen plenty of women do it without the epidural.

I would like to say that in the births I have attended as a doula that pitocin induced labor is different than naturally starting birthing times.    You can see my doula stats here and see that the moms I have worked with that get pitocin are more likely to choose an epidural than moms without any pitocin.

From my observations it seems like Pitocin Pressure Waves are like Transformation Pressure Waves.  Longer, stronger and closer together.  So instead of 15-60 minutes of transformations, it can be hours and hours of them.  Now, not all moms experience it like this, but many do.

One way to help prevent it to be so strong so quickly is to turn up the pitocin very slowly (2ml every 30 minutes to an hour) and then stop turning it up once they have a good pattern.  It isn’t a race to get the baby out.  If it takes 12 hours but mom and baby are managing things well, that is preferable then 6 hours and mom not managing well.

So from my experience, yes they can be different!   So with your next birth remember this is a new baby and a new birth.  Your birthing time will start on it’s own and you can go un-medicated if you want.

6AM Saturday Morning

I wake up and immediately check my phone – no text.   Ok, maybe no news is good news?  I text Alison for an update.

7:45 AM Saturday

We are driving to the airport and I get a text!  Lisa is starting to push!!!  Whoo Hooo!

I assume I will get a text before we take off at 10.

10 AM Saturday

On the plane.  The Flight Attendent gives me a dirty look.  “PLEASE turn off ALL electronic devices!”

NO text.

The whole flight I am praying.  “Healthy baby, healthy mom, vaginal birth.”  What if she did all this work and needs a cesarean?

Trying to read, too tired, worrying, wishing I was there, wondering what is happening.

Noon Saturday

We land.

As soon as I am able to I check my texts.

YES!  Baby born vaginally at 11:35 am  Over 52 hours after her water broke.  She did it with no epidural or any pain medication.  Pitocin and 2 night with only 3 hours of sleep and she did it!  Lisa ROCKS!

I want details, but we are in Mexico and I tried to call once but didn’t get a hold of anyone so I have to wait to find out what Lisa felt about the whole experience; wait to find out what happened that night; wait to find out anything.   But I am thrilled that she and the baby are healthy and she had a vaginal birth!

While pondering her birth, I think Lisa’s birth was perfect timing.  It goes along with my theory that if I am meant to be at a birth I will be.   If I had to stay at her birth for 2 nights, I don’t know if I could have given them the support they needed that second night.

Come back tomorrow to find out what happened that night and what Lisa thought about her birth!

5:30 AM Friday

We “woke up” and everyone took showers.  We ate breakfast (snuck some to Lisa so she would have the energy she needed.)  We met OB #2 and got a new nurse.  Lisa and Ryan were ready to start some pitocin.  That was started by 9:30 AM.  It is upped nice and slowly 2ml every 30 minutes.  We had lunch around 12:30.

1 PM Friday

Lisa finally needs to relax through the pressure waves. YAY!

4:20 PM Friday

Lisa gets her first vaginal exam more than 33 hours after her water broke! I was thrilled that they patiently waited that long.  She was 3cm 70% -2 station.

Lisa is a little disappointed she isn’t more.  But I reminded her that really her birthing time hadn’t started until 3 hours earlier when she had to relax through her pressure waves.  She was just starting active birthing time!

5:20 Friday

Lisa is getting tired and frustrated.  She had been alternating walking and rocking and sitting on the birth ball for hours. She loses a bit of focus and it having trouble relaxing through her PW and is not very comfortable.   We decide Ryan will read her a script while Lisa rests in the chair.  I am sitting nearby watching while he reads the Hypnobabies Script and it looks like she has fallen asleep, I honestly thought her PW had stopped and I went to check the monitor.  She was still having them every 2-3 minutes.  Gotta love Hypnobabies!  Lisa said she thought maybe they had stopped too, but then realized they were just comfortable now.

Her 3^rd OB and nurse came in during this and saw the strip with the PW and saw how nice and relaxed she was and gave a big thumbs up!  (These are nurses and OBs familiar with Hypnobabies)

8 PM Friday

Lisa gets another Vaginal Exam.  She is now 4cm and 80% effaced.  Her nurse is so encouraging!  You are entering a new phase of birth!  You are really going to start progressing quickly now.  Lots of positive comments from all the staff the whole birth!

I am realizing I am probably not going to see this baby be born.  Alison is called to come in as back up doula.

9:30 PM Friday

New Blood!  I think that having a fresh alert doula arrive at 9:30, helps Lisa and Ryan move forward in their birth with some new energy.

10 PM Friday

I am exhausted and am home by 10 PM.  I finish packing and am in bed by midnight.  I am hoping I will wake up to a text saying baby is born!