I want to take a minute and talk about induction of labor. The opinions on induction of labor are as varied as the people who feel free to offer them so readily. Many only what to share what amounts to “the ugly truth about induction of labor.”
Sharing things like: Induction is bad. It’s going to be more painful. It should only be for actual medical reasons.
The fact is, as a doula I’ve been present for inductions for all kinds of reasons and other than a healthy baby one of the goals my clients had was to have a vaginal birth. Most of them achieve both.
In spite of what critics of induction will tell you, for most, it worked out just fine.
I see it a lot in the natural birth community. Passing on this notion that induction of labor is bad and that Pitocin inductions are this “big terrible” thing that no one can endure.
While most cite their intention as helping to “inform” others of the “dangers” I think they sell birthing individuals short when they set them up to expect the “great terrible” Pitocin experience.
These families are being told to expect failure, instead of given tangible support.
In my 18 years of practice as a labor doula, I have seen countless clients who have chosen or needed to begin their labors via induction. Many of which did so without any pain medication.
My being present for those client’s experiences helped me to have my own beautiful induction experience with my last baby. With Pitocin, and without pain medication. I knew it could be done. Therefore, it was an achievable goal.
What I know from professional and personal experience is this:
Pitocin inductions can be approached gently and effectively. When done so, it doesn’t have to be a “great terrible” thing. Or at least not any more so than the average birth is anyway. For most of us, it’s going to hurt. At least to some degree.
For my clients and myself what I’ve found works best is a gentle approach.
First a favorable cervix.
A good Bishops score is needed for a Pitocin induction to be successful for most. So if there is 0 dilation and effacement, it’s generally not going to work unless cervical ripeners are used first to increase the bishop’s score by softening the cervix. That may mean 24 hours or more of cervical ripening before Pitocin ever starts.
Keep the bag of waters intact.
Many providers will want to artificially rupture the membranes (aka bag of waters) as part of an induction of labor. In my experience, it makes the perception of the contractions more intense. Once the bag of waters is broken, there may also be a time frame imposed upon the labor. Have a discussion with your provider about their protocol before deciding for or against it.
Start low and increase slowly.
Beginning the induction at the lowest possible dose and increasing the Pitocin every 45-60 minutes by two vs. the typical doubling it every 15 minutes goes a long way to making labor more tolerable. This may require some self-advocacy on your part. You can have a say in how this goes down. The key is to convey your wishes in a clear and non-confrontational way.
“While my primary goal is a healthy baby, I also strongly desire to avoid the use of pain medication. I’d like to request that we start the Pitocin low and increase it more slowly over time. I know this might make the process longer, but I understand it will also give me the best odds at achieving my goal. Can we discuss this approach more in depth?”
Over the course of my career, I have learned that this approach can most closely mimic the natural onset of labor.
Support is essential. Having support from someone who doesn’t believe that a Pitocin induction is “the big terrible” but another option that can still lead to an otherwise unmedicated vaginal birth is essential.
The kind of support that your Tucson Doulas are known for.
Well before labor, I ask clients what their goals are. Most want to avoid induction and as much intervention as possible. Some just want to have a baby, no matter the means. As their big day comes closer, we often discuss the necessity or choice of induction and if it will change their plans in any way. Based on their response I offer to go over gentle induction approaches if they desire. I then help them to formulate a dialogue to have with their providers about how they’d like to proceed on the day of the induction. This approach has been wildly successful in helping clients achieve births without pain medication or vaginal births overall when that is their goal.
This approach has been wildly successful in helping clients achieve births without pain medication or vaginal births overall when that is their goal.
The Ugly Truth About Induction of Labor
So what is the ugly truth about induction of labor? Well, that depends on who you ask.
Some will say that it’s a terrible, no good, very bad thing that you shouldn’t do, practically ever. Others will say that there’s just no way possible to do it the way you want to and that you’re just fooling yourself into thinking you can.
For me, the ugly truth is that it’s tough to find support. The tangible support that provides you with information, tools, and an unwavering belief in your ability to not only give birth but to make healthy choices.
That’s the ugly truth.
But here at Tucson Douals, we are different. We believe in you. You know what is best for your baby, your body and your particular set of circumstances. Should you need to be induced, we will support you, guide you, continue to believe in you. Should you choose to be induced for any reason, we will support you, guide you, continue to believe in you.
We will be with you, every step of the way providing you the non-judgmental, non-biased support that you need to help you succeed. It’s what we do!