There are many reasons why an induction might be strongly recommended or suggested to you. There is so much to say about inductions, but I’m focusing here on how to best prepare for your induction experience. My favorite source for evidence based information on this topic is www.evidencebasedbirth.com, if you are seeking information about inductions in general.
Several years ago I took a Birthing From Within workshop. Our instructor, Virginia Bobro, told a touching story about a client she was working with as a doula. This client had all her hopes set on a natural, low intervention birth. When she needed an induction, she was absolutely crestfallen. In response to Virginia talking with her about her feelings, she came up with an idea on the spot in the hospital. She requested that everyone involved in the birth, including a variety of hospital support staff, bless / put their positive intentions into the first bag of pitocin that she received. Virginia was happy to accommodate her request, and so were her doctors and nurses. Each person took a moment with their hand on the bag of pitocin, putting their prayers and thoughts into it. Not only this, but Virginia got permission to walk down the hallway carrying the bag of pitocin, and asked everyone she saw to bless the bag! People were touched, and so happy to take a moment out of their busy day to do this. Her client went on to have a happy, healthy and uncomplicated induction. Doing this ritual provided the laboring Mom with a way to accept her birth story. She shed tears of grief that acknowledged the loss of her dream, while opening to the magic of the story that would unfold in front of her. I have been humbled to watch many women courageously let go of their dream birth and open themselves to “Plan B.” A helpful way to see interventions is that they are simply tools that are available to us as options when and if we need them.
Here are my top suggestions when preparing for an induction:
- Know your body and your Bishop Score
Your Bishop Score impacts the timing of the induction that is being recommended as well as the measures that will be taken to induce. Your score gives your provider information about both the timing and success of inducing labor at any given time. This might mean starting your induction with any combination of a foley bulb, cervadil, cytotec, pitocin, or sometimes a combination of pitocin and artificially rupturing your membranes (AROM), also known as breaking your water. Another factor in how this is determined is how many vaginal births you have had. Inductions after a previous vaginal birth generally (but not always!) go faster and require less cervical ripening. Occasionally some women only need cervical ripening and/or a very low dose of pitocin and their bodies take off into labor! This is something to give thanks for if this is you!
- Ask as many questions as you want.
Ask as many questions as you need until you understand exactly what is going on to the best of your ability. If you are unsure about something that is being recommended, ask your care provider to show you current obstetric literature on the subject that supports their recommendation. Doing this can make a difference in the confidence and trust that you have entering into your birth. If you feel comfortable with your care provider and their recommendations; give thanks!
- Sleep. Sleep. More sleep!
I cannot emphasize the importance of sleep enough. I do encourage my clients to ask their care providers for sleeping aids if they are not able to sleep in the hospital. It is of utmost importance that you enter into an induction as rested as possible. If you know you are a light sleeper, come to the hospital prepared with ear plugs and an eye mask. You will have monitors going off in your room every 20 – 45 minutes. Some care providers may recommend you come to the hospital in the evening if you need cervical ripening before pitocin. That way, your cervix can ripen while you sleep. After your night of cervical ripening, it may be time to begin pitocin in the morning. If you have a foley bulb and it is very uncomfortable, ask your provider to double check that it was placed correctly. If it is still uncomfortable to the point that you cannot sleep, I encourage you to consider using a sleeping aid under your provider’s guidance.
- Patience. Patience. More patience!
Photo by Jessie Fultz
You may be surprised by how long you are in the hospital with what seems like nothing happening. A typical induction can last anywhere from a few hours to two or more days. Most inductions with a first vaginal birth are somewhere around two days if we start counting at the beginning of the cervical ripening phase. Remember, a lot of this work is work that your body would typically be doing at home that you might not even notice. It’s important work.
- Eat good food and hydrate!
Ask your friends and family to bring you whatever food(s) you want before you begin pitocin. If you are on pitocin and you feel hungry, talk to your nurse about getting some nourishment in your body. While you are supposed to be on clear liquids when pitocin begins, sometimes this rule can ever so slightly bend especially if you are not far along in the labor process yet. It is important that your energy level stays up.
- Have fun and set the scene.
Before you are feeling your contractions is a great time for distraction techniques. Watching a funny movie, napping, reading, etc. Make the room beautiful and home-like. Wall hangings, Christmas lights and family photos can all create more comfort. Make sure your loved ones know that the process could take a few days. They will want to have a comfortable place to sleep (the waiting room doesn’t count). Remember that this is a temporary experience, and take lots of deep breaths!
- Other interventions can be your friend.
If you were hoping for a low-intervention birth you may have a quick reaction to say “no” to any intervention that is suggested. There can be times in which other interventions such as AROM (breaking your waters) or an epidural can actually help you in having a vaginal birth. It’s important to weigh all the possible outcomes and factors. Ask questions of your care providers, your nurse, and your doula. While your doula can’t give you medical advice, she can help you get clear on risks, benefits and alternatives of all your choices. That said, if you are feeling overwhelmed by the contractions, try getting in the shower and tub before considering other measures if that is in alignment with your goal. Your doula can be very helpful in these moments.
- Be gentle with yourself
There are big differences between a birth that is initiated with the body’s own oxytocin and pitocin contractions. Countless women report that contractions with pitocin are different and more challenging. Be very gentle with yourself. Try and have a fluid, flexible and open mind and body in all senses of those words. Let your feelings come and go, with as little judgment as possible. You are bringing a life into the world! You are amazing!
“Whatever way birth happens, it is your rite of passage into motherhood, and that passage is to be celebrated. Natural childbirth is a passage, cesarean birth is a passage, and birth with an epidural is a passage to be celebrated. That passage cannot be taken away from you. Every mother’s birth experience is valid,and an act of courage.” – Ananda Lowe
To learn more about the process of labor and birth and harness the power of information so you can make informed decisions and learn your choices and options when it comes to YOUR birth, consider enrolling in one of our Birth With Courage childbirth education classes. We offer an Early Pregnancy Class, 6-week childbirth education series, Birth Boot Camp, and refresher class to help you prepare.
