Induction without pitocin

[chocolatepie]

What are my options? I know pitocin is effective and seemingly the drug of choice, so to speak, but I'd love to avoid it if possible (I hope to go without an epidural and have been told pitocin labor is extremely difficult). High risk says I'll be induced between 37-39 weeks (hopefully this week at my next growth scan a timetable will be set). As a first pregnancy, I'm guessing I won't be going into labor on my own in that time period so I'm getting myself prepared for an induction.

I've heard of the foley bulb but am not sure how effective it is. Anyone use/have knowledge about acupuncture helping? I went regularly during IVF and saw great success against all odds.  

Are there are other medical alternatives to pitocin that I could talk to my OB about?

[mccallister84]

The hospital where I delivered didn’t allow the Foley before 40
weeks for first time moms.

I had a cervical ripening drug and then pitocin.

[swiftlyirun]

I’m no help with your actual question, but just here for support. I had an induction with cervadil the night before (which was pulled after a few hours because i over responded) and then pitocin the next am. I had my baby without and epidural and didn’t find labor to be any more intense than my first baby with whom I went in to labor naturally. You can do this!!! I would say, if you go the induction route and want a med free birth, get a doula. She was such a great advocate when I went through transition and begged for an epi.

[sunflower17]

I don’t believe there’s any option for induction without pitocin. I was induced the first time at 38 weeks. I had cervadil, the foley, an epidural and pitocin. If we’re being completely honest—that Foley was the worst part. It was very painful for me and I needed IV pain meds.
They say pitocin contractions are more intense than natural, but I had nothing to compare it to and it didn’t seem that horrible.

[Poppy]

I did not want pitocin either but ended up with it. I didn't think labor with it was noticably worse, but then again it didn't do a whole lot for me in terms of progress. I ultimately delivered without an epi after things picked up considerably when my water broke. (It was my second birth, first was spontaneous labor also no epi and I think contractions were about the same amount of painful.)

[pinkplasticdoll]

My doctor and I agreed to no pitocin when I was induced, my water broke and there was meconium in the water so he apologized and said that I really didn't have a choice because of the meconium. I'm hoping to avoid a induction this time around and I talked to him about avoiding it unless absolutely necessary. He really was apologetic about the pitocin Because he knew how much I wanted to avoid it. I came into the hospital about half a cm dilated and from the time my cervadil was placed until DD was born it was 23.5 hours.

[jade]

I was induced with 2 doses of misoprostil followed by cervadil. That was enough to get things going so they never started pitocin. I was drug free the whole time. Like you I was very nervous about going med free while being induced but it worked out.

[Susie]

I had an induction in June for my 2nd baby.  My OBs do inductions pretty much by formula:  if you're <2 cm, you start the night before with cervidil.  If you're 2cm+, they start it morning-of with AROM in hopes that it goes on its own from there.  If not, then they start Pitocin.  We never discussed foley bulb as an option.

I was right at 2cm on induction day (39+3) with a history of fast labors, so we did morning-of, skipping cervidil.  They broke my water around 9am and nothing happened.  I walked around, bounced on the ball (eventually had to stop because it was messing with the signal on the external monitoring), nada.  I started Pitocin around 11am, and made the entire progression from 2cm to delivery by 3:41pm.  No epidural or other pain meds.

Having done that, I don't blame you for wanting to avoid Pitocin if possible, if med-free is your goal.  The Pitocin induction hurt more than my spontaneous labor with baby #1.  The contractions weren't really worse, but they were much closer together so there was very little rest in between.  They came so fast that from somewhere around 5, 6, 7cm onward, I had trouble changing positions within the down time between when one ended before the next one began.  I was on a low dose of pit, but I still asked for it to be turned down as I was reaching full dilation.  It was difficult to tolerate.

That being said, if you want to do med-free and if Pitocin is necessary:  you CAN do it!  It was worth it to me to be able to get up, labor in the bathroom when I needed to, come back to the bed, and move around.  Then afterward, I was up and on my feet right away.  After my tear was repaired and we'd done skin to skin, I was able to get up, go pee, put on my own clothes (nothing fancy, just a black roll-down waist skirt and nursing tank), and held DS in a rocking chair for a while before going to mom/baby (wheelchair was SOP, but I could've walked).  I felt a lot more like myself than I expect I would have, if I'd had an epidural.  I don't plan to have any more babies, but I'd do a pain med free induction again if I were.

[cherryvalance]

I'm no help with your actual question and this is just anecdotal, but my pitocin contractions weren't worse than my natural ones with my daughter.

[jorja]

There are two “parts” to an induction...getting the cervix to dilate and getting the uterus to contract. Stuff like the Foley bulb and Cervidil are for dilation...which might trigger your body to start contracting on its own, but might not.

You obviously need contractions to happen for a successful vaginal birth. Pitocin is the most commonly used drug for that part, but I believe Cytotec also causes contractions? I don’t think that it is as reliable, and it is also not something that can be titrated like Pitocin can. You could talk to your OB about that as an alternative, and also stuff like just rupturing your membranes once you are dilated enough, which sometimes causes your body to start contracting on its own as well.

[pooh8402]

Sept 15, 2019 14:18:31 GMT -5 jorja said:

There are two “parts” to an induction...getting the cervix to dilate and getting the uterus to contract. Stuff like the Foley bulb and Cervidil are for dilation...which might trigger your body to start contracting on its own, but might not.

You obviously need contractions to happen for a successful vaginal birth. Pitocin is the most commonly used drug for that part, but I believe Cytotec also causes contractions? I don’t think that it is as reliable, and it is also not something that can be titrated like Pitocin can. You could talk to your OB about that as an alternative, and also stuff like just rupturing your membranes once you are dilated enough, which sometimes causes your body to start contracting on its own as well.

this, exactly. cytotec can and does cause contractions, but too much can cause too many contractions and really put baby into distress. like jorja said, it can't be titrated and once we give the cytotec, we can't take it away like cervidil and pitocin. we only do cytotec-only inductions with fetal demises.

that being said, my first baby was induced. I had 2 doses of cytotec, then my water broke on its own, then I started getting painful contractions every 2-3 minutes. I never needed pitocin but the cytotec essentially triggered my body into labor. but my baby was in distress (although due to have a cord wrapped around his neck rather than the cytotec). I was being flip flopped and had oxygen and the whole nine. the only reason I didn't end up in a c-section, the way his strip looked, is because I went from 5 cm to complete in an hour.

however, most of my patients needed pitocin to get past 3 cm after already receiving 3-4 doses of cytotec, or a full 12 hours of cervidil. and the foley bulb is a mechanical dilation only. it will dilate, but it will not efface at all. and effacement is really really important. someone can be a 2, but 90% effaced and I know she will go quickly. but a 2 and 40% effaced and I know I have my work cut out for me.

[gastro]

With baby number 2 I was 40+5. OB broke my water and that’s all it took to trigger contractions.

[imbatman]

With my 2nd baby they started cervidil the night before I was to be “induced” with Pitocin. The cervidil had to be pulled after an hour because I over-responded, but it was enough to get things going and I didn’t end up needing Pitocin...had the baby long before it was ever supposed to be started.

[killercupcake]

No real advice but just wanted to say that my water broke on it’s own at 39 weeks with my first. I was put on pitocin pretty much right away and the contractions were pretty tolerable. But I did get an epidural as soon as i was given the option, about two-three hours after they had started pitocin.