Two Inductions Gone Right (part 1)
I will be the first person to tell you that I'm quite passionately against inductions (unless medically necessary). There are many reasons I say this, but most importantly because I believe our bodies were designed to have babies and know how to go into labor when they're ready. Induction also increases the risk of interventions and c-section. Recently, I was pleasantly surprised by two inductions done with integrity and with the best interest of mom and baby at the heart of it all.
This past week I had the incredible honor of being the doula for two amazing families. Client #1 was due July 9th and had a midwife. Client #2 was due July 14th and had a female doctor. I knew there was a chance they may go into labor on the same day, but honestly, there is NO formula to this job. You schedule clients 2 weeks apart who go on the same day or who are due 2 days from each other that go into labor weeks apart.
I had met with both women prior to their birth as I do all my clients. We talked about their wishes for birth, stages and phases of labor, comfort measures we would likely try during labor, newborn procedures, and the postpartum period. Both women were planning for a natural birth. By natural I mean going into labor on their own and no interventions (artificial rupture of membranes (AROM), minimal fetal monitoring, no epidural, no episiotomy, etc.) during labor or delivery. Basically they wanted to allow their bodies to do it's thing. They both were educating themselves by reading books, taking classes, and asking questions.
So, having said all of that, here's how their births went down ;)
Client #1 (we'll call her M):
July 9th came and went. M was really quite calm and okay with going past her due date and really was expecting it. She knew it was typical for first time moms to go 8 days over their "due date" (yes, I put this in quotes because it's *such* an estimation...we will talk more about this later). 7 days past, 8 days past, 9 days past. M was doing everything she could think of to try to get baby to make her entrance. She tried walking, squatting, evening primrose oil, among other things. Her midwives were just fine with letting her go 2 weeks past her date, but wanted her to come in sporadically over that last week for a non-stress test and biophysical profile. At 10 days past, on July 19th, M went in for the tests to be sure baby was okay. The test results showed that M's amniotic fluid was low and she would need to be induced that evening.
M was adamant, from the very beginning, that she did not want to be induced. She had hoped to labor at home as long as possible and get to the hospital just in time to deliver. M was understandably upset. We talked through what the induction would be like and ways we could make it as natural as possible. M would be induced with cervadil (a cervix ripening agent) on Tuesday evening and then would start Pitocin on Wednesday morning. M's midwife assured her that if her body would take over, they would be willing to turn off the Pitocin and allow her to labor on her own.
At 9:00pm on Tuesday the cervidil was in inserted. At 9:30pm, M started having contractions! The midwives were not expecting that the cervidil would work to send her into labor, but indeed it did! This was such an answer to prayers!! M labored through the night and her husband called me about 3:00am to let me know that contractions were getting intense and they would probably need me around 6:00am. I got a call about 4:00am and was told I needed to come earlier. I got my stuff together and out the door I went.
I arrived at the hospital about 5:00am. M was definitely in labor and working like a champ through her contractions. At 6:20am (when the Pitocin was suppose to be started), the nurse checked M's cervix and found she was 4cm dilated. She was doing this!! They decided her body was clearly in labor and Pitocin was not needed.
M continued to breathe through her contractions. She tried several different positions on the bed and birth ball. She was doing really great. The pain was getting more intense and M was starting to question herself (which is typical of all mom's at some point in labor). She had hoped to be able to get into the water at this point, but unfortunately baby had had a couple of decelerations in heart rate so she had to keep the monitors on the whole time. Instead she breathed deep, rocked her hips, and her amazing supportive husband encouraged her through each contraction.
About 7:30am M's pain became quite intense and she said she was feeling ready to push this baby out. The nurses checked her cervix and found her to be at 9cm. They *very* quickly called the midwife, who had to travel to get to the hospital. By 8:00am the midwife had arrived and M began to push. At 8:20am baby was born! Baby's cord had been very tightly around her neck and she was having trouble breathing, so she went right to the NICU team and then soon to the NICU ward. Not long and they had baby breathing and back with her mommy where she belonged! It was a scary little bit, but dad was a huge support to mom. They truly were an amazing team!
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I share this beautiful birth story because I think it's so important for women to hear and see that 1) some inductions ARE necessary and 2) just because you're being induced does not mean your dream of a natural labor and delivery fly out the window. With an open dialogue with your care provider (PRIOR to the day of birth as well as the day of), education, and a great support team you *can* have the birth you hoped for.
I also VERY MUCH believe that M was able to deliver her baby naturally because she waited as long as possible to allow her body time to be ready to labor.
Please visit Ashleigh's doula blog:
http://belladonnadoula.blogspot.com
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