Inductions are Unavoidable

Don't let the heading mislead you, a lot of women go their entire pregnancy without talk of induction. But sometimes it's just completely unavoidable in cases of gestational diabetes, gestational hypertension, group b strep, and many more complications that can arise from being pregnant. Growing a baby is hard work! And sometimes birth just doesn't go the way that Mom hoped and prayed for.

Let's talk a little bit about gestational hypertension (GH). In layman's terms all this means is high blood pressure in pregnancy. Don't confuse this with Pre-Eclampsia. The difference between the two is just that GH doesn't have protein in the urine. 15-20% of GH cases can turn into pre-eclampsia, so while gestational hypertension is slightly less risky than pre-eclampsia, the risk of it developing is still there.

I was able to talk to another photographer about her story and she was willing to share for the purpose of this post. Being able to have someone go through this and be willing to share their stories is amazing! It puts it into perspective for some other moms, new or experienced, and allows them the chance to be aware of what may happen. Unmedicated births are absolutely still possible when going through a medical induction, while harder because the Pitocin that is given is synthetic oxytocin, which means that contractions are going to be much stronger than natural labor contractions.

Henry's Birth:

"I was being medically induced at 38 weeks for gestational hypertension. The two previous appointments baby was having heart decels during NSTs (non-stress tests) and we had to have the c-sesction talk, which was scary and upsetting. We made it to induction day, my birthday! We went in at 5am, I was 1.5cm and having irregular contractions approximately 4-5 minutes apart, then at 6am we started Pitocin. I chose to rest in bed for a little, but that was cut short because he started having decels again. We tried turning sides, all fours, and the ball. By 9:30am pitchin was at an 8. At 12:50pm I was still 1.5cm, and he was still high. We kept Pitocin the same, contracting every 2-3 minutes. My nurse brought me wireless monitors because I wanted to labor in the shower. After the shower, around 4pm I was 3-4cm and had my OB break my water. I knew things would progress fast and I had a little cry to release my fears. My husband called our doula and photographer to come.

Once my water was broken, Pitocin was turned off and I was unhooked from everything to allow my body to labor on its own. My doula arrived just as my contractions intensified. I shared my fears and she talked me through it. We rode a few contractions on the birthing ball, then she said we should move to the toilet ("the dilation station"). This is where I had to focus on surrendering and release all tension which was incredibly difficult. I went through transition within the twenty minutes we were in the bathroom. It was time to be checked as baby was having more decels. I was 8-9cm and was instructed to lay on my side to bring his heart rate up, but just as did I felt pressure. Next, the fetal ejection reflex took over and I couldn't control it, baby was coming."

~Kayla | Minot, ND

It's incredibly hard when birth plans change and deviate from your desires. When you want for something such as the unmedicated, no induction labor and delivery and then end up having to have conversations involving c-section (the complete opposite of the plan) it's so hard to stay hopeful.

The risks associated

Unfortunately, there are some pretty big risks that come with inductions, as I've said before, Pitocin is synthetic oxytocin. This puts mom at a higher risk for needing a c-section, whether from fetal distress or maternal. Contractions are hard on both mom and baby, and if you're forcing the female body to have contractions when it's not needed it's going to put a lot more stress for all parties involved. 29% of all inductions turn into c-sections, and this is the opposite of what majority of moms want. Infection can occur during inductions also, especially if the water is broken already.

Hemorrhage, uterine rupture, and many more complications can occur also. There are some less risky complications that come with like breast-feeding issues. The fluids that come from the IV and Pitocin can put more weight on the baby so after a couple days when baby loses that weight mom thinks that she's not producing enough. Although it's completely normal for baby to lose up to 10% of their weight in the first few days. Furthermore, if you do end up getting an epidural then baby may be significantly sleepier than normal in the immediate days following birth. This can cause baby to not want to latch as often as they should.

Don't let this scare you! The chances of these happening are not very likely, but providing you the chance to be informed about inductions is important to me.

All the risks aside, sometimes inductions (while not the initial plan) can go exactly the way the plan was adjusted to. Sometimes, mom still gets her dream birth just maybe not in the dream location or with the desired circumstances.

What should I bring?

I talked about this in another blog post (read that here), but it's along the same lines. The only other things that I recommend bringing is something to do. Inductions can be a super long process and they can be very uneventful. Typically with inductions they'll schedule you a specific time to come and get checked in. As far as I'm aware, Minot only offers two induction times. And once you get checked in they'll check your cervix before starting you on Pitocin. But from that point there really is nothing to do during inductions except wait.

So, I recommend that if you're getting induced in Minot maybe look into bringing a fire stick setup, maybe some card games or board games, a book or two, maybe a pillow for napping between contractions or when they aren't so strong. Something to keep you busy rather than focusing on how long you've been at the hospital for!

How do I go unmedicated with Pitocin?

The big ticket question. What works for one may not work for another, we know this, we embrace this, and we find different ways around it. As a doula, I'm going to find something that works the best for my clients, whether thats a position, a scent, a specific movement, whatever it is we're going to find it.

This is where experimenting before going in can come into play, get comfortable being uncomfortable. One of the best ways to do this is by holding ice in your hand for at least a minute. During this time you can find a way that works to keep you calm throughout. Think of this through contractions.

Breathing techniques are so important. You have to know how o breathe through contractions. When one starts you're going to breathe in for five seconds and out for ten. This is going to give you some semblance of control throughout contractions. And remember not to tense up, the more you tense the worse the contraction is going to be. Ride the high that comes with the contraction.

Birthing balls and showers. Minot has both of them. Use these to your advantage, they are there for a reason. Turn the warm water on, jump in the shower and spray the water where the contractions are hitting the hardest. Doing this can relax the muscle that's tightening with contractions (your uterus) so that it eases the discomfort. You can even throw the ball into the shower and do figure 8's with your hips while water is on your belly.

Birthing combs can also be a really good tactic (you can order one here). You'll put it in your hand with the teeth facing your palm and squeeze. You don't want to squeeze so hard it hurts, but you want to squeeze enough so that it gives you the acupressure feeling that helps distract your brain from focusing on the contractions.

Fun fact: Your brain can only focus on one pain receptor at a time, if this receptor is in your hand it's not going to be in your uterus which hurts a lot more than your hand.

Last, but absolutely not least. Mindset. Birth is all a mind-game. If you can trick your brain into thinking that labor and delivery isn't painful, just uncomfortable that's all it will be. Having the right mindset is key to having a successful unmedicated birth. Get in the right headspace and you'll be golden.

Here's the thing, if you go into labor or go in for an induction thinking "the epidural is there if I can't take the pain anymore, I'll just get it if I need it" then you're more likely to get it than going in with the thoughts "women before me did it for centuries without any kind of pain relief, if they can do it, so can I". Now, this mindset won't work for everyone, but it worked for me. And hey, what's the harm in trying.

All that to say, labor and delivery really is a mind-game, especially labor. Delivery is the easy part as shocking as that sounds. If you're getting ready to have an induction and you're nervous about it, it's okay, you got this, the nurses got you, you're going to do amazing and congratulations on your sweet new addition!