Towards the end of pregnancy women are "done". We get tired and cranky; uncomfortable and swollen; nauseated and exhausted; short of breath and just a wee bit crazy. Did I mention we start to think absurd thoughts? During my second pregnancy I remember trying to convince myself otherwise, but I truly believed that I might not ever go into labor. I hadn't even made it to my due date!!!
With that being said I knew I never wanted to be induced again. An induction is a procedure where your labor is artificially started by means of medication/physical manipulation/or breaking the bag of waters.
With my first daughter I was induced. It was not planned and I had very little warning. That morning I had woken up with contractions every 5 minutes. They weren't very strong but they were very consistent and they felt more "real" than any other contractions I had in my pregnancy. I went to my regular scheduled OB appointment and when they asked me if my baby had been moving I answered, "No." I hadn't felt her move since the night before. So the medical assistant hooked me up to the monitor and we watched for over 40 minutes, no movement or accelerations on her part, but consistent contractions. So then I was sent for an ultrasound. No movement on the ultrasound either. The doctor offered me a cesarean section right then and there.
Since I figured I was already in early labor I bargained with him a little bit. He agreed to let me try a vaginal delivery as long as I could go to the hospital right then to be induced (some people would say my labor was augmented- or sped up- but I feel it was an induction). Her heart beat was continuously monitored and I was given IV fluids. My membranes were stripped (physical manipulation to help labor progress) and then later my bag of waters was artificially ruptured by the doctor (AROM). I was fortunate enough to not have pitocin during my induction, but that labor was hard and heavy and FAST! I was completely blown away by how intense the contractions immediately happened.
After an hour of lying on my side, thinking I was peeing my pants every time more amniotic fluid leaked out, I knew it was more than I could handle. I asked for IV pain medication. This drug let my body relax enough that I was able to last another hour. During this hour I went from 4cm to 7cm and I quickly woke up in transition. Talk about another thing to not be prepared for. The pain medication left my mind in a haze, I kept shaking my head trying to clear my thoughts and think straight, but I was unable to. It made me sluggish and put my daughter's heart rate in an even more distressed state- but since I was progressing so quickly they weren't too concerned.
After my epidural my temperature started to rise. I was already being given antibiotics for GBS so I received antibiotics for 24 hours after she was born. Thankfully my daughter didn't have the GBS infection transmitted to her, it might have started because she had stopped moving, but that is just a thought. I might have also started to get a uterine infection, but thankfully it did not turn out this way.
I might want to mention the entire time I was in the hospital I was on oxygen to help my daughter's heart rate. I also was almost always on my side, and despite all of these efforts her heart rate never really looked very good. For any of you medically minded people out there- here is a picture (blurry) of one (of many) of her late decelerations
Fortunately my daughter wanted to cooperate with me. She gave my parents and sisters time to jump on the first airplane out of Oakland and make it to Phoenix with a little time to spare. My active labor was quick (about 6 hours) for a first time mom and I only pushed for a little more than 20 minutes.
Here is a very unattractive picture of me pushing- a way of pushing that I usually discourage my patients to do- but it was time for her to come out and with an epidural sometimes this is the way it has to be done.
Fortunately my first daughter was born with excellent apgars and despite her non-reassuring heart rate through most of my labor, she impressed us all. She didn't breastfeed well for the first couple of weeks- but you can hear that story another time.
So- to add to the "inductions" stream of trusting Tuesdays- sometimes inductions ok. There is a time and a place for medical indications for inductions. I never want to have an induction again, BUT at least I know that I possibly helped prevent my daughter from getting a GBS infection by being induced.
Next week we will hear another story of an induction that possibly didn't go the way it was planned.
If you are interested in sharing your induction or labor story with us for a "Trusting Tuesday" post, please email me at brittikay[at]gmail[dot]com