My Experience with Induction
Being induced has a different meaning for every mother. For some, the choice is based on medical necessity. Whether that is of the baby/babies and/or the mother, doctors often “kick start” labor to prevent further complications. Sometimes induction occurs around a particular schedule. The schedule may be that of the doctor or the mother, or it may be to alleviate the physical unease or discomfort of a mother whose body has had enough.
Whatever the reason, the need to be induced is often a simple solution for a mother passing her due date. While I won't discuss my personal opinion on selective induction, I will share my personal experience of induction. For me, it was a word that I initially feared. I had recently learned of the multiple options I had before me concerning my daughter's upcoming birth, and I knew I wanted her to come when she was ready.
I was specific in my birth plan (naive, but confident in my choices). My OB, Dr. K, was less than excited at the mention of a birth plan or the fact that I was opting to forgo the epidural. She was a very intelligent doctor, experienced and a mother herself of two boys. Though her bedside manner was lacking, she was respectful of almost every single choice of mine.
When the subject of being induced first came up, I was nearing my due date, and I asked her what her thoughts were. She replied that if necessary, as in a medical emergency, she would order me to be induced. She then offered that if I became uncomfortable passed my due date, I could also consider inducing. We discussed what methods would be used and what I was comfortable with. I explained that I did not want my membranes swept, and I did not want my water broken prematurely.
Dr. K explained that an option I may consider was Cervidil – a small gel insert that softens the cervix and in turn can trigger labor. I agreed and off we waited for ten more days.
Ten days past my due date, after a routine ultrasound and stress test, Dr. K matter-of-factually told me I was going to be induced that night. She explained that my daughter's amniotic fluid levels were gradually dropping, and she was fearful of pushing through the weekend until Monday to induce (it was Friday at the time). For the first time since we met, I did not ask many questions.
Something inside me, though terrified, believed her. Perhaps it was her authoritative tone or the way she presented it to me – not an option, an instruction. I agreed and asked her if she would be the doctor on-call. She agreed that she would be throughout the night, and then she asked to check my cervix for any dilation.
Usually a cervical check isn't entirely comfortable, but not painful. I remember feeling a slight pressure as usual, but then a sharp scraping. Dr. K finished her examination, stated that I was only an inch dilated, and sent me home to prepare.
I left her office with a time to report at the hospital, an admittance sheet, and a soreness I had not experienced before.
After making necessary phone calls (my husband who was at work, my parents, my in-laws, etc.) I hopped in the shower and saw faint signs of blood smeared on my thighs. In my naivete, I was elated. I believed that maybe the timing was perfect and this fresh blood was a sign of impending labor. My husband came home just as a I finished showering and was just as hopeful as I was when I told him I was not only feeling contractions, but was slightly bleeding. (Little did I know then, but Dr. K had swept my membranes without my permission - another post for another time.)
For me, the tone at the hospital was very relaxed. Dr. K inserted the Cervidil that evening and said she'd return in the morning to check my progress. My mother slept in a chair beside the bed, and my husband took the sofa. I couldn't sleep in my own bed anymore, much less in a hospital bed with an IV connected to my arm. Sleep found me for an hour or so at a time. If I had to use the bathroom, which was fairly often at nine months pregnant, my mother would wheel my IV stand into the bathroom then help me lumber back into bed.
When I finally found a comfortable spot on the bed where a deep sleep felt inevitable, the new nurses entered the room with Dr. K. She removed the Cervidil and checked my cervix. Two inches.
I had dilated an additional inch. I was heartbroken. My first question was about my daughter. Was she still okay? Dr. K admitted her heart rate was fine as was mine. She offered to give me until nine o'clock to dilate more before we would have to explore our other options.
If the pressure to go into labor hadn't been on before, it certainly was now. For two hours I paced the delivery room floor. I talked with my mother as she recorded me on a Flip-cam. My heart plead with my body to hurry, get going so I wouldn't have to force my little girl out.
Two hours later and I hadn't progressed any further. Dr. K explained she would now break my waters, but I would only have about twenty-four hours to deliver before my daughter would be in trouble. I was reluctant at first, but I didn't know what else to do. The clock in my mind was ticking, and so I nodded my consent to my husband.
The nurses lay me down on my back completely flat – which is one of the most uncomfortable positions in the world for a pregnant woman (all weight now rests on the spine). With my legs open, Dr. K inserted a long metal rod past my cervix, and I felt a slight tinge of pain before a gush of fluid.
Dr. K briefly explained she would return to check me after dinner. Contractions began to increase steadily, and I reminded myself to trust my body and my baby. I remembered my birth educator's voice: do not fear pain – pain is the result of your body working to bring out your baby. I knew we could do this. I prayed that my body would cooperate and that my daughter would come swiftly and safely.
The wonderful, amazing nurses reminded me I could do this. They were encouraging and gentle. Their voices still resonant within me when I remember my daughter's birth. They shared their own birth stories and experiences. Instead of clinical and stern, they were soothing and kind. They took me off my IV as long as I continued to drink water and allowed me to be intermittently monitored rather than constantly so I could move around. Their understanding and accommodations were what I needed to proceed. I carried their strength on into the day.
The hours ticked. I paced and swayed on my husband's shoulders. As the contractions increased and the pain began to sharpen, I found a sense of peace in the shower. In his swim trunks, my husband fed me Cheezits (my mother had swiped them from the nurses' station since I wasn't allowed to eat), massaged my back, and told me inappropriate jokes in between contractions to make me laugh.
After two more visits with a disapproving look on her face, Dr. K left me at 4:30. She told me I needed to progress to full dilation by 7:00 pm or she would order Pitocin to increase my contractions. Once again I asked how my baby was. She was healthy and her heart beat was fine. I told her I understood and wanted to give my body more time. Dr. K said little and left the room.
I was given another round of encouragement from my nurse before I was left with my husband and mother. By 8:00 I was laying in bed on my side. The labor pains were firmly resting in my lower back and anus and walking was the last thing I wanted to do. The pain now thundering in my lower body allowed me to completely forget about Dr. K's time limit (though she hadn't returned since).
I was crying and entering the stage of pure fear that many mothers experience right before they fully dilate. Holding my mother's hand, I whimpered that I couldn't do this. She told me I could. One of the worst contractions I can remember slammed into my body, and I stared at a focal point (a metal knob on the corner closet) to push through.
The lights were now dim, the television was off, and I wanted quiet and darkness. My mind was slipping deep inside itself as I prepared to push. Seconds later the nurses returned to inform me I was fully dilated, and it was time to push.
Dr. K was not present.
After trying various positions, I found myself squatting on the bed with my arms bracing myself at the head of the bed. My amazing husband never left my side. He let me hold onto his arm for dear life as I whimpered and groaned. He told me I could do this. The nurse to my left coached me until I felt my body set it's own pace, and I fell into contracting and pushing at it's order.
Within those forty-five minutes of pushing, Dr. K returned to catch my darling girl as she emerged. Sadie greeted us all with a scream at 9:37 pm, twelve hours and an eternity after my waters were broken.
For the first time, I saw Dr. K genuinely smile to me and congratulate me. She tied my darling girl's belly button into an outie, and just as quickly as she had reappeared, she disappeared until dawn the next day.
My induction was successful. In many ways, it was a beautiful blend of what I had prayed for my birth experience to be and what Dr. K had hoped (hospital setting, pushing progression as needed). Had it not been for the incredible nurses, I don't know how well I would have done. Their encouragement and confidence in me granted me to access the strength I had deep down inside – that all of us women have.
To me, the word induction is no longer scary. To me it is now somewhat stressing, but nothing to fear. Though I was not induced with my son, I was prepared for it (he was twelve days overdue). The biggest strength I had was the knowledge I'd gained during my pregnancy. I understood my options and knew my rights as the patient and mother. I had the gift of my husband and mother as my birthing team.
So though induction may mean something different to everyone, it is not a term to fear with the right knowledge, understanding, and people at your side.