Episode 33: Medical Labor Induction Tips (Revisited)

While most people plan for labor & birth to start spontaneously, a large number of people find themselves surprised to be discussing a possible medical induction of labor later in their pregnancy. I want you to be prepared to have these conversations with your medical care provider. We discussed induction back in Episode 6, but it's worth revisiting and I have some new tips for you!

Medical induction tips:

• Take the time you need to make a mindful, whole-hearted, and informed decision.
  • Assess the three-legged stool of informed decision making: Balance 1) research data, with 2) your own perspectives on risk, medicine, and your individual circumstances, balanced with 3) your care providers professional opinion).
  • Assess BRAIN (Benefits, Risks, Alternatives, Intuition, do Nothing)
• Reduce fear of the unknown: learn about the induction process before hand (like in Module 5 Lesson 5!)
• Once you've whole heartedly embraced medical induction as the way you'll start your labor, perhaps mourn the birth you had envisioned, and get excited, all at the same time. We can hold complex emotions.
• Plan for the induction process to take 2 or 3 days, total. Bring entertainment! Before contractions start, give your birth partner breaks to go get take-out or run errands.
• Create a cozy, comfortable, home-like environment in your birth room. Battery operated candles, twinkle lights, your favorite music or movies playing.
• Don't feel rushed. Take the time you need to allow your cervix to soften & thin, and allow your labor to begin gently and manageably.
• Consider waiting until later in the induction process to have your waters artificially broken, and avoid a timeline.
• Once Pitocin contractions begin, stay upright and active. Dance with your IV pole! Labor in the shower! (Your nurse can help you protect your IV port from water with plastic and tape).
• Embark bravely and with curiosity on your journey to meet your baby.

See you next week!

Full Transcript

Hello, and welcome to your next episode of the free weekly, brave journey, birth preparation videos, where I pick a topic related to birth or postpartum. And we talk about it today. We're talking about medical induction. Many of you may not think that you need to learn about induction but a large percentage of folks end up navigating whether or not to induce their labor with the medical interventions, nearing the end of their pregnancy.

There are lots of different reasons why someone may be deciding to potentially have an induction. And I think a lot more people are grappling with this decision than they ever expect to. So I want you to have this knowledge ahead of time. So I'm going to give you some tips for medical induction and going into this process.

I'm Cara Lee. I'm a birth doula and a childbirth educator, and let's get started.

[00:01:00]

Let's get started with some tips for a medical labor induction.

So first off, take the time you need to make a mindful wholehearted, informed decision. Don't feel rushed into making an appointment. Don't feel like you have to rush over straight away after you've decided to have a medical labor induction.

Take the time you need to do a little bit of research. Check in with yourself. Check in with your birth partner, and make an informed decision of whether or not to have a medical labor induction. And this is so that when you go in for your induction, if that is your choice, you are going in wholeheartedly. That you have embraced that this is the process that you're going to take.

So informed decision making. And I talk about this at length in the Brave Journey Birth Preparation Program, is there's two different ways that I like to offer. One is BRAIN. You'll see that a lot in birth education, but this is where you collect information enough to be able to compare the Benefits against the Risks, compare against the Alternatives, listen to your Intuition, check into what your intuition is telling you, and then always assess [00:02:00] whether or not you can do Nothing. The N, whether or not you can do nothing.

So that's the brain method of making informed decision making. Another method of, of, of, of decision-making is sometimes called the evidence-based decision-making or the three-legged stool of decision of informed decision-making. But this is where you would compare. The evidence or the data that is at play with your decision here, the, with the medical opinion of your medical care providers. So what's their opinion and recommendation. And then you would also include on that three legged stool of decision-making your own personal perspectives on medicine and risk and what it feels like in your. Body and what your perspectives are on this. And you weigh those three things to make your decisions.

So again, That's just like a one minute version of something we talk about at length in the Brave Journey Birth Preparation Program, but this is what you're going to do before you show up for your medical induction appointment. You do this work. And so then this way, when you show up for your medical induction, you have chosen this as the best option in your current situation in your current [00:03:00] circumstances. So you can embrace wholeheartedly the induction process.

Just because you've embraced it wholeheartedly. It doesn't mean that you might also be mourning a little bit to the spontaneous labor you may have envisioned. And this isn't everybody, not everybody feels that sense of mourning, but I've seen it in some people who have chosen a medical induction and I meet them at the hospital and there's a sense of mourning the spontaneous labor they had been envisioning. Because if we approach labor and birth as a normal physiologic process, that generally shouldn't be messed with or interrupted. And that's how we're preparing to labor.

But then we start our labor with a medical induction. It inherently medicalized is our birth process and it's a different kind of an experience. It just is. That's a fact. It may be a beautiful experience. It doesn't have to be a bad experience, but it's different, maybe, than what you envisioned.

And so we can hold complex feelings. We can feel more than one thing. So it's okay to hold that sense of grief and mourning that you're not having this spontaneous labor you dreamt of with the excitement that you're starting your labor process and [00:04:00] it's happening. You're going to meet your baby within the next couple days.

So my next tip is to learn the induction process beforehand because learning about things makes them less scary. So reduce your fear of the unknown, reduce the unknown and research. And again, we talked about this at length in the Brave Journey Birth Preparation Program in the induction lesson, but learn what does a typical induction include?

What kind of medications are used, how long does it generally take? So definitely do that research and find that information for yourself.

My next tip is don't allow yourself to feel rushed. Do not feel rushed with this induction process. Go in to your medical labor induction process with the anticipation that this is going to take two to three days. You may be pleasantly surprised when it only takes one day. That'll be great, but go in with the understanding that it may be a two or three-day process that you may start the induction process.

With some cervical ripening agents where you're not even in labor for the first 24 hours, have you checked in instead, they've been applying a medication to your cervix and that's normal. So bring [00:05:00] entertainment, bring movies downloaded onto your computer. So you're not using the crummy hospital internet.

Bring your favorite things to watch and listen to and bring. Uh, decorations to create a cozy environment. So that's my next step, but I talk about this all the time, but the importance of creating a cozy environment in your hospital room to make your body and yourself and your birth partner feel at home.

So bring some flameless candles, bring some twinkle, twinkle lights, bring your Bluetooth speakers, bring, um, some things that you want to have around the room. Bring snacks, bring like legit, good food. Send your partner out to get takeout. Like actual food that you want to eat. Guys. Hospital food is *shakes head indicating 'no good'*. Send your partner out to go get some actual food and eat that before your labor has started.

You just you're. You may be there for a while. So make it feel like home and really just don't feel rushed. Just recognize that you may be there a few days before your contractions start, or you may, it may take a long time even after your contractions have started. And without that feeling of rushed ness you can really [00:06:00] just settle into the moment and experience what is coming up for you in this process?

my next tip is for you to perhaps consider waiting to have your water released, have your waters broken until you've been in labor for awhile. So once your water break. You're put on a timeline. Generally, every medical facility has it, it depends. Some of them wants you in active labor within 24 hours. Some medical facilities would prefer for that you've had the baby within 24 hours after your waters are broken, but you just don't want to be messing with the timeline until you're really in an active labor pattern.

So the medical care provider may suggest breaking your water as a, um, as an induction method saying, it'll speed up your labor, but there's actually not a lot of good data to show that that's what actually happens.

So you can wait, you can just, maybe you're going to choose to have them break your water later on and you'll have weighed the risks and benefits of that.

But you don't necessarily need to start your induction process with your water's being broken, because that puts you on that timeline and it makes you feel rushed. So there's just no need. So just wait, just wait.[00:07:00]

My next tip is once your contractions have started. So usually that's after they've started Pitocin. Once your contractions have started, this is where you stay upright and moving around as much as possible, just because this is a medical induction doesn't mean that you don't get to do all these positions that you may be prepared to be active with.

What this means is you're dancing with an IV pole. You're just dragging. And this, this Pitocin ID pull around the room with you. Maybe you're also strapped up to those continuous fetal monitors, but stay upright near where you have to, if you're stuck close to the bed, if they don't have the, the, the continuous electronic fetal monitors that allow you to be remote, if you have to stay connected, then you're just dancing with your IV pole on your monitors right next to the hospital bed,, but you can be on a birth ball. You can be leaning forward on the bed. You can lay out some towels and sheets on the ground and be on all fours on the ground, not on the actual hospital ground, you know, like lay out some, um, you know, protect yourself from some of those germs on the floor, but, you know, lay out some towels and then some sheets on top of the towels and you can be on all [00:08:00] fours doing cat cow, rocking your hips side to side.

Stay moving and active once your contractions started and this will help your baby find their path down. And it's the same idea as with spontaneous labor that when you're laboring upright and moving around, it's associated with shorter and more straightforward labors. So definitely try to move and change positions as much as possible and stay active.

My last thing to mention is that Pitocin. And we talk about this when we talk about interventions in the Brave Journey Birth Preparation Program, but oxytocin and Pitocin are similar. Oxytocin is the natural hormone that your body produces spontaneously. And Pitocin is a synthetic form of oxytocin. Oxytocin brings contractions Pitocin brings contraction. Oxytocin also bathes your your brain in feel good, wonderful, like feel a positive, cozy feeling hormones.

So you just get into a mind state of, of happiness and coziness. And Pitocin does not Pitocin does [00:09:00] not cross the blood brain barrier. So the experience of Pitocin contractions are very different than oxytocin. So I want to just preface this, that when people say that inductions tend to be associated with epidurals, that's true.

Not everybody chooses an epidural for pain relief when they're having a medical induction, but some people do. And it does because Pitocin and oxytocin are not the same. So staying upright and moving around, working through your labor, you may not feel the desire or the need for epidural or pharmacological pain relief, or you may, and you may, because Pitocin and oxytocin, those contractions do feel different.

So I do want to, I think that to avoid that and to not talk about it is to not give, um, real information. So I always want to include that information. That's just a fact.

Okay. So those are some tips for a medical induction. Again, a lot of people don't think they need to think about induction if they're planning, a spontaneous labor, but unfortunately it tends to come up more often [00:10:00] than you'd think at the end of a pregnancy.

So it's something to have done a little bit of prep work for, and those are my tips for you. Okay. I'll see you next week.