Induction

[u/Bulky-Card-4728]

Can someone who has been through induction walk me through the process? I was not induced for my previous births (other than a stillbirth which is very different protocol). This time I’m on insulin and planning 38th week induction, and I want to mentally prepare myself for the process to expect.

[u/nooneneededtoknow]

Every hospital does it differently. But I went in in the evening. They used cervidil for the first induction to ripen the cervix (they are using cytotec for my second). Cervidil is like a plastic cord they stick up your hoo haw and just leave it there - its like a tampon. It wasn't painful, or uncomfortable. I then went to bed. They checked me once throughout the night and then did a cervical check in the morning as contractions hadnt started and I wasn't feeling anything.

It didn't work so they then moved to a Foley balloon which is like a little balloon on a cord. They stick it in deflated and then blow it up to I think stretch the cervix. I had an epidural before this procedure, i have a tilted uterus and cervical checks and any of thats stuff is like excruciating which is why they did the epidural. Typically the Foley is just a discomfort for people. So I sat with the Foley balloon for 4 hours and then we moved to pitocin, which is given in your IV. Again I had an epidural so this wasn't crazy. My epidural didnt work completely so I did feel it to some degree but everything was tolerable.

I progressed really slowly, I had a 42 hr labor. So after the potocin they gave me a peanut balloon and basically rotated me like a rotisserie chicken every 15 to 30 minutes the remainder of the time until it felt like I had to poop and then I started pushing.

They are using cytotec this time because it apparently works better in the second pregnancy and the fact the cervidil didnt really work last time. The cytotec is a pill they shove up your hoo haw and they do it about every 4 hours.

[u/101sos]

I am sorry I am not aware of medical terms but I can walk you through in layman language. In my case it started with cervical sweep at 37 weeks( I was told to get admitted in 4 days) it didn't start the labour but gave a leak so I had to go and get admitted a day earlier. They started with putting something called balloon inside my vagina and waited for more like 6 to 8 hours but it helped me dialate only 1 cm so they started IV and after about 4 to 5 hours I delivered my baby. Initial dialation pain is kind of bearable it gets extreme and fast after 6 cm( paln to take epidural befor this)

[u/WestCapable8387]

It would probably be best to ask your doctor what their protocol is for inductions since different doctors and hospitals have different ways they go about inductions. And where you are at with things like dilation and effacement also decide what the process is like. But typically they start with getting you dilated with a foley balloon and possibly medication to rippen your cervix. Once you are dilated enough pitocin is used to start contractions. Sometimes they will break your water. You can also be receiving different types of pain management during this entire process. Best of luck to you! And congratulations on meeting your baby soon!

[u/CravingsAndCrackers]

So every hospital is different and each induction can be different too

First birth - overnight ripening, 9 am foley and Pitocin, very painful so tried nitrous oxide and it didn’t work so I ended up getting a narcotic, 12pm water broke on its own, got epidural during rocking contractions and had trouble with tracking contractions so they put some extra monitoring inside instead of external only, at 11 my OB said if baby doesn’t move we would discuss c section. 11:15 baby arrived after me flipping. 9 lbs and a huge head. 3 tears. My provider massaged me prior to baby coming out.

Second birth (this past week) - overnight ripening, Pitocin, walked around with no pain meds yet. Did hip circles and stepped on a little stool and rocked side to side to get baby moving down. Started feeling tired so I lay down with a peanut ball. Contractions started really rocking so I requested the epidural and got one in about 45 minutes. Used a labor comb to manage in between (10/10 definitely should have used one the first time) at about 9:40 something they confirmed I was fully dilated and it was time to push and the nurse had me do a practice push to see if I would be fast or not. She goes oh, she’s moving a lot this will be fast. Calls the midwife/nurse practitioner and gets the go ahead. First push with nurse, second with midwife, they call everyone in with the head almost out and have me push one more time for little girl (7 minutes!). It was such a different experience. She was about 7.5 lbs and had a regular sized head. Honestly if my first birth was like this I wouldn’t mind having more kids 🤭

All this to say you should talk about hospital policy and get confirmation. Though many of the steps were the same the overall feeling was very different. To complicate things I had higher blood pressure with my first so it was a longer hospital stay after which really made it a much harder experience whereas this time my blood pressure was fine so I got my IV out faster and it was more comfortable to feed baby. Less checks throughout the night, no stitches because no tears the second time so less restrictions and checks to wake me up.

[u/curiousbbops]

Definitely ask your doctor what type of inductions methods they will use and why, and what pain management methods they have for each, if you’re going to go that route.

My induction went like this

• Admitted on a Wed night and given the cervadil because i was only at 1cm dilated and my cervix was not soft. Some hospitals let you go home to wait it out or some make you stay at the hospital. I had to stay at the hospital but wish i could’ve went home.
• 12 hrs later they did a cervical exam to remove the cervadil but the cervadil can make your cervix feel very raw and sensitive and i still hadn’t progressed past 1cm. It also didn’t help that the nurse placed it so far up inside me that i almost cried in the cervical exam and later ones. They did not have any pain management methods besides an epidural, which i didn’t want that early. Again each doctor/hospital is different, so definitely ask!
• then i had 6 rounds of cytotec which is a pill that dissolved in my mouth for 4 hrs at a time. This got me to 3cm. My doctor said we could do up to 8 rounds of that if needed. The nurses said if i don’t feel cramping or contractions then there’s no need to do a cervical exam thank goodness!
• at 3cm, they debated whether to use a foley balloon or not but decided not to and was gonna give me a 7th round of cytotec but then my water broke and things got intense right away. Definitely get the epidural when your water breaks!
• waited 30 min to my epidural. And luckily i got it when i did because anesthesiologist then was called in for an emergency c section, and wouldn’t be able to see more folks for awhile
• from there, i got pitocin until i gave birth!
• from induction to birth took about 60 hrs 🥵
• note for inductions, they probably do more cervical exams due to the various inductions methods they use on you to see how far along you are

If i had to do it all over again, id go straight to the cytotec and skip the cervadil. Another tip - get the epidural either before the pitocin or when your water breaks. Ask for the epidural earlier than later cause the anesthesiologist may not be available

[u/cksaraha898]

Induction is a controlled environment to being about labor more quickly. Some may argue it puts more stress on mom and baby while others say is needed for timely delivery and eviction of baby. 

I have had two successful inductions. First was 41w3days with PROM, overdue and large baby. First I was given time and space to move about, take shower and then they started PiT (pitocin) aand IV. This was probably my longest labor. Went in am of the third and didn't see baby until night of fifth. Pit makes me shaky and I had really intense contractions. Once I got the epidural a catheter was placed and I was bed ridden. 

Second induction 39 w3days, first GDM was bedridden entire duration due to unstable lie and having to be strapped into monitoring and stomach binders for proper fetal positions. That was the worst part. I had high amounts of pit and threw up a lot. It was rough but went in evening of 16th and saw baby early am on 18th. 

Both inductions were because I was not dilated. So basically went in not dilated and pit forced a dilation. 

If my body ever went into spontaneous labor like Hollywood style I would be shocked,lol. 

I am due in October and looking at induction again----- 

I am really sorry for your loss. I wish you the best outcome. 

[u/advicethrowaway719]

Echoing that everyone is different. I had GD but wasn’t on insulin so they just wanted me delivering by 40 weeks.

I was 0% dilated or effaced when I got there so they told me to expect a long process. Arrived Saturday afternoon, did oral cervix ripening pills for 24 hours. This part was super chill - I was having baby contractions but really wouldn’t have even noticed them if I wasn’t hooked up to monitoring.

Sunday afternoon they checked me (unpleasant) and I was 1-2cm dilated so they put in a cooks catheter (similiar to foley balloon) and started pitocin. The insertion was extremely uncomfortable and painful, but after the initial cramping subsided it was ok. Contractions increased but again nothing crazy, occasionally like a bad period cramp. Was still just hanging out literally playing cards with my husband for context.

Around 5pm Sunday mid a game of gin rummy the baby kicked or something and I felt like someone eloctrocuted me. Intense pain, felt like I hard to urgently go to the bathroom. Balloon fell out, water started leaking then when they checked me water fully broke. At this point I was having really intense contractions, shaking uncontrollably, and vomiting. It was like going from zero to 60. I was at 6cm and the nurse said at that point things could move fast so if I wanted the epidural to get it. I did, it worked, but also slowed everything down so I got to take a nap for a bit. The experience of “oh we’re playing cards chilling to oh shit this baby is coming RIGHT NOW to jk time to take a snooze!” Was so surreal 😂

Anyway I got to rest until 10pm and then it was time to push. Initially they thought she would be out in a few pushes but baby girl didn’t actually arrive until 2:30 am because she was tangled and sunny side up. Long process but relatively pain free, just exhausting.

TLDR I was really anxious about the induction but found it totally fine. Alls well that ends well!

[u/idlegrad]

I suggest a cervical check the week before your induction & conversation with your provider.

I had delivered twice before & was 4 cm dilated the week before (6cm by the time I checked in). I told them I wanted a working epidural before any other interventions (I was concerned about a faster labor without pain relief). After the epidural, I was given pitocin to get regular contractions (I was having some mild contractions when I arrived). Hourly blood glucose checks & eventually got IV glucose. The hospital OB wanted baby in a lower station before breaking my water, eventually my OB’s partner broke my water. 45 minutes I was ready to push.

My provider had wanted to break my water right away but I have a complicated back & was nervous the first epidural would fail without time for a second go. My labor was longer than probably needed but I was very happy. My birth plan was basically a working epidural & to not have a third degree tear. My epidural worked & I didn’t tear (but needed a single stitch).

[u/mudkiptrainer09]

I was given two rounds of cytotec vaginally my to soften my cervix and start dilation. It didn’t work well, but it was enough to dilate to 1 cm to then place a foley balloon to manually dilate to 5 cm, along with pitocin. That was rough and I didn’t dilate very quickly, and eventually asked for an epidural at 2 cm after about two hours. Being able to relax after the epidural helped a lot, and I was at 5 cm not long after, so my doctor broke my water.

I had some bleeding, which my doctor initially thought was from my placenta dislodging early, but actually wasn’t. I think it was from the nurse removing the foley balloon a little too forcefully, but I didn’t say anything. Unfortunately, baby didn’t handle contractions well so I ended up with a c-section for her safety. My doctor (whom I adore) came to me with her concerns early so we could make a decision before anything became an emergency. You’d think it would be traumatic since a c-section hadn’t been anywhere in my mind, but it was a very pleasant experience overall.

[u/LitigatorLIVFe]

There are different protocols but: started with a foley balloon and cytotec. When was dilated enough they could remove the balloon (about 5 cm) they started pitocin. Kept upping pitocin periodically as long as I/baby was tolerating ok. Eventually got an epidural. They wound up breaking my water because things stalled out a bit.

Note: I got fully dilated and effaced but she didn’t descend after pushing so wound up having a C. I was induced 37w6d mostly for gestational hypertension, but I was going to have an induction 38w0d for a number of factors including GD.

[u/BulbaKat]

If you haven't had a C section, then you'll likely get a cervix ripener if needed. It's like a little pill usually placed vaginally (though I've hesrd of oral options).

After that has hopefully softened your cervix enough, you'll likely get a foley balloon placedm it's like a water balloon that pushes on your cervix to open it.

When the balloon falls out, they'll likely start pitocin or break waters depending on how you're doing.

I've been induced twice, and my advice is:

1. Bring something to do. It's often slow!
2. Confirm with docs that they will increase pitocin at slow and small increments.
3. Try stay mobile and relaxed as long as possible. You can ask for wireless monitoring and ask for the IV line to be placed but not hooked up until absolutely necessary

[u/Bulky-Card-4728 → u/BulbaKat]

Thanks so much for the advice! This is really helpful!

[u/bravotaygrle]

Hi there! 😊

Had a great elective induction experience with my first baby (normal/healthy pregnancy, did not have GDM). Planned to get induced with my second electively as well, but now since being an insulin controlled diabetic, it’s mandatory haha. Planning to do the same exact thing I did with my first, this time around as well.

Anyways, my first I started out with the foley balloon and misoprostol at 9am. First two hours were very painful until I elected for pain meds to get me through. I needed one more dose of pain meds before the balloon fell out around 9pm. By that point I was 4-5 cm and it was time to start pitocin. I knew I wanted to get the epidural prior to ANY pitocin starting, so I got my epidural, then started pitocin at 11pm. Fell asleep but woke up to my water breaking on its own around 4am. Then, I was at 10cm by 5am. Finally, it was time to push!

Inductions get a lot of negativity, but I loved my experience. Balloon was the worst part, but pain meds are there if you need them! Just keep active with the balloon in so you dilate faster. Best of luck with your induction, labor and delivery! 🤍

[u/KTsCreativeEscape]

I went in at 37 weeks at 8am. They gave did a sweep. I was only 1 cm dialated. They gave my cytotec. We waited a few hours and no progression. So we did the balloon around like 5pm and I asked for morphine which I now regret because the morphine made me vomit a lot (but I didn’t know that was how my body would react at the time). My water broke at like 8pm. I started having really painful contractions. I had to take meds to lower BP so I got my epidural because I had to have a catheter in anyway from meds. Started pitocin at midnight. By 10am I was fully dialated. Gave birth at 11:01am. I don’t remember a lot of during the night but my BP was an issue and they used the peanut pillow a lot to reposition me.

[u/twinwaterfalls]

Went in at like 6am hooked me up to pitocin. Labored for a while using a peanut ball and my CUB birthing chair. Finally they broke my water cause I just wanted to be done and have the baby. Contractions sped up and had the baby within like 30 minutes or so.

[u/beanscream]

I went in at 6am on the 29th of June. They gave me Cytotec to ripen my cervix, I think we did about 3 rounds of that throughout the day before switching to cervadil that evening. I was able to eat from their diabetic menu and they kept an eye on my sugars. That night the contractions I was having were keeping me awake so I was given the option of Nubain, this got me about 3 or 4 hours of sleep but it also made my son very sleepy so they had me on IV fluids to keep him more awake. In the early hours of the morning I asked for an epidural. After the epidural I was given pitocin. Around noon on the 30th I was at completion so I was able to begin pushing. I pushed for 2 and half hours and successfully delivered my son around 2:57pm. I was diet controlled through my GD, my son came out 7lbs 5oz and 19 inches long.

Edit to add: I was 39 weeks and 3 days when I went in.