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Old 10-03-2012, 04:17 PM   #21
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Heather,

I am doing well! I will be 22 weeks on Friday with a so far healthy baby green team! The only issue is GD already!

I had NO epi at all with my stillbirth delivery as there was NO time to get it...that's how fast that medication worked for me. The doc that was supposed to deliver had gone to dinner and the literally had to "grab" a doc who I THOUGHT was a janitor to come deliver! I would have had an epi as I've never had a negative experience (sorry :-) ) with it and I'm not one to refuse meds :-) ( I sound like a druggie!!)

I will be watching for updates!!

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Old 10-03-2012, 04:46 PM   #22
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Re: Possible induction for high BP and really nervous

Didn't have HBP but did have an induction. This is based only on my experience. I didn't want to be induced. In retrosepect it was the right decision. I wanted all natural and was very unhappy. That being said, it was not the worst experience of my life (certainly not the best) and here's what I would have done differently.

First, it seems from reading posts here on DS that there are a lot of procedures called "induction." There is the you just need a little pit to get you going on the one hand to starting from zero, get the cervidil/cytotec doing for 12 to 24 hours then start pit then maybe AROM, etc... DISCUSS with your dr/mw what exactly the game plan is. This will calm your fears (hopefully) and help you make better decisions.

I had started with a bishop's score of 3. The bishop's score is a matrix of dilation, cervical softness, station, effacement and other factors. It's used to predict the sucessfullness of an induction. The lower the score, the worse your chances.

I checked in to the hospital at 10 pm on a thursday. They gave me cervidil early in the morning (this is the one that is made for induction vs. cytotec which is the off-brand usage). The benefit of cervidil is that it can be removed (it's a string) if induction isn't going well and stop whatever side effect is going on. The downside is that it costs around $300. Drs use cytotec (costs about 35 cents) not approved for use as a cervical rippener and cannot be removed.

I was hooked up to a monitor but I was able to get the dr to agree to let me walk around for 15 min every hour if everything looked good. This was essential to keep my sanity. I had 2 doses of the cervidil (24 hours worth). I did have some random contractions but nothing big time.

Sat at about 4 or 5pm they started the pitocin. That was when things got bad for me. I really really really didn't want an epidural. It was the most pain I have ever experienced. At 11 pm the baby's heart had decels and they stopped the pit. I was dilated to an 8 but the baby was still really high up. There was a big discussion on whether I was c/s worthy or not. I told them I needed an epi RIGHT now and couldn't discuss/care what was going on until I had pain relief. They let me keep going.

I had the epi and slept (haha) until 6 in the morning. I'm fine with needles and the epi didn't really seem scary to me anyways. I was surprised at the level of feeling that I had. I could totally feel my feet (which scared the crap out of me b/c I thought that I could have had a c/s at any time until a nurse told me they turn it up) but my butt and thighs were numb.

At six, I could feel the baby's head was down there. I told the nurse and she said we were finally a go to have a baby. They turned the epi down or off. I pushed for 2 or 2.5 hours and had a vaginally birth. I had no need to push what so ever, but i could definitely feel the contractions. The nurses were great, helped me figure out how to push. The nurses constantly re-positioned me - side laying, squat bar, pulling on towel, sitting up, laying on my back, etc. There was no yelling or counting, they told me to push during the contractions and that was it. I KNOW the epi had worn off at the crowning because I felt the ring of fire.

I had a 6.0 lb girl with no tearing or episiotomy. I refused to have a AROM until about 20 min before she was born and kept internal exams to a minimum.

I would have gotten the epi a lot sooner. I think that as soon as I wasn't in pain, my body relaxed enough to let the baby drop. So don't view an epi as the enemy, per se. I wouldn't have gotten the epi at the first twinge of pain either, but 6 hours was way too long for me.

It sounds like you're in a more favorable state than I was, so it probably will work out for you. Go in with a birth plan or clear idea of how you want the induction to go. Just because you will be hooked up to the monitors, etc doesn't mean that it's all or nothing. You can still say no to extra checks, AROM, and other things. Have the epi turned down as low as possible, esp when pushing. Ask that the pit be stepped up gradually.

Get with your dr. to find out what he wants to do because I have heard just as many "I needed a little pit to get started" stories as there were like mine.
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Old 10-03-2012, 04:58 PM   #23
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Re: Possible induction for high BP and really nervous

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Originally Posted by songbird516 View Post
My biggest concern with breaking water artificially is the risk of cord prolapse or compression that wouldn't have happened without that intervention (most likely).

My best friend had two natural births and then was induced with her third. He ended up being posterior but she still managed to avoid the epidural even with the pitocin, and stay mobile enough for him to turn. She said that looking back she probably shouldn't have agreed to the induction, but the doctor was insisting. It's definitely possible to be induced and make it through without the epidural, although I personally wouldn't want to do it! But as much as I hate needles...I think that might be the option that I would prefer.
I agree that your body is probably ready enough that an induction would work; the part that I would worry about more are the risks associated with induction like cord prolapse, fetal heart rate issues, and risk of infection from the procedures that come along with the induction. But you aren't going into this blind; you can make choices that will be safest for you. Like, make SURE that baby is engaged and preferrably in the anterior position before allowing AROM, and limiting vaginal exams..etc.
If you have to be induced, make it work for you, and I hope that everything goes well!
Thank you for saying this. It was very empowering and a confidence builder. You are right. I'm not going into it blind. I do know the risks and I have researched and am now researching more since this is slightly new territory for me, medical induction especially with possible meds and no pain meds. The risks are what worry me as well. But, high BP has risks for baby too. So, it's a balancing act, KWIM?

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I agree with this. I would not agree to cytotec because it can overstimulate the uterus and there is no way to stop it when that happens. Especially since you have already had 5 children...it might be too much.
Personally if I had to be induced, was already dilated, effaced, and already had several vaginal births, I would make sure that baby is engaged and in a good position, then start with the lowest dose of pit and increase every hour, not more often than that. Once labor is established in a good pattern, I would ask for the pit to be turned off and see if labor would continue on it's own, maybe using things like a breastpump to keep natural contractions going until baby is born. I would not consent to AROM unless there was a very good reason.
This is exactly what I am leaning toward. After a lot of research in the last few hours, I'm planning to refuse the cytotec. I'm not totally convinced on pit or AROM. I had AROM with my last pregnancy (twins) and that was it and it went very smoothly. I know that has risks too, but I'm thinking I might prefer those risks to the ones that go along with pit. I'm just not sure yet. Because I also feel like if I don't let them break my water and the pit isn't working, I can opt to stop it all and wait another day or two. I can't do that once my water is broken and like you said, AROM certainly has risks too. I just really don't want to be strapped to the bed. I'm really nervous about giving in to the epi. Like I said, I don't respond well to it at all. Last time, I had a very severe reaction with my temp soaring to almost 104 within an hour after delivery and me shaking and convulsing so hard my ALL muscles hurt for a couple days. I will never forget how severely cold I was, probably caused by the fever. I was in and out of consciousness too. It was very scary and that doesn't include my BP dropping and needing epinephrin to get it back up when it was first inserted, 3x's (2 different labors and one needing it done 2x's in my last labor). So, when I say I don't react well, I really do mean it. I want to do whatever I can to avoid it.


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Originally Posted by finleyjudemommy View Post
Heather,

I am doing well! I will be 22 weeks on Friday with a so far healthy baby green team! The only issue is GD already!

I had NO epi at all with my stillbirth delivery as there was NO time to get it...that's how fast that medication worked for me. The doc that was supposed to deliver had gone to dinner and the literally had to "grab" a doc who I THOUGHT was a janitor to come deliver! I would have had an epi as I've never had a negative experience (sorry :-) ) with it and I'm not one to refuse meds :-) ( I sound like a druggie!!)

I will be watching for updates!!
I'm glad to hear everything is going well. Bummer about the GD, but that's manageable. While I do tend to shy away from meds and do believe that if you can go without pain meds it is the best option, I'm not totally against them. I would still want to do this naturally, but with an induction I would be willing to get an epi again if my reaction wasn't so strong. And, it got stronger and stronger with each one I've had. (Copied and pasted from above) Last time, I had a very severe reaction with my temp soaring to close to 104 within an hour after delivery and me shaking and convulsing so hard my ALL muscles hurt for a couple days. I will never forget how severely cold I was, probably caused by the fever. I was in and out of consciousness too. It was very scary and that doesn't include my BP dropping and needing epinephrin to get it back up when it was first inserted, 3x's (2 different labors and one needing it done 2x's in my last labor). So, when I say I don't react well, I really do mean it. Otherwise, I wouldn't be so worried about getting pit.

I do have a small update. My husband took my BP tonight after I'd been sitting for a while. It was 142/80, which is high, but totally acceptable. So, I'll definitely be refusing to be induced right now and insisting on bed rest for now. Hopefully, my OB will not need much convincing.
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Old 10-03-2012, 05:03 PM   #24
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Re: Possible induction for high BP and really nervous

My guess is all you would need is Cervadil or your water broken. I have had great natural births and great inductions....and hard ones of both too. I think you will be fine and an induction is better than getting into a true emergency with your BP and needing a C-section.
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Old 10-03-2012, 05:15 PM   #25
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Re: Possible induction for high BP and really nervous

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Originally Posted by AniMommy View Post
Didn't have HBP but did have an induction. This is based only on my experience. I didn't want to be induced. In retrosepect it was the right decision. I wanted all natural and was very unhappy. That being said, it was not the worst experience of my life (certainly not the best) and here's what I would have done differently.

First, it seems from reading posts here on DS that there are a lot of procedures called "induction." There is the you just need a little pit to get you going on the one hand to starting from zero, get the cervidil/cytotec doing for 12 to 24 hours then start pit then maybe AROM, etc... DISCUSS with your dr/mw what exactly the game plan is. This will calm your fears (hopefully) and help you make better decisions.

I had started with a bishop's score of 3. The bishop's score is a matrix of dilation, cervical softness, station, effacement and other factors. It's used to predict the sucessfullness of an induction. The lower the score, the worse your chances.

I checked in to the hospital at 10 pm on a thursday. They gave me cervidil early in the morning (this is the one that is made for induction vs. cytotec which is the off-brand usage). The benefit of cervidil is that it can be removed (it's a string) if induction isn't going well and stop whatever side effect is going on. The downside is that it costs around $300. Drs use cytotec (costs about 35 cents) not approved for use as a cervical rippener and cannot be removed.

I was hooked up to a monitor but I was able to get the dr to agree to let me walk around for 15 min every hour if everything looked good. This was essential to keep my sanity. I had 2 doses of the cervidil (24 hours worth). I did have some random contractions but nothing big time.

Sat at about 4 or 5pm they started the pitocin. That was when things got bad for me. I really really really didn't want an epidural. It was the most pain I have ever experienced. At 11 pm the baby's heart had decels and they stopped the pit. I was dilated to an 8 but the baby was still really high up. There was a big discussion on whether I was c/s worthy or not. I told them I needed an epi RIGHT now and couldn't discuss/care what was going on until I had pain relief. They let me keep going.

I had the epi and slept (haha) until 6 in the morning. I'm fine with needles and the epi didn't really seem scary to me anyways. I was surprised at the level of feeling that I had. I could totally feel my feet (which scared the crap out of me b/c I thought that I could have had a c/s at any time until a nurse told me they turn it up) but my butt and thighs were numb.

At six, I could feel the baby's head was down there. I told the nurse and she said we were finally a go to have a baby. They turned the epi down or off. I pushed for 2 or 2.5 hours and had a vaginally birth. I had no need to push what so ever, but i could definitely feel the contractions. The nurses were great, helped me figure out how to push. The nurses constantly re-positioned me - side laying, squat bar, pulling on towel, sitting up, laying on my back, etc. There was no yelling or counting, they told me to push during the contractions and that was it. I KNOW the epi had worn off at the crowning because I felt the ring of fire.

I had a 6.0 lb girl with no tearing or episiotomy. I refused to have a AROM until about 20 min before she was born and kept internal exams to a minimum.

I would have gotten the epi a lot sooner. I think that as soon as I wasn't in pain, my body relaxed enough to let the baby drop. So don't view an epi as the enemy, per se. I wouldn't have gotten the epi at the first twinge of pain either, but 6 hours was way too long for me.

It sounds like you're in a more favorable state than I was, so it probably will work out for you. Go in with a birth plan or clear idea of how you want the induction to go. Just because you will be hooked up to the monitors, etc doesn't mean that it's all or nothing. You can still say no to extra checks, AROM, and other things. Have the epi turned down as low as possible, esp when pushing. Ask that the pit be stepped up gradually.

Get with your dr. to find out what he wants to do because I have heard just as many "I needed a little pit to get started" stories as there were like mine.
Thanks for your experience. I was reading about the Bishop score. I'm going to have my OB check me tomorrow. I'm thinking it won't take nearly as much to get me going as it did for you, just because I'm already contracting so much. I've been here before (not with the impending induction with meds, but with the early contractions and dilation). All it took to get me going was breaking my water and the babies were born 5 hrs later. Hoping it is easy again...we'll see.

As for the epi, after you posted, I posted my issues with the epi. I've had one with all 3 of my previous labors. I really don't want one again. Hopefully, I can do it.

weesej - Thanks! I'm leaning toward pushing the induction till next week, but not toward forcing the issue too far because like you said, I don't want to end up in an emergency.
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Old 10-03-2012, 05:17 PM   #26
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Re: Possible induction for high BP and really nervous

Also, do you have a bp cuff at home? I found it much more informative to monitor my bp a few times each day at home than the single reading the mw took when I was stressed about it being too high already. I kept a log and took it in with me to show that while at home and resting, it wasn't so scary high as while I was in the office.

I know how frustrating high bp can be.


I agree with researching cytotec... Ihad it with my first and would not consent to it again if I could go back. I didn't have any adverse affects but I did read the FDA warnings after the fact.
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Old 10-03-2012, 05:49 PM   #27
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Re: Possible induction for high BP and really nervous

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Also, do you have a bp cuff at home? I found it much more informative to monitor my bp a few times each day at home than the single reading the mw took when I was stressed about it being too high already. I kept a log and took it in with me to show that while at home and resting, it wasn't so scary high as while I was in the office.

I know how frustrating high bp can be.


I agree with researching cytotec... Ihad it with my first and would not consent to it again if I could go back. I didn't have any adverse affects but I did read the FDA warnings after the fact.
My husband is a PT and can take it at home. That has been helpful in all my pregnancies. It's almost always lower at home, but wasn't last night. However, tonight it was 142/80, so lower. I will bring that tomorrow when I go. I think he is going to take off on Friday to allow me to rest during the day. He'll also be able to take it several times throughout the day and over the weekend to see what it's really doing. BP is frustrating especially since it usually has no symptoms and you feel fine. Ugh!

I've already decided not to consent to cytotec.

Thanks!
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Old 10-03-2012, 07:15 PM   #28
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Re: Possible induction for high BP and really nervous

I've had 2 successful inductions for the same reason... BP creeping up, but not into the we HAVE to get baby out NOW stage. I agreed because I was SO done - so fat and so miserable. I was 38w3d with #1 and 39w6d with #2. My inductions/labors were SO similar to each other...

Cervidil started... contractions started within about 45 minutes... progressed nicely and within 12 hours of each, kiddo was out - no IV needed - no pain meds needed.

I didn't want the Pitocin (even though they were telling me I "should")... I didn't want an IV period if I didn't need one.

The cytotec - never would have consented to that one!

I bet if you ask them to strip your membranes and then start with cervidil, that your babe and your body will cooperate.

I started out at 1cm with #1 and was 3cm with #2 at the start of inductions.
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Old 10-04-2012, 08:30 AM   #29
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Re: Possible induction for high BP and really nervous

Heather, why don't you see how you feel about stripping membranes when you find out how dilated you are? You might feel okay with that. IMO, it's far less invasive than any meds or breaking water. And it might/might not work, but it would be worth a try, and better to try now than wait until you are at a deadline of some sort and pressured into something you really don't want. KWIM?

I had a membrane sweep with my ODD AND I agreed to AROM b/c they threatened me with a c/s b/c of FTP after I'd only been at the hospital for like 3 hrs with no progress. I delivered within 9 hrs or so (IIRC)

When my water was leaking with my DS, my MW did a gentle membrane sweep, and I drank a whole bottle of castor oil AND did nipple stimulation for hours. He was not born that day, despite getting into a good contraction pattern and dilating to a 5 (this is when I was telling you before about labor stopping b/c of my mom coming in). A week later, my membranes were stripped again and he was born within 24 hrs.

So, I think stripping membranes, while it's not something I consider ideal, is a good way to try to get labor going without being too invasive. Just kinda like telling the body, "Hey, I know you're on your way there, but could we hurry this up, please?" Not something that will throw you into labor if you aren't ready.

Anyway, just a thought.

I'm thinking of you today and hope you have a great doc. appt!

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Old 10-04-2012, 12:50 PM   #30
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Re: Possible induction for high BP and really nervous, *UPDATE*

Kiliki - Thanks. I was going to ask about that. Luckily, I didn't need to. I'm so relieved that for now, I'm in the clear for being induced. Yay! (See update)

And, bump for update.
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