As a Doula, I try and encourage my clients to go the more “natural route” when it comes to labor beginning. However, there are times when it becomes medically necessary to induce labor. That being said, Pitocin is not your only option. I have nothing against Pitocin, it’s a great tool when you need it! But some women fear induction because of the use of Pitocin. It’s important that you know what your options are before moving onto a Pitocin induction.
Reasons Why You May Need to Induce
There are several reasons why your doctor or midwife may recommend inducing labor. These reasons include (but are not limited to):
- An infection of the uterus
- Amniotic fluid levels being dangerously low
- High blood pressure
- Preeclampsia
- Severe gestational diabetes
- If you have a past history of stillbirths, or other complications during childbirth
- Kidney problems
- Blood problems due to Rh factor issues
Whatever the reason for your induction, you deserve to have the birth you want. If you are no longer medically able to remain pregnant and don’t want a Pitocin induction, there are several induction options that you can ask your provider about.
“If you have to have an induction, why not just opt for Pitocin?”
While Pitocin is a popular way to induce labor, it can lead to several issues. You may want to consider these risks before agreeing to use it.
- Overstimulation of the uterus. (Pitocin is a strong synthetic hormone that can cause contractions that are sometimes too strong. These strong contractions can sometimes overstimulate the uterus)
- Fetal distress. (Because of the overstimulation in the uterus, the baby can get “worn out” from being squeezed too much and not getting a break between contractions. Remember, your baby is as much a part of your induction as you are. They’re working very hard to get out!)
- Infection. (Chorioamnionitis is an infection that occurs in the amniotic fluid, the fetal sac, and the placenta due to the introduction of bacteria in the birth canal)
- Rupture of the uterus. (Sometimes your uterus can rupture because of the intense contractions, but this is very rare)
- Unbearable contraction pain. (Again, Pitocin causes strong contractions that you don’t often get a break from. These strong contractions can sometimes be unbearably painful.)
- The need for a C-section. (The need for a C-section is often higher when Pitocin is involved. Mostly because of the different potential risks I’ve listed here)
Pitocin inductions work great for some women, while others prefer to try different methods before moving on to using Pitocin.
So, What Options Do You Have?
Sometimes in a non emergent situation, a doctor or midwife will give you the option to try at-home induction methods for a few days before medical intervention has to occur. If you have that option, try the methods that I’ve listed in part one of this blog post.
If the only options you have are forms of medical induction, there are a few options you can ask your medical provider about before you move on to a Pitocin induction.
1.
Amniotomy. An amniotomy is when a healthcare professional pops the amniotic sac that surrounds the baby inside the uterus. This is usually a quick and painless procedure. It may be uncomfortable since they have to reach all the way up there to get to the amniotic sac. This can also only be done if the cervix is dilated enough to make the amniotic sac accessible. This procedure sometimes works to start labor because it tricks your body into thinking it’s time for labor to start. The risks of an amniotomy include an increased risk of infection, increased labor pains, more intense contractions, the risk of cord prolapse, and neonatal sepsis. If you are considering an amniotomy over a Pitocin induction, be sure to go over the risks and benefits of this procedure with your doctor. As well as the risks and benefits of a Pitocin induction before you make your decision. Sometimes weighing these risks and benefits against each other help you as you make your decision whether or not it is a good option for you, your body, and your baby.
2.
Cervical ripening. Sometimes it is possible to dilate the cervix by inserting a catheter with a small balloon (also known as a Foley bulb) on the end, or by introducing a substance that absorbs water. These methods open your cervix slowly, and eventually the device will fall out. When you reach that level of dilation, you are almost always in active labor. Be sure to ask your doctor or Midwife what your options will be. If you reach that point of dilation and active labor has still not started. Overall, this procedure can be pretty low risk. The most common downsides to using a Foley bulb are: developing a fever or an infection (because there is a device in your cervix for so long which can introduce bacteria into that area), pain, and discomfort during the procedure, and sometimes baby will experience changes in their heart rate.
3.
Stripping your membranes. This is a fairly simple procedure and your doctor can do it at a an office visit. Call me your doctor and Midwife reached their gloved hands up to your cervix and sweep over the membranes, connecting the amniotic sac to your uterine wall. Many women find this procedure, incredibly uncomfortable, but much more bearable than some other induction methods. Once the connection between your uterine wall and the amniotic sac is separated, your body will sometimes start to produce hormones that start labor. Note: this message is only possible, if you are already dilated a little bit. It’s impossible for them to reach their finger through your cervix if it’s completely closed. The risks of this procedure include accidental braking of your waters, the introduction of bacteria into the cervical area, random, bleeding, and uncomfortable cramps if it doesn’t work to start labor.
To Sum It Up
No matter what you choose to do when it comes to induction, there is always still a risk of needing Pitocin. And that’s OK! Whatever method of induction you choose, there will be risks and benefits to all of them. Make sure you ask any questions you have and make your decision based off of what you think what is best for you and your baby. Not based off of what is most convenient for your doctor, midwife, or medical staff.
Some babies are stubborn, and they need a little extra help to be born. Just know that no matter what you decide or what happens when your baby is born, you are the best mom for that baby! And your birth story might look different than someone else’s. But it’s YOUR birth story, and that is beautiful.
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