Saturday, February 25, 2012

Induction Without Pain Medications- Can It Be Done?

(Picture via http://www.globalrph.com/oxytocin_dilution.htm)
Inducing labor- in the natural birth community it has a well earned bad name.  I admit to feeling the same distaste for the common place attitude toward induction.  A study recently even found that induction more than doubled the chance of c-section, so one could say that the "bad reputation" that induction has is well earned.  Many women, like this one, came away from their induction with a very upsetting birth story and plans to NEVER be induced again. 

So why the post on epidural free inductions, especially from a sworn advocate for totally natural birth? 

Well, occasionally I run into women who have a very valid medical reason for induction and often they are shut down in their attempts for at a birth without any pain medication.  My first reaction is also "DON'T GET INDUCED!!!!" but frankly, that isn't always helpful, especially when the induction is needed for the safety of the baby.

Yes, I do personally believe that women are induced too often for non-medical purposes and that the procedure is far overdone.  But, when it is needed, a woman CAN still get induced and avoid an epidural.

Here are some thoughts (not medical advice- because of course, I am NOT a medical person!) and tips from other moms on how they approached induction and still had triumphant, often pain-med free, birth.  This is NOT a hopeless attempt and you are still capable of having a good birth.

~Begin with a positive attitude~

If you really do need an induction, don't throw in the towel on your epidural free birth before it even begins.  Women DO this.  You can too.  But you have no chance of accomplishing it without an epidural if you never try.   Plan for the best and do everything you can to get what you want. 

~Select your birth team carefully~

One big thing that separates a great birth from a negative experience is simply how a woman is treated in labor and postpartum.  Birth is a deeply emotional and impressionable time that mom will remember forever.  A birth staff (doctor, midwife, nurses) that are simply NICE can make a huge difference.  If they are also understanding of your desire for a natural birth and willing to help you, then you can have a very different experience than if the staff just thinks you are some stupid yahoo.  

~Think about a doula~

If an induction is needed a doula can be an invaluable tool.  They often are familiar with the hospital system and come equipped with comfort techniques and natural ways that may help speed your labor.  It can be really helpful to have someone on your side who can help you, guide you, and buoy you up, especially during a long induction.  This can be a great tool for dad too, as dads need breaks!

~Try to naturally prepare your body for labor~

There are things that women find helpful in getting labor started outside of the hospital.  (Note, I am not recommending any of these, just throwing ideas out there for consideration.)

-Sex with orgasm- This will help get your own natural oxytocin pumping and and the semen can serve as a natural cervical ripener.  You might even enjoy it.  And it is FREE!

-Staying active- Keep up with your upright and active lifestyle might help with positioning and uses gravity to get that baby down.

-Practice relaxation- relaxing in any labor takes practice for most women.  Practice daily, with your partner and by yourself.  Try relaxing in different situations (stressful, painful, before bed, at work, sitting, laying, walking, etc).  Learn to recognize your breath, control it, and release all non working muscles. 

-Various other things like Chiropractic, massage, and acupuncture are tried to start labor.  Many women swear by these methods.  

~Be aware of "natural induction" techniques~

There are tons of things out there that women try to induce their own labor.  Though not personally a fan just because you are "tired of being pregnant" for some they may be better than the alternative medical induction.

Some things that people try and recommend-
  
           - Black and blue cohosh- herbs that some feel help kick start labor.

-Evening Primrose oil- sometimes people insert it vaginally to soften the cervix, others take it orally or both.


-Red Raspberry leaf tea- said to be a uterine tonic that helps tone and strength then uterus. 

-Castor oil- though it sometimes causes vomiting and diarrhea, some claim it is very effective in starting labor outside of the hospital.


~Research various induction methods and decide which ones you think might be best for you~

There is more than one way to get induced medically.  Obviously you need to listen to your care provider, but here are some medical methods of induction so that you are aware of the many options out there.  This is not a comprehensive list.


-Sweeping the membranes- pros- does not involve medications- cons- can be uncomfortable.

-Cervadil- a cervical ripening agent, sometimes you can even go home and rest and see what happens.

-Foley bulb or catheter- inserted inside your body, it is filled with water and can apply pressure to help open the cervix without drugs.  Pros- no medication Cons-can be very uncomfortable.  The bulb will fall out around 4 centimeters dilation.  

-Cytotec- also considered a cervical ripener.  It is (last I knew) not approved for use in labor induction.  But it can start contractions.  One pro that I have heard from a few mothers is that they liked not being attached to an IV and the freedom of movement that that gave them.  Con's- some deaths reported and very intense contractions.

-Pitocin- probably your most widely know induction drug.  Usually given via an IV.  Pro- it can be adjusted and even turned off and sometimes a woman's body will begin to labor on it's own after just a little nudge from Pitocin.  Cons- some report difficult contractions, IV hook up can be uncomfortable and limit mobility, and is different than your bodies own naturally produced oxytocin.  You can read the full package insert here


~Avoid breaking water~

(Again, not telling you what to do!)  Breaking water is often a routine part of induction.  It does not involve medication, but you do need to know that once your water is broken, you are usually expected to deliver a baby within 24 hours.  If you don't want that restriction, you may want to avoid having your water broken, or wait until dilation is pretty far along.  (It is often done as early as four centimeters). 

 ~

I hope that all women can have a birth experience that is wonderful and healthy for all involved.  To end I wanted to share a few different induction birth stories that women have sent to me.  Their tips will be much more helpful than mine! 








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