Inducing Labor and why it is done.

Hello everyone,

My last entry was about covering the options you have regarding epidurals and whether or not it’s a good choice for you, if you haven’t had the chance to read it and or submit a comment, please feel free.  Today, I am going to write about inducing labor.

Induction of labor or artificially starting the process.

Why would you induce labor ?  Usually for medical reasons of some sort, either with mom or with the baby and or the placenta.

Mom may have medical issues, problems with blood pressure being too high, or if she has any underlying medical disorders, such as heart problems or lung problems.

There also may be baby growth issues, the baby may be growing ahead of schedule and getting to be too big or on the other side of the coin, maybe not growing sufficiently because of placenta issues not functioning 100 %.

The most common reason other than those is post dates, that being the baby is 1 week or more overdue.

There are 2 types of induction.  Which one is used depends on your dilation and cervical effacement, ( or thinning ).  If your cervix is very little dilated and not soft, and if your having no or irregular contractions, the doctor’s will probably try a cervical ripening agent, prostoglandin, to help get the cervix ready.  It’s administered in the form of a vaginal suppository placed behind your cervix during an exam.

If your cervix is more dilated and softened, the doctors will progress right to Intravenous Oxytocin called Pitocin to help.  The Pitocin works with the contraction you are already having to make them closer and stronger and will help make your labor progress.  It can also be used to help a labor that has been going but has slowed, to get it going again.

Thats pretty much it with inductions and how they work and why you may need one.  As always I would like to encourage you to submit your experiences with our other readers and thank you for visiting. 

God bless,

Meredith – RNC

Epidurals – to get or not to get, that is the question.

Hi everybody,

It’s been a few days since my last entry.  I’ve had to work and taught my birthing class yesterday so i’ve been a little busy.  But, today I’m going to write about your options regarding whether or not you should get an epidural. 

There are 3 options in the medicine realm.

1. Natural childbirth – no medicine no drugs.  Hey, believe or not, many women still take this route, not me, but many do.
2. Narcotic shot via IV or subcutaneous injection to “take the edge off” – it will not fully take the pain away.
3. Epidural Analgesia – an injection into your epidural space surrounding your spinal cord, and placement of a catheter (very small) to give you continuous medicine for pain.

Natural childbirth – This is really difficult but obiously possible.  Even now as I have stated, with all of our medical advancements, women still occassionally choose to go natural.  Excellent focusing skills and relaxation are needed, along with mental strength.  But it’s still doable.  Just last week I had a lady with her 3rd child and she did it naturally.  It was a very good labor and a relatively easy birth, but it was also her third child.  :  )

Shot of Narcotic, either through your IV or injected subcutaneously.  Many drugs can be used at my institution, we use either Stadol ( in the Demerol family ) or Nubain ( in the morphine family ).  Onset is short if IV, usually 1-3 mins., up to 5-10 mins. for a shot in the arm.  These drugs last for approx. 2-3 hours before wearing away.  The only problem with these meds is the timing.  They cannot be given if you are dilated to 8cm or more, as birth may occur before drug is out of mom and baby’s system.

Epidural Analgesia – is becoming more and more popular.  There are some requirements for an epidural.  You MUST have an IV running, the Anesthesiologist won’t do the procedure unless you’ve had 1 Liter of fluids or more.  You also MUST have results of a CBC ( Complete Blood Count ) to check your hemoglobin and platelet levels.  Also, you MUST be dilated to 4 cm ( a few docs say 3cm ) before you can get it.  You will have to sign a consent form for the procedure and your nurse will help get you into the proper sitting position, sitting up with your back curled, lower back pushed out.  You MUST hold still during the procedure for safety.  Placement takes approx. 5-10 mins., you’ll feel a “bee sting” of local to numb the area that they will be working in.  Then, you’ll feel some touching and pressure, but nothing sharp.  After placement, the anesthesia staff will secure the catheter to your back with a good amount of tape.  Then after returning to your back, your blood pressure will be monitored frequently for a short time.  The epidural takes about 10-20 minutes to fully work.  Contractions will progressively become less strong, with a 70% decrease in pain as the goal. 

After the epidural is placed the nurses will empty moms bladder about every 2 hours.  Moms legs will be numb and unable to get her to the bathroom, your bladder will be numb also.  :  )

There are PROS and CONS of course:  Pros – decreases pain, significantly.  Increases relaxation of muscles.

Cons – It can slow labor, pain relief may be spotty or sketchy at times, mom may be unable to push if she can’t feel much, and she has to remain in bed and cannot get up.

 

Thats about it, at least for today.  As always, I hope this entry will be of some help to you and please feel free to chime in with your experiences and thoughts.

God bless,

Meredith – RNC

Today’s entry in pregnancy and childbirth

Hello,

Today I am going to be writing about what I usually do in the second step of my Labor and Delivery classes.  Generally my next step is to go over how to time contractions.  It seems pretty easy, but lots of people don’t know the right method to do it.

The proper way is from the beginning of 1 contraction to the beginning of the next one.  We really don’t have to know how long each one lasts, or the interval between them. 

I also make it clear that this isn’t rocket science, you don’t have to keep track of EVERY contraction !! Trust me, I have occasionally had dads ( Generally with first babies, obviously ) that showed up with all kinds of charts and graphs : ) .  Funny stuff really, you’ve got to appreciate that kind of excitement.  But, this is not necessary, have them read this.  Daddy, this IS NOT NECESSARY !!! DON’T PANIC OR OVER DO IT ! RELAX !

Generally, over each hour we approximate the numbers – i.e. – from say 4pm to 5pm contractions were between 4 1/2 – 7 minutes apart.  THATS ENOUGH !!!

In the next couple of days I will be covering when to come to the hospital for labor and or other concerns.  I hope this entry was somewhat helpful, and I will be blogging to you soon.

Have a great weekend, God bless,

 

Meredith  – RNC