Induction can be a scary topic! We have all probably heard horror stories on how long and drawn-out inductions can be; how painful and overwhelming they can be; and how many may lead to a birth you did not expect or want!
But induction does not need to be scary! We tend to fear what we do not understand, so better understanding your options can help you feel more prepared for a possible induction!
Here are my tips as a doula on how to navigate induction.
1. Understand your options
If you know what options you have available to you in your birthing location, you can better navigate how you want your birth to go. If you don’t know your options, you don’t have any. Does your hospital only offer cervadil as a cervical ripening agent? Do they let you go home after your receive your first dose or will you need to stay in the hospital? Different hospitals, states, and countries have different pharmacologic options at each step of induction.
This includes both the pharmacologic options AND holistic options, such as pitocin versus breast pumping or nipple stimulation.
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2. Learn the labor induction timeline
Each step of induction is like a choose your adventure timeline, where you can start anywhere in the timeline, but then also stop at any point as well. Where you start in the timeline depends on your cervix favorability, or what is going on with your cervix. Where you end in the timeline depends on what puts you into labor. It could be helpful to have a cervical exam if you know you maybe induced soon, so that you can better plan or understand how your induction may begin!
The first step usually includes some sort of cervical ripening, where the goal is to help the cervix soften so that it can then be more easily manipulated and changed. It’s important to remember that most first time moms will efface before they dilate, so their cervix will get thin and soft before it opens. This is the same for induction; we want the cervix to be soft first.
Then the next step usually includes some sort of mechanical dilation, or forcing the cervix open. In some areas this step and the previous are done together. It is important to note that when you force the cervix to open, your labor hormone levels do not catch up immediately. The labor hormones levels still build gradually, so even though you may finish this step at 5cm dilated, your body doesnt know it’s 5cm yet. So, it may take longer than you think to finally reach 6cm.
The last step can go be either option, and it may vary from birth location to birth location. The first option is synthetic oxytocin, or pitocin, which stimulates contractions. The other option is to break your water, or artificial rupture of membranes, which can also stimulate contractions.
3. Patience
As you can see, there are a lot of steps available in a labor induction. Patience is really important!! If you want to minimize intervention or the number of steps you need to take, you need to take your time with each step and allow each step to try and work. It may take hours with each step!
Focus on setting a labor vibe in your room: dim the lights, quiet voices, soft/relaxing music. Invite labor to come! Setting the vibe can help to encourage your own labor hormone, oxytocin, to release to help bring on contractions.
If you do need pitocin, and have been really patient with your process this entire time, focus on continuing to support your own natural oxytocin release. Things such as keeping that labor vibe, loving touch from your partner such as massage or hugging, can help stimulate oxytocin release to limit how much pitocin you may end up needing!
4. Balance
But you also don’t want to be in a 4-day long labor induction. We need to balance between being patient and taking our time, and also remembering what limitations or restrictions we may be under that could affect our labor in the long run. Things like fatigue/exhaustion and starvation/hunger.
Nothing really happening yet? Will you be able to sleep, or can they prescribe a sleep aid to help you get some rest before you process to the next step? Supporting your energy levels is really important for long labors, especially inductions!
Ask the staff how long they support you eating during labor; continuing to fuel yourself is really important! Is there a certain point when they no longer welcome solid foods, such as after you receive Pitocin or after you receive an epidural? What is the real or actual risk of eating during labor? Read about the labor snacks I had ready for my home birth here.
As a doula, my focus is to help my clients understand what all their options are at each step of an induction; help them navigate when to progress to the next step or when we may want to wait a little longer; and then provide support at every step of the way!
We will be breaking down induction and our approach to it in our labor induction mini-course!
We also break down your options during birth in our childbirth education courses, if you prefer to learn in in a self-paced learning environment!