What to do when the doctor wants to induce
Monday, September 14, 2009
Lysa Farrell's first child joined the family 40 minutes after her water broke.
The second baby appeared even sooner-in her car, which her husband had urgently parked in front of the Hinsdale Hospital emergency room while he went for help. When the Downers Grove mom became pregnant with her third child, she had only one thought-"I didn't want to have this baby in the house."
After consulting with the midwife who would deliver the baby, Lysa and her husband, Andrew, decided she would be induced at 39 weeks.
Inducing moms-to-be who deliver ultrafast is only one reason doctors and midwives might encourage a mom to go this route. Induction is also used for pregnant women who have gone past their due date or if there are medical complications with either the mom or the baby, says Dr. Nadine Bolger, an obstetrician at Northwestern Memorial Hospital.
The best time to talk to your doctor about being induced is well before the procedure is ever needed. "I think it's important to get a perspective on a doctor's philosophy (about induction) early on, to understand upfront … their timing of inductions and reasons," Bolger says.
If a doctor recommends inducing, have a discussion about the rationale and the method that will be used, as well as what the risks are for a possible failed induction or Cesarean rate.
"If a doctor's recommending induction for medical reasons, there isn't time to wait. But if you're thinking of it more for an elective approach-for instance if other kids and child care issues are in the picture-the doctor may say let's wait a bit," Bolger says.
Once the doctor and soon-to-be parents agree it's time to induce, there are a variety of ways to get things moving. The doctor can soften and dilate the cervix, break the bag of water or administer drugs such as oxytocin or prostaglandins to stimulate contractions, Bolger says. How quickly after that the child is born is variable and depends on how many children the mom has had previously, how far along she is in her pregnancy and how favorable her cervix is at the onset of dilation.
In Farrell's case, her midwife started her on the drug pitocin at 9 a.m.; her baby was born at 2:04 p.m. Although many other moms had warned her of the pain from being induced, Farrell found the pain tolerable with the help of a mild pain-relieving drug. Any pain was outweighed by the more relaxed atmosphere this time around.
"We were in the labor and delivery room; we got to experience it and sign papers and check in," she says. "Before it was, you come in and your baby's delivered. This time it was a little bit more control and the pain was managed very well."