Scheduling Inducing Labor

  1. Hi everyone,

    I'm a student nurse and have a question that relates to me and my family personally.

    My aunt is currently in labor with her first child. Her due date was last week and the doctor said that if she did not start labor by 11:00PM last night (Memorial Day) she was to be admitted to be induced at that time because they felt the baby was growing too big.

    Now, this got me thinking, as medical things are oft to do to nursing students, but I was wondering how labor inductions are scheduled at your facility. I thought it was odd that they would want her to come in at 11:00PM on a holiday. On the plus side, I guess if she starts laboring in the middle of the night hopefully she'll have the baby on day shift when there are more nurses and doc's around and also it will no longer be the Memorial Day Holiday.

    But, I also don't like the idea that she or any woman has to "purposefully" go through labor through the night and early morning.

    After being given drugs she started contractions at 1:00AM this morning. The contractions were coming very close together, every couple minutes, but per my grandmother they have now slowed down and still no baby yet as of noon today (Tuesday).


    Anyway, just wondering how things are done where you live.

    Col
    Last edit by colleen10 on May 27, '03
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  2. 10 Comments

  3. by   Dayray
    Not knowing the specifics, it's hard to say weather or not induction was indicated. It's common for people to be induced when they are past their due date. Usually the concern is not the size of the baby but the function of the placenta.

    Placentas are meant to work for 40 weeks. 42 weeks is about the longest most docs will let a pregnancy go. There is of course debate about this. Some say that post dates aren't a good reason to induce, but standard of care sees it as prudent to induce past 40 weeks and before 42. However, its hard to say if this is the reason your aunt is being induced without knowing her actual due date.

    Going in last night, starting contx at 1 am and not delivering yet sounds normal to me. Where I work we start people out with cytotec q 4 hours times 3 and then start pit 4 hours after the last cytotec so the initial process take 16 hours in most cases. Having contx for several hours without a baby is fine. labor is defined by cervical dilation not contx. We only become concerned if the contx are a minute or less apart or if they are lasting more then 90 seconds.

    It's hard to be in the hospital with nothing else to think about other then contx so it probably seems like they are coming more often then they really are.

    I hope she delivers soon and wish the best for her and her baby
    Last edit by Dayray on May 27, '03
  4. by   SmilingBluEyes
    Not knowing the medical history of your aunt and her pregnancy, I cannot comment on the appropriateness of labor induction. I hope hers was *informed* consent to do this---and I hope hers is a safe, healthy delivery and a beautiful baby. I wish you all the best. Just as an aside, labor inductions are scheduled ALL the time where I work for many reasons. among them are:

    Large-for-dates (diabetic, etc); IUGR (intrauterine growth restricted); post-EDC gestation; low amniotic fluid indices, Worsening of maternal medical conditions such as PIH/Pre-eclamsia, etc. The emerging most-often reason? "SOCIAL".....in any event------

    It's up to the health care provider to inform the expectant family why labor induction is beneficial medically and obtain informed consent to do this. I see "SOCIAL" reasons WAY overused these days; for M.D. convenience AND for Maternal convenience, as well.
  5. by   colleen10
    Thanks for your responses.

    I totally understand why inductions are necessary, just wondering if you schedule them any time of the day or prefer to schedule them at specific times of the day like in the AM, etc.

    From the perspective of the patient I just think it stinks to start an induction at 1:00AM.
  6. by   CoffeeRTC
    I'm not in L&D, but I guess it depends on how far along she is.. is she dialating, effaced? I had to be induced at 36 weeks secondary to toxemia, I went in the hosp around 7 or 8 in the evening...... (ended up having a rushed cesarian) I guess the time they want you in varies..... an induction isn't instant birth.. it takes a while...
  7. by   Dayray
    Most inductions come in at 8 pm and deliver sometime the next day
  8. by   SmilingBluEyes
    we usually schedule pitocin inductions at 0600. cytotec inductions are usually scheduled either early early in the morning or evening time, depending on our census and patient situation..... Just in case you did not know, cytotec is used in advance of pitocin for ripening the cervix for induction.
  9. by   canoehead
    When we used Cytotec in the morning we found that nothing would happen all day and then the woman would deliver in the middle of the night. So we started giving it at night and having the delivery during the day. That may be their reasoning.
  10. by   colleen10
    Thanks for your well wishes and responses everyone.

    After 19 hours of induced labor they finally performed a C-Sect around 8PM last night. She had a baby boy close to 9 lbs.

    I think she and the docs really tried to hold out as long as she could for a Vag. Birth because this will probably be the only child she has due to fertility problems but in the end it just wasn't happening. But everything turned out OK and they are both doing really well.
  11. by   SmilingBluEyes
    Glad to hear it. Best wishes to the family!
  12. by   HazeK
    (400 deliveries/month unit)

    We schedule 8 cases per day...be they c/s, inductions, cerclages, versions, etc.
    These are spread throughout the day, to keep from slamming the staff by trying to do everything at 8am or noon!

    many cervidil or primip inductions are scheduled for evenings...pts then tend to deliver on dayshift following...which makes the MDs happy!

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