Elective induction

Nurses General Nursing

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Do any current nurses (ob) have any opinions about the pros and cons of elective induction?

Just doing a presentation on this and would love the input

Thanks!

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
well you can't have an induction without continuous monitoring or an epidural

You definitely can have an induction without an epidural, and even with continuous monitoring, you don't have to be flat on your back in bed. Women can still ambulate in the room, sit on the labor ball, and if the hospital has tele, even walk around the unit. Women who have been induced (even if they have an epidural) do not have to push in the lithotomy position.

I don't disagree with you that inductions increase the risk of C/S, but there are certainly ways to mitigate that, and some of the stuff you said is just not accurate.

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Specializes in Psychiatrics.

My mom has four children...me and my three younger sisters. I was born naturally. My next younger sister was born an emergency c-section due to the fact that she thought she was gonna come out like Geronomo...and come out feet first (this wasn't found out until after she had gone into labor and the doc came in and did the exam and felt toes.....thus an emergency c-section) Sis number 2 was born VBAC and came out fine. Nearly 7 years later.... Baby sis decides to make an appearince.

Through the entire pregnancy mom had issues with her gallbladder. She would get sick, on top of the morning sickness. She would have more and more attacks of pain as the pregnancy progressed. About a week before baby sis was due, the doc advised that she be induced. Mom agreed. She was induced around 8am, at 11am doc broke her bag of waters (2cm dilated), at 11:47 baby sis was born.

Mom said that if she had to do it again, she would not have induced, said that it was the WORST of the four labors that she had......sooo....that's my mom's story....

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You definitely can have an induction without an epidural, and even with continuous monitoring, you don't have to be flat on your back in bed. Women can still ambulate in the room, sit on the labor ball, and if the hospital has tele, even walk around the unit. Women who have been induced (even if they have an epidural) do not have to push in the lithotomy position.

I don't disagree with you that inductions increase the risk of C/S, but there are certainly ways to mitigate that, and some of the stuff you said is just not accurate.

find me the numbers of women who have pitocin inductions without eventual epidurals. Pitocin contrations are more intense and I do not know of any friends that did not have epiduals with an induction. I am not saying inductions are the devil, I had 2 healthy boys -but let's be realistic, most women who choose to have a natural lady partsl birth and not electing to have inductions. How many women are willing to change positions and work with alternate pain therapies? Some will, alot will not.

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"find me the numbers of women who have pitocin inductions without eventual epidurals. Pitocin contrations are more intense and I do not know of any friends that did not have epiduals with an induction"

I had two full inductions with no epidurals...not saying it was fun but I want the credit :)

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Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
find me the numbers of women who have pitocin inductions without eventual epidurals. Pitocin contrations are more intense and I do not know of any friends that did not have epiduals with an induction.

How about me?

Went in on a Sunday at 6pm (41+ weeks) for cervidil and pitocin induction, no epidural. Monday morning did some soaking in the labor tub, some walking, and some labor ball sitting.

Ended up breaking my water manually around noon the next day in order to do internal monitoring -- very irregular decel patterns that they wanted to watch more closely/accurately. Meconium in the water, so they added a flush. (I had no idea that you could have THAT many tubes and wires up your hoohah at one time!) Spent most of the afternoon on my left side, with occasional adjustments when the baby decided to not like that position anymore. Finally ended up doing a c-section with general anesthesia around 6pm (couldn't get an epidural in me in the OR and didn't want to delay any longer).

The brat had the cord around his neck and his foot -- he was basically hog-tied in there. (This explains why he stayed breech the entire time from weeks 19-38, and why the ultrasound tech had trouble finding the cord at 38w.)

My need to have a c-section was not, IMO, related to the induction. In fact, if I hadn't been on continuous monitoring (because of the induction) it's possible we wouldn't have caught his decels at all (they were very sporadic for much of the labor).

Given the way that he was hog-tied in there, I am very glad that we didn't attempt a lady partsl birth (and I am VERY MUCH a pro-natural-birth type person... you should have seen the things I did to try to get him to flip b/c he was breech, just b/c I wanted to avoid a c-section!). I know that often times the cord can be moved out of the way during a lady partsl birth when it's around the neck, but the extra loop around his ankle could have prevented that.

I ended up with a healthy little boy, ten fingers and ten toes and a brain that functions more than adequately (he's 10yo and tests 2 years above grade level in most subjects and 8 years above grade level in science). On the other hand, a girlfriend of mine has a sister who was a "blue baby" back in the early 70s, and to look at her you wouldn't know there's anything wrong with her... until she talks. Her grammar and pronunciation and everything is just fine... she's just dumber than a box of rocks. She's coming up on 40yo and still isn't able to live completely independently.

I thank God that my midwife recognized the danger signs and called in an OB. And my amazing midwife stayed with my husband throughout the surgery, explaining what was going on throughout the procedure and reassuring him that our baby boy was doing well.

Long story short, it is ENTIRELY possible to do a pitocin induction without an epidural. I've BTDT!

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
find me the numbers of women who have pitocin inductions without eventual epidurals. Pitocin contrations are more intense and I do not know of any friends that did not have epiduals with an induction. I am not saying inductions are the devil, I had 2 healthy boys -but let's be realistic, most women who choose to have a natural lady partsl birth and not electing to have inductions. How many women are willing to change positions and work with alternate pain therapies? Some will, alot will not.

Um, I take care of women all.the.time who have inductions without epidurals. About 40% of our patient population are Mexican immigrants, and for the most part, those women do not get epidurals.

A good L&D nurse will suggest position changes and alternate pain therapies. Not all L&D nurses are med pushers, and not all patients want meds, even with inductions.

And since you wanted stats, I just went through the last six months of our delivery log, and approximately half the women who had inductions did NOT get epidurals.

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