Induction craze

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My unit is being overwhelmed by inductions. I work on a LDRP unit and as labor nurses we triage, circulate in the OR, L&D, recovery, early newborn care and occasionally go to the main OR's to monitor pregnant pts undergoing other surgical procedures. Most days there just are not enough of us to go around. We find ourselves spread dangerously thin and inductions really push us over the edge. We have tried putting policies in place to cancel and reschedule inductions that are not medically necessary but now the doctors give diagnosis to make all of them medically necessary by claiming oligo, macrosomia, and early PIH. Are other units finding this to be a problem?

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I see you lost a baby last year and I can bet that is what is weighing heavily on your mind. I would discuss my fears with my doctor and be very upfront with the nursing staff about what you are feeling from hour to hour. Let them be on your side, supporting you by sharing how you feel and your anxieties. They are natural. I have not seen anxiety itself interfere with labor itself starting, but severe anxiety CAN have an adverse effect on the wellbeing of you and your baby. Stress hormones can affect labor and even fetal heart tones at times....yes they can! Consider having a doula with you, if you can. If not, make sure you surround yourself with supportive people who may be relied on to communicate your wishes should you feel you may not be able to or things get rough. That alone can do WONDERS to alleviate stress and anxiety.

If you have not already, begin open and honest dialogue with your doctor or midwife about what is going on with you and be clear on what you do and do not want done (intervention wise) in labor. Most will do anything they can, that is medically sound, to accomodate you if you are assertive and clear. I really wish you the best. May you have a healthy and happy delivery and baby. Do your best to RELAX , starting RIGHT NOW. ((((((((((((HUGS)))))))))))))

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"Do you think I would have a valid reason?"

Oh, Heidi,

Of course you have a valid reason! You body will go into labor, stress or not. But feel free to request an induction as soon as your cervix begins to ripen at all. In fact, if I were you, I would request an NST every other day until you deliver! In my community, our docs would have delivered you at 37 weeks, just for your mental anguish!

Are you keeping a fetal movement record? Are you getting biophysical profiles?

And with all your fears, once reassured by your OB & testing, do some "conscious relaxation" or meditation or yoga to let go of some of that stress! It isn't good for you OR the baby! (remember all those vasoconstrictive hormones released in the flight or fight response?)

I'll say a prayer for you today, too.

Haze

Old L&D nurse

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I wish we had only 3 deliveries a day. 8 inductions on the book as well as scheduled sections and whatever else may come up. Scary, and yes, spread too thin.

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I am a nursing student just browsing here, and I am also 39 weeks pregnant. My last baby died at 5 weeks old, he had Osteogenesis Imperfecta and had many complications. Since I was about 20 weeks with this pregnancy, I have been extremely stressed and in a panic about this baby. I am just so afraid of something happening before she is born, it is interferring with my daily life, I can't eat or sleep, just struggling to get through each day because of this fear. I am afraid I am too stressed and won't be able to go into labor on my own. I would rather not be induced, but am considering asking. Do you think I would have a valid reason? Please be honest.

Heidi

3rd semester ADN student

mother to Anna born 11-5-01

Ethan 5-4-03 to 6-10-03

EDD 6-30-04

Being stressed is not a reason for induction. It will happen when the time is right. We have many docs that induce early for convenience or whatever, and I disagree. Mother nature is a wonderful thing. Has your baby been diagnosed with any problems, such as OI?

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I have been on both sides of this issue, as a nurse and as a mom who was induced.

As a mom, I was induced with my first because I was bleeding, nothing to do with the baby, but my OB thought the babies head was putting pressure on a friable blood vessel. I only bleed after I had been lying down and when I stool up, I gushed. This happened at 36 weeks, OB did amnio to see if babies lungs were ready, but they weren't. Now, mind you the three days I was in the hospital, I had reactive NST, great fetal movement, and the bleeding diminished to nothing. My OB gave me the choice to lie in on the antepartum unit, or go home on bedrest. I chose the bedrest.

At 38 weeks, it was a deja vu' of two weeks before. I got up to go to the BR for my 1am pee, and as soon as I stood up, I gushed again. My OB decided to induce me.

I lost my second baby at 18 weeks.

My OB decided to induce me with my daughter because he wanted to do what I was comfortable with. We have no idea why I lost the second baby, and though it was more for me than his convenience, I also wanted the induction. Whoever said stress is no reason to induce, no flames intended, but if you have never been through the stress of losing a baby, and carrying a subsequent pregnancy, the stress can be maddening near the end. As I said, no flames please, I only speak from my own experience.

My last son, was induced because we lived an hour away from the hospital, and since I was a gravida 4, OB thought induction was appropriate. And honestly, with two other kids at home, I found it much easier to plan for their care when I knew when I would be going in.

Anna'smom, go with your gut! Whatever you decide, my thoughts and prayers are with you!

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NOW, as a nurse...

I have seen OB's throw a hissy fit because THEIR pts couldn't be scheduled for an induction on the date of their choosing. Even had one MD, he was Jewish, schedule his inductions and scheduled inductions on Christmas Day. Same MD, often threaten OB Director he would take his pts to another hospital if he couldn't have his way at this hospital. Same MD often resorted to forceps or vacuums after mom only pushed for about an hour. Now, who was benefitting from that?!? Heaven forbid a mother should have to push more than an hour and screw up his social calendar. Sad part is, the lay person does not know that the forceps and vacuum are not necessary as long as she is making progress with the pushing.

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Thank you for your responses. I have tried to talk with my doctor about how I feel, but she just doesn't seem to understand. I have had a couple of NST's that looked good, and several ultrasounds that show that this baby does not have OI, but once you lose a baby from one thing, I think you become afraid of EVERYTHING. I have also been measuring 4 weeks behind, which worries me. I think if I make it to my 40 week appointment next week, I will ask to be induced. Otherwise I think I will have a nervous breakdown. I haven't really been able to bond to this baby yet, I am so afraid. People ask if I am excited and I say no, I don't know if I get to keep her yet. Getting through this pregnancy has been almost as bad as watching Ethan die.

Heidi

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Anna's Mom, my heart goes out to you. I think you expressed yourself eloquently. Prayers are sent you way for yourself, your new little one to be and your angel in Heaven. Best of luck on the delivery :kiss

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I can only offer online hugs and my best wishes to you...........................my heart goes out to you, as well.

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She was born June 27th, perfectly healthy! Her name is Grace Marie, she was 7 lbs. 3 oz., and 20.5 inches long.

It was very fast, I started having contractions at 1:00 am, and she was born at 3:27 am! When I got to the hospital I was 9 cm. Needless to say, it was all natural.

Heidi

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

congratulations and best wishes!!!!!

:balloons: :)

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Specializes in Telemetry, Case Management.

Congratulations on your new little miracle!!! I am so glad for you that everything went okay, and that you are at home with your new little baby!!! :balloons: :balloons:

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