Published Mar 25, 2004
Just wanted to ask the nurses a few questions (not medical advice) and I know things are different with each pt and each pregnancy, but if your willing to listen...
I'm 40 weeks, 1-2 cms dialated, baby still floating, have borderline PIH, hx of PIH and toxemia with 1st and 2nd baby, #1 was a csection, #2 VBAC with latened/ prolonged labor. This baby is measuring around 7.5 lbs (I'm overweight if that means anything).
Question... I'm getting induced in the am with Pitocin...(tried cervidil with #1 at 36 weeks and didn't work).. Doc said that if by the evening I wasn't progressing I may need a C section. Didn't say anything about fetal distress or anything at this point. Since I'm not really dialating or anything... with the pitocin be effective?? will this be a one day thing??? or will I be in labor for ever?? Not to sound impatient..how long will it take??
As far as pain control..I'd like an epidural and will wait as long as I can for it. Any input would help.
dawngloves, BSN, RN
I don't know about the other stuff, but I'll tell you this from expereince: Get the epidural ASAP with that Pit! Hurts like a b**ch! Tried to be tough with #1 and lasted 3 hours before I begged for anesthesia to come. With #2 lasted an hour after I thought "Oh yeah! I hurts as much as I remembered"!
i would like more to know how effaced you are...that is a better predictor as to how ripe you are for pitocin induction. if not effaced well, they may choose to ripen your cervix BEFORE pit, to avoid hitting the brick wall of failure that may occur. Pit does NOT ripen a cervix, only makes contractions stronger and more effective to effect dilation. If you are well -effaced, hopefully, it will succeed. I agree about an epidural IF you are worrried about a lot of pain. Pit labor is MUCH more intense than natural labor is as a rule. good luck!
canoehead, BSN, RN
When the doc says, "if you are not progressing by evening you may need a csection" get a little more specific. If the baby and you are doing fine there is no reason to section just because it is evening and he wants to go home.
Amen. Good advice!
These days it is not recommended to use prostaglandins for induction on a VBAC pt. If they are inducing because of your condition, and pitocin is their only option, that may be why their talking csection if the pitocin doesn't work.
However, if your BP's are stable and you don't have other symptoms of preeclampsia during the induction, and you're not progressing (on their time table) it is possible to ask for something to help sleep, and try again the next day. Then again, there is a possibility that since you are a multip, just a little pit will do the trick. :)
If you are planning for an epidural, then by all means get one when you are able. Be prepared though, to have to wait until good labor starts. Good luck.
Keep in mind, YOU are paying him the big bucks. If everything's going well, why not keep going?
No wonder why the c-section rate in this country is so high.
I'll get off my soapbox now and get back to my reading. :)
LadyT618, MSN, APRN, NP
AMEN! AMEN!! AMEN!!! Can't stand these docs who push for sections.....they only do it for them cause they want to go home and it makes their pockets fatter.
OH SHOOT i missed you were doing a VBAC....sorry. It's true, we never ever use prostaglandins on VBAC cases. GOOD POINT!
Had pit w/ 2nd baby -- felt like my labor was driven by the devil himself! It worked though. Would have gotten an epidural but progressed so fast and furious that didn't have time. Same feelings r/t Doc thinking he will need to section if you're "not progressing enough" Spare me! If you're OK, and baby is tolerating well -- he can nap in the Doc's lounge and get his high paid fanny back in the DR when YOU are good and ready to have that baby!!! :) We had a doc who was a big C-section man on Fridays... If you came in on Fri am -- you were pretty likely to have ababy -- ONE WAY OR ANOTHER by 6P.... and hunting season...............HMMM! Just don't let someone determine what is best for you and baby based on social engagements or happy hour!:) Have a beautifu, healthy, fabulous baby and let us know when all is well!
We use Pitocin on VBACs but are just real cautious with it. Our normal protocol is to increase by 2mu q15min. On a VBAC the docs usually do 2mu q30-40 mins and put a cap on high you can go up. I still think though unless you have been sitting at the same dilitation for 4 hours, have high BPs or the baby is in distress you don't have to have a c-section. You already have had a VBAC so you have a "proven pelvis" so to speak.
we use pitocin but NEVER cytotec or other prostaglandins. AND we tend to use IUPC in VBAC cases to be sure we are dosing it right.
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