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Discussion

Vistaril in labor induction

I'm curious, has anyone had a labor induction patient that was prescribed vistaril to help them sleep? At my facility, we have a few midwives that prescribe Vistaril for their inductions, but only if they come in for their scheduled induction on the night shift. Their phone orders include vistaril to aid with sleep, limit their vag exams, and let them sleep instead of walk between their cytotec doses. Has anyone else come across this order? This is my only L&D job so I have nothing to compare it to, but it just seems like these two CNMs only want their patients to sleep so that they (the CNMs) can sleep. Why bring them in for an induction if they want them to sleep through it, couldn't they achieve this at home and save the bed for an actual labor patient?

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At my facility, they don't order Vistaril, they order Ambien for the same reasons. I think it's more for patient comfort. There isn't a whole lot of reasons to wake the provider for a cytotec induction if everything is going well, unless she becomes active. I think patients are generally pretty anxious when there for induction. It's nice for them to get a good nights sleep before the labor starts.

We do not use Vistatil in induction. We DO use it, however, in people in latent labor who are uncomfortable and cannot rest. It helps them get much-needed rest and if they are going to kick into active labor, will let them do so in a more rested state. They either wake up in active labor or at least, have gotten some rest while waiting it all out. This is what we call therapeutic rest.

If a person is being induced/ripened with cytotec, (usually the night before a pitocin induction), she more likely will get Ambien for rest, not Vistaril, in our facility.

Same here: usually use Vistaril for early latent phase and Ambien for overnight cervical ripening. Labor is difficult enough when it starts in a well rested woman. For a woman who has had no sleep before labor even starts, it's even more difficult.

We rarely do it and I wish we did with cytotec pts (we never do anything for latent phase) ... they usually are not active "inductions" in the sense that pit inductions are (most of ours don't do anything labor-wise overnight until pit starts in the morning (which, btw, I wish our MD's would explain... these people come in with their entourages expecting to have a baby in a couple of hours since they are being "induced"!) and it can be really hard to sleep in the hospital, much less being keyed up with "induction". So, ours get no sleep and go into their "real" pit inductions the next mornning exhausted - not a good deal.

How is it going to change what the provider does overnight? It's not going to stop labor if it is really going to become active, & then they are going to have to come anyway, right? So I don't see how it's any different except helping the pt to sleep?

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