I recently have a mom who was beginning to take homeopathic tinctures to get her labor going. I asked her why she was considering this induction. She was taken aback by my question. She had no idea she was about to begin an induction. This is not to say she should not have been doing so. Nor do I believe that in most cultures there are things done and items consumed to help get a mom going if she is at the end of her pregnancy. But it made me aware that sometimes we do not know what an induction means.caulophylumcomplex

When you do a web search of induction of labor you will find things like this:

Induction of labor

Web definitions:(obstetrics) inducing the childbirth process artificially by administering oxytocin or by puncturing the amniotic sac.

ACOG states:

Cervical ripening is the first component to labor induction. If the cervix is not sufficiently dilated, then drugs or mechanical cervical dilators should be used to ripen the cervix before labor is induced. Once the cervix is dilated, labor can be induced with oxytocin, membrane stripping, rupture of the amniotic membrane, or nipple stimulation. Misoprostol, a medication for peptic ulcers, is a commonly used off-label drug that both ripens the cervix and induces labor. The ACOG guidelines indicate that inducing labor with misoprostol should be avoided in women who have had even one prior cesarean delivery due to the possibility of uterine rupture (which can be catastrophic).

We understand the risk of medical inductions. The domino effect can often cause a surgical birth to be the outcome when it is rushed and not done gently. But I want you to consider things outside of the medical induction as induction. I believe anything outside of your normal activity or what would be normal for most, is an induction method. And I would then suffice that anything that is not common or natural for your normal activity is a means of inducing.

So, having sex- great sex- can give you prostaglandins (semen) and oxytocin or nipple stimulation (orgasm) – therefore it is not an artificial or unnatural method of induction. Going for a nice walk is normal. Having good oils in your regular diet would also perhaps help to ripen your cervix and would fall in that normal realm. But taking castor oil is probably not something your body is used to having on a regular basis. Taking evening primrose oil is probably not in your regular diet either- although it is not an induction method but can ripen your cervix. Eating papaya, pineapple and eggplant is normal foods- and they are found to be natural cervical ripeners.
Taking a homeopathic like sites like www.gentlebirth.org state:
Cohosh (in my experience) can make lots of uncomfortable toning contractions and false labor sometimes with the risk of raising the blood pressure. Because of this, I suggest another option which is taken orally. Nutritional Formulas make Matrigin. A similar medicine is made by Weleda with a different name-Dolisos Caulophyllum Complex. It is a 5 remedy homeopathic concoction that has reduced the length of labor in a double blind study in France (The Dolisos Study). Women started taking it at the beginning of the ninth month.I have used it for preventing postmaturity and ripening the cervix in a few women who would seem to benefit from that. The remedies in the combination are Arnica, Caulophyllum, Cimicifuga, Pulsatilla and Gelsemium. Perhaps clients seem to fit to the personality/fears/symptoms of a certain remedy, in which case it is better to give a single remedy if a remedy is even warranted. Cimicifuga fears she will die in childbirth, for example. I have turned to caulophyllum in a putzy labor.

But although some folks may take items like arnica for bruising or injuries, it is doubtful that most of you would the other homeopathics on a regular basis. If it is not something you have taken before, remember you could be hyper sensitive to this.

So realize although something may be homeopathic or natural in a sense, it may still be a means of induction. It is not just about breaking the bag of water, putting Pitocin in a woman or giving a medical method of cervical ripening for it to be the only method of inducing a labor. And any method of induction may not be without risks.

This reminded me of weaning a breastfed baby. Many do not realize that putting a pacifier in the baby’s mouth or offering a bottle of breast milk or formula is weaning. You do not need to offer solid foods for it to be weaning.

Make an informed decision.  Do your research. Understand the benefits. Know the risks. Take your birth decisions back and make the right ones for you and for your baby.

Yesterday I received a call from a third time repeat doula client. She felt something different was happening from her normal braxton hicks contractions. She has FAST labors and is 40 minutes from the hospital of choice, so watching and being mindful is imperative for her with two little ones to settle first. She chose to go into the office for a labor check first. So, the exam was inconclusive. She was dilated to 4 cm and was 40% effaced and definitely contracting, but could it be early labor or prodromal labor, who can tell. Oh I forgot to tell you, her usual behavior in labor is to contract without any real pain until transition- then she speedily gives birth. She is a no mess around, get her done kinda birther. So the fact that she is not moaning, not swaying but contacting every 2 to 3 minutes with a firm belly is her normal labor. So she decided to wait around the area of the hospital for another hour and sure enough the pattern became stronger and closer together, so she decided to check into the hospital. Her dad and mother in law were called to come help with the kids and she enlisted me to come meet her and her husband.

I took more than an hour to get there due to the rain and nearing after work traffic but found her the way she is in the middle part of her labor. She would stop and breathe heavy ever so few contractions and then begin to talk and chat about wishing she had eaten more since she was now hungry but feeling a bit nauseous at the same time.  She would sway, stand by the bed, sit in the bed, eventually eat a sandwich and chat. She began to be frustrated with the lack of progress and eventually at the recommendation of the midwife on call, decided to try to sleep. And exam 12 hours after the first one- with another offered somewhere in the middle- showed no further dilation. We had kept hoping that something would break loose and she would be having a baby quickly like the previous times. (more…)

This is something we hear all the time! It is amazing how many women have no idea how many options for birth are out there. Often they sit with me or attend our Meet and Greet and tell me they had no idea that they could choose things like a water birth, a breech birth, twins unmedicated and vaginal, a non induced birth if they go past 40 weeks, VBACs and more. It is amazing to me that we have tried to get the word out but somehow have missed getting it fully out there.

I love that Dr. Brad Bootstaylor, one of the founders for Atlanta Birth Center, says that a good provider will offer you options that are available even if they are not options that are offered where that provider services. Often times women will tell me that they will ask their care provider about things like water birth and midwifery care and the reply is that they do not offer that. And that ends the conversation for many.

Women must educate themselves about their options. We can not rely on our main stream doctors to provide non main stream services. Women must do their own searches for what they want- the internet- their friends- books and magazines.

Here is a great blog radio link to Marsden Wagner speaks on Genna Kirby’s radio station on informed consent. He discussed induction as being one of the most invasive and dangerous things that happen to pregnant women. 40% induction and over 30% cesaerans are way too high and carry huge risks. marsden wagner md

http://www.blogtalkradio.com/progressive…

Dr.Marsden Wagner will be our very special guest on Progressive Parenting. We will be discussing the safety of home birth, and informed choice. He spent 15 years Director, Womens and Childrens Health, World Health Organization

Take responsibility- read- research- listen- watch videos like the Business of Being Born and Orgasmic Birth. Have the birth you desire by taking back your birth! Hire a midwife! Hire a doula! Take non hospital provided classes!

actually happened:

  • mom has taken Birthing in Awareness childbirth preparation with her first child
  • has fast, gentle birth of first child on the day her child chose
  • mom has history of hypertension which is only exasperated with pregnancy each time
  • mom is pregnant again
  • prepares with the FEAR to FREEDOM class and a review of the Birthing in Awareness class they took the first time
  • mom has continued issues that cause her doctors to consider her high risk:  age is one issue, weight is another and her BP is the third
  • hospitalized for tests and passes with flying colors
  • threats of induction only to be dismissed by her perinatologist each time
  • finally the hypertension and fear of placental abruption after all of the physicans now show concern, causes her to enter hospital for induction nine days before her official due date
  • cervidil placed in the evening
  • cervidil removed in the morning with little change
  • baby is high, still bloatable- perhaps as high as -4, so midwife does not want to break her water yet, but pitocin started
  • although told it would be slow management, the midwife says the doctor has ordered active management of pitocin

  • mom does not agree to active – fast pitocin and it is agreed to do it slowly
  • pitocin on all day with no real change
  • doctor comes in and wants to break her water- although baby is still high- mom declines
  • midwife comes in to talk about options, doctor returns to offer his suggestion- still wanting to break the water although baby is high
  • mom and dad discuss things and decline option of breaking the baby or water
  • doctor sends word via midwife he thinks this is a big baby who does not want to enter the pelvis and suggests a cesarean
  • mom and dad decline the idea and instead go with the option of turning everything off and resting for the night
  • by morning although the cervix remains the same, the baby is much lower, now at -1 rather than-3
  • midwife pin pricks the amniotic sac and water leaks slowly out
  • pitocin started back slowly
  • baby is born within two hours of active labor starting, only four hours after pitocin started that morning
  • no pain medications needed- although offered by the midwife about an hour before the birth- mom declined
  • mom and dad ecstatic that their second baby is born without any pain medication- mom says one of the most empowering things she ever has done!

now let’s look at how this normally happens in our area without an educated consumer and perhaps without a doula:

  • mom takes a one day, six hour childbirth class with her first child, probably taught by the hospital which could be how to be a good patient class
  • mom has hypertension and agrees to an induction of her first child
  • gets an epidural due to it being an option that drops her blood pressure and since she is not allowed out of bed due to her BP
  • mom’s history of hypertension is only exasperated with pregnancy each time
  • mom is pregnant again
  • does not further preparation since her first class she found to be of little help
  • mom has continued issues that cause her doctors to consider her high risk- age is one issue, weight is another and her BP is the thrdi
  • hospitalized for tests and falls prey to the fear that her doctor shares and decides to have an induction almost three weeks early
  • cervidil placed in the evening
  • cervidil removed in the morning with little change
  • baby is high but doctor suggests pin prick to break the bag slowly although he does say it could risk breaking abruptly
  • parents do not fully understand the risk of prolapsed cord

here is where things could have drastically changed:

  • cord prolapsed when bag broken since baby was at -3 station and the gush of water carried the cord out
  • immediate cesarean under general anesthesia without her husband by her side

 

or this could have happened:

  • water trickles out and baby moved down
  • pitocin started and brings about cervical change but with increased discomfort
  • mom receives pain medication
  • mom goes on to give birth without incidence but not feeling as empowered as she would have if unmedicated
  • baby born early and needs to go to nursery for observation
  • baby does not nurse well since born 3 weeks prior to due date- officially premature since he did not complete his full 37th week of gestation

or this could have happened:

  • water trickles out
  • pitocin started and brings little or slow change
  • doctor discouraged at the progress the mom is making suggests cesarean
  • mom and dad go to the OR to have their baby

I share this to say, being full informed, knowing what your options are, knowing the questions to ask, having a doula by your side, understanding risks and dangers and knowing that a doctor can not truly predict size or outcome can really make a difference.  The baby that the ultrasound had suggested was probably close to nine pounds was only 8#5ounces, only 7 ounces larger than her first! Patience, asking the right questions, being strong in her desires, having a great support team and the preparation she and her partner did made a huge difference!

My pregnancy was easy with no complications.  I obsessed over natural birth information, took classes, read books, did yoga, and planned on an unmedicated birth. A doula friend said her 2nd choice for natural birth was the midwife practice right up the road.  The practice had 2 midwives and an OB, and delivered at our local hospital, with the wonderful reputation for supporting natural birth.  I LOVED the midwives until I went into labor.  I didn’t think I needed to have a doula, because I felt so confident and relaxed about the process.  I trusted my midwives and the hospital.  I also fully trusted that my body would know what to do when it was time.  I didn’t realize how much I would need someone to advocate for me.  I was naïve.

My due date was Thursday August 11; it came and went.  Wednesday night the 17th – I was up all night with contractions and bloody show.  By morning things had slowed down, so my husband and I went to my scheduled 41 week appointment that morning. 

I saw one of the midwives, M, and she said everything looked great.  She said my fluid felt great, baby was in a great position, and she did not see me needing to be induced.  Said we’d probably have our baby by the weekend. She stripped my membranes, which got me to about 4 cm dilated, and told me to keep doing what I was doing and just wait.  Then she realized we were supposed to have had an ultrasound before we saw her.  So she sent me across the hall so that they could do an assessment of the following 4 areas: fluid; movement; heartbeat; and placenta.  This is where things started to go downhill.  The baby would not move.  She moved all morning, and don’t you know, she moved as soon as we left that office, but when it counted, my girl wouldn’t budge. They also couldn’t measure an “acceptable” amount of amniotic fluid, despite the fact that my experienced midwife could tell by feel that my fluid levels were fine.  They must be able to measure a pocket of a certain size. They couldn’t.  So we failed 2 parts of this test, and scored 4 out of 8 points.  The midwife informed us that they needed to induce.   I started crying.   She said it was not an emergency, and that nothing was wrong.  She told us to go home, eat, do what we needed to do, and then go to the hospital.  She repeatedly said it was not an emergency and that we did not need to rush. (more…)

Recently I was asked to be a part of a prime time special on the risks of inductions. The camera woman, Leona came out to tape me teaching a group of students on the risks of inductions and the real reasons they were sometimes necessary. She ended up also interviewing four of my students and then spent another hour interviewing me. I had also given them the names of another student and one of my doula clients who had been induced previously and wanted to share the ramifications it had caused the child that was the induced birth. Shannon and Tinika did a great job sharing their stories. The show was originally supposed to be a full hour but then it was whittled down to a half hour. I ended up getting two sound bites… but information was shared and that was what was most important. I thought I would share the link with you here so you can watch it and gather some information as well!

Labor of Love Television  Special

Patience: –noun

the quality of being patient,  as the bearing of provocation,annoyance, misfortune, or pain, without complaint, loss of temper, irritation, or the like.

How do you encourage a woman who is bloated, peeing all the time, feeling fat, can’t sleep, getting kankels, hearing rude comments from strangers about how you look like you are gonna pop, feeling so unsexy, afraid of getting stretch marks- or more of them, scared that the baby is only getting bigger and won’t fit, hearing all of the horror stories from “friends” about birth, wanting support and wanting to schedule having help who needs to buy a plane ticket, desiring to stomach sleep again…. and more…. to be patient?
Waiting to go into labor on your own without an induction or without any fiddling on your part or on the doctor’s part is difficult. But birth is not broken. It is a wonderful thing to wake and realize that your baby has chosen their birth date. It is an empowering thing to realize your body knows how to do this without any nudges.
I have been there- ten days post due date each time. I know how she feels. Her fears may be different than mine- but they were there.  So I encourage, support, cry with, pray with, scream with, listen to her vent and complain and love her through the days and weeks up to her baby arrives. And sometimes I go with her to be fiddled with and induced supporting her decision although I keep praying for a gentle birth to occur in spite of the intervention.
Patience- she will learn it either during her pregnancy or soon after when she has that baby in her arms who seems to be inconsolable in the wee hours of the morning. My mantra is “control is merely an illusion, God is in control.” And yes I have that tattooed on me too!
I recently re-read the birth story I wrote after my first daughter was born. My labor was augmented with pitocin because my water had broken and I wasn’t progressing.  If I had had a doula, I think I could have avoided the intervention, but that’s another story.
I wrote:  “So she started the pitocin.  I hated the pitocin.  I hated what it did to me.”

“One of my favorite stories concerns a Buddhist scholar and a Zen Master. The scholar had an extensive background in Buddhist Studies and was an expert on the Nirvana Sutra. He came to study with the master and after making the customary bows, asked her to teach him Zen. Then, he began to talk about his extensive doctrinal background and rambled on and on about the many sutras he had studied.

The master listened patiently and then began to make tea. When it was ready, she poured the tea into the scholar’s cup until it began to overflow and run all over the floor. The scholar saw what was happening and shouted, “Stop, stop! The cup is full; you can’t get anymore in.”

The master stopped pouring and said: “You are like this cup; you are full of ideas about Buddha’s Way. You come and ask for teaching, but your cup is full; I can’t put anything in. Before I can teach you, you’ll have to empty your cup.”

This story is and old one, but it continues to be played out in our lives day-by-day. We are so enamored of our own ideas and opinions and so trapped by our conditioning that we fill ourselves up to the brim and nothing can get in.” http://www.prairiewindzen.org/emptying_your_cup.html (more…)

Tips for Clients
(Ana Hill’s CAPPA training topic)

No complaining about normal discomforts to your care provider- complain to your doula or your friends- but the care provider often feels the need to “fix” it for you with an induction.

Adjusting your expectations about your due date- first time moms are usually pregnant for 41 weeks and a few days, and moms who have given birth before usually go 40 weeks and five days… so remember your due date is a guess date based on a 28 day cycle. Only 4% of moms go into labor on their due date.

Correcting suspect due dates with caregiver- do this early if you do not have a 28 day cycle- advocate for yourself if you know how long your cycle is- share it early on so that is taken into consideration.

No horror stories told or listened to… they affect your mind body connection as well as how your care provider sees you. Don’t listen to the stories and don’t offer up any for him or her to project onto you.

Chiropractor care and prenatal massage is great for helping the baby to be lined up properly. Gail Tully’s website www.spinningbabies.com also offers some great guidelines for aligning your baby for optimal fetal positioning. We also offer a great Line Up Your Baby for Labor class.

Sexual activity- those who stayed sexually active tended to not go postdates. The oxytocin and prostaglandins are wonderful ways to get things going.

Prodromal labor is a problem for many moms who have a malpositioned baby- so optimal fetal positioning is important. But often times it is also some issues that are causing fear that will delay labor beginning and sometimes cause labor to become dysfunctional once it does begin.

Some studies are showing perhaps these things can help:

Vitamin D supplementation- 4000 IU daily is recently been linked to more cesareans and malpositioned babies when the Vitamin D is too low… perhaps considered in the way the pelvis is lubed by doing so…

Fish oil- 400 mg DHA daily…matures baby’s brain and helps the mom prevent PPD.

Protein 80 to 100 grams a day.

Rest and hydration go together… don’t over do in the last week as to go into labor and be exhausted. Some say take your current body weight divided by 2 is the number of ounces you may want to drink of water daily.

Consider your expectations and determine if they are realistic with the birth care you have selected. Perhaps a change of venue and care provider will get you the birth you desire.

Keep in mind induction is not the same as labor. Our bodies being pushed into labor is not the same as our body going into labor on its own. Oxytocin and endorphins work very differently than the drugs used for induction- it does not pass the blood brain barrier. It can be more challenging since it brings on a different labor pattern- contractions much closer a lot sooner- transition lasting longer.

Remember what is controllable and what is not. The method of pain relief may not be as effective. The method of birth may be different. Failed inductions does not mean your body failed. The body’s job is to protect the baby from being born too early. So if your body does not think this baby is really ready to be born, your body will try to work against the induction medicine. Some studies show it may increase your cesarean rate by 50% over the normal rate. So understand what happens if it does not work- you may have a cesarean birth.

Find out what your Bishop score is before you go in so you know what your chances are of an induction that may be smoother.

You can consider acupuncture, a competent herbalist, a chiropractor and a massage therapist. There may be some risks to consider when doing herbal or homeopathic or kitchen sink inductions. It is an oxymoron to say “natural induction.” (these are my therapists- my acupuncturist, chiropractor and massage therapist.)

The bottom line is know what to expect and be a great advocate for yourself prior to going to the hospital for your induction.

Consider these sites if your induction does not go as you had hoped. Solace for Mothers and ICAN.