Talk to me about pitocin induction?

The wheels in my head are still spinning and I was in tears last night after learning Twin A had turned head down and a vaginal delivery was possible. Poor DH is so confused. Isn't this what I wanted? YES! But I had given up completely on a vaginal birth so I'm not mentally prepared at all. I gave birth to my other 2 kids with a midwife that I adored at 39 weeks. I was induced but with misoprostil and breaking my water so it was much more natural. I didn't have the threat of a c-section hanging over my head so ominously.

This time I have a male high risk OB who may or may not be the delivering doc. I have the concern over whether my cervix is ripe this early? Whether the 2nd twin will cooperate and turn to be born breech or head first? The reality that the OB will stick his whole hand INSIDE my uterus to grab the 2nd twin. OUCH! That twin A could be born easily but if twin B goes into distress, they'll want to do an immediate c/s and I'll end up with the "full meal deal".

I overheard the OB's nurse on the phone with L&D scheduling my induction. She referred to the breech delivery of twin B saying my doc was going to "John Wayne it" WTF does that mean? And then she said "oh yeah, this is going to be fun." What???? Why???? At the appt. yesterday I had to talk him into letting me have a vaginal birth. He's concerned that twin A is more than a pound smaller than twin B but relented because their head measurements are the same and I've given birth to 9lb boys before. Now I am wondering if we made the right choice?

I am scheduled to be induced with pitocin at 35w6d. Is there anything I should do before hand? Cervix ripening stuff? What do I need to know?

PS - I'm really vulnerable right now so careful with the real scary stuff, K? Thanks!

 

I think you are going to be pleasantly surprised! I had pit with all 4 of my deliveries. Sure the contractions can come harder and faster, but you request an epidural ASAP. They don't have to turn the pit up any higher until you aren't feeling the pain!

Your twins are most likely not that big at this point. Mine were born at 36 and 2, and were 5.5 and 5.3 pounds. Having delivered an 8 1/2 pounder before, these babies were nothing! Cassidy was vertex and came out in 2 pushes. Chloe came out butt first after 3 pushes. It was a little harried, as I think many breech deliveries are b/c nobody knows for sure what will happen.... but it was so fast. And my gosh, you have pushed out 9 pounders!

My 8 1/2 pounder was born after 41 weeks and my cervix wasn't ripened at all. Again, everything was okay.

I am going to see if my husband knows exactly what the John Wayne thing is all about, and I'll get back to ya!

My position on this is NO WORRIES!

 

My husband said that the John Wayne remark means they are taking a chance. Really nothing you didn't already know. With a breech delivery there is always the slight chance of a c-section. BUT, you have had 9 pound babies!

 

I just wanted to let you know.. That after my Twin A was born.. My twin B went into distress and i did not need a c section. If you are that nervous... You can still opt for a c section.

Good luck!!

 

Just wondering why they are delivering you so early 35w6d ?

They tried to induce me with Pitocin, tried for two days and I didn't dilate I was 37 weeks, so ended up with C section, but I know lots of people who have been sucessful with pitocin.

Good luck to you.

 

Hmmm....

I would put my foot down and ask for a scheduled C-Section. Plain and simple. But that's just me.

I was induced with pitocin with my first, BUT I was already in active labor. It was to help it move along. Now, I can honestly say that I didn't even know I was having contractions 2m apart when I went it because I was scheduled to be induced anyway. HOWEVER, I do have a high pain tolerance. But once the drip started, I could feel the discomfort very clearly. I had an epidural eventually and that was okay.

I don't understand why your doc would want to induce so early. Anything before 37 weeks is considered premature. So I am confused ... that doesn't make sense to me.

 

I have had pit with a singleton before, and I was 6 cm dilated not in any kind oof active labor. The contrax were harder, but the stuff worked. With twins, I think the OB would be quick to give you anesthesia when you asked for it.

I have a friend who loves to be induced with pit and then gets her epi pretty quick. She swears by it and is up walking around like nothing happened and feeling good quite soon after her labors. She's had four kids that way. . . always blows me away to go visit her afterwards!

I wish a vaginal was my best option this time. I think recovery has got to be more natural and quicker. . .

 

I know I was scared too because of the unknown of delivering twins, but you have made it so far & it will be over soon. I was induced at 38 weeks, baby A was born vaginally, head down, no problem, Baby B was breech & was delivered 6 minutes later by breech extraction and he was bigger than Lila (baby A). It was not an ideal situation but it has been done many, many times and in the end it was all fine. No complications at all and like you I had delivered 9 pound babies before. Out of my 4 pregnancies, I was induced twice & never found the labor to be any different than the times I went into it naturally. Good luck to you, I hope you have a very easy delivery! :hug99:

 

You sound just like I did -- so many hesitations about being induced. The "plan" was to start me on pit on the day of my induction (38w4d) but when I got there I was already dilated to 6cm so they didn't need to. Before these twins, I had delivered 2 of my 4 boys at home (all 4 have been 9+ pound babies) with no epidural and personally haven't been a big fan of epidurals. I talked with my Dr. and he highly suggested that I get one because Baby B was Breech and they were going to be going up inside "up to his elbow and try to manually turn her and it will be very painful".... that was all it took and I opted for the epi -- looking back I am SOOOO glad I did. Baby A (8lb 2oz) was out in 2 pushes and then they attempted to turn Baby B (7lb 2oz) -- I could see the Dr. all red faced and really working hard at getting her to turn but I literally couldn't feel a single thing (and am so grateful :a_smil09: ) They couldn't get her turned so just grabbed a hold of her little feet and literally just pulled her out (I *think* I pushed a tiny bit to help out but they pretty much got her out solo). They were only 4 min. apart and everything went so fast! I thought for sure that after the epidural wore off... I'd be feeling the effects of all that "man-handling" up inside but to my surprise... I had no pain afterwards. I tell you this because before I went in I was soooo scared of not getting Baby B out and needing a C/S or feeling such intense pain and it was completely opposite of what I had been fearing. Things went fairly smooth and I was pretty much pain free.
If your body is used to delivering 8+ pound babies... it will know what to do and I WISH YOU THE BEST! I know it's hard not to worry and fret about it - especially all of the uncertanties.... but try - LOL (I know.. easier said than done!).

 

well... I have only had inductions with singletons so far.. but they suck.. no doubt about it.. the contractions are 10x worse then with my natural labors. I will NOT do an induced labor without an EPI.. And I will do EVERYTHING in my power to avoid a c section..so my plan is to labor naturally as long as both babies are head down and come on their own.. if induced or if baby B is breech.. I will go with the EPI (and will probably request it as soon as I walk in the door..lol). I am prepared for the possible c section.. but I refuse to let that be my only option at this point.

Remember that over all.. no matter what way you deliver.. the most important thing is a healthy mommy with 2 healthy babies.

 

Thanks so much for your replies. My OB is inducing so early because of my pre-eclampsia symptoms. I've been hovering with BP in the 140/90's and urine protein just over 300 since 32 weeks. Now my BP is creeping up to 155/95 but my labs still look good. There is a question too with the growth disparity between the twins, whether Twin A's placenta is working very well and whether the pre-e is affecting her.

In any other situation I would push to delay labor til my body was ready. But after being hospitalized with high BP and getting steroid shots, a tour of the NICU etc. at 32 weeks. Then put on bedrest and monitored twice a week, I feel lucky to have made it this far!

 

I was induced with Addyson because of pree, and I had pitocin...and it was horrible. Sorry! The doctors had to keep upping and downing the pit because my bp would go up. It took me 25 hours to finally have Addyson. It was a really scary time with my bp on the rise and then Addyson's heartrate was dropping, so in the end they had to cut me completely and basically take Addyson out. My doctor scheduled a c-section for 38 weeks when I was only 12 weeks along. He doesn't like risking a vaginal delivery with twins, plus with my previous labor he is just not wanting to risk it all. I didn't have this doctor until after I had Addyson (we were using my husband's insurance, and now I'm using mine).

I hope that you have a great delivery....I know there are plenty that do. So don't stress about the bad, and be optimistic.

 

Both my kids were pit babies. It's not a big deal. You don't need to plan or do anything, it goes in your IV and just makes your contractions harder and faster than without it. (It's synthetic Oxytocin, which is the hormone our bodies naturally produce during labor any way.)

I understood the John Wayne comment to mean that they would "corale" the second baby with external means (pushing from the outside) to make sure baby B moves down into the pelvis in a head down fashion after baby A is out. I could be wrong. LOL That is how my OB explained the process to me. If he does have to reach up in there, you won't notice it as his fist/hand is smaller than the baby that just came out of there any way. That's not to say that the thought isn't weird but it's not something to worry about. In the heat of the moment, chances are you won't notice him doing it any way.

I hope we have allayed some of your fears about this. Don't worry but as PP suggested, ask for the epidural ASAP after the pit, the contractions are a real doozy on it! (My first child was natural w/ pit and I wanted to die. (No epidural offered at that hospital at that time...)

 

Yeah I think I'll get that epi right away. With my other labors, I waited til I had had enough pain so that I could walk around to help labor. With DS2 it took so long for the bolus of fluid to drain that the epi was given 10 mins before he was born! But I CAN'T walk much at all at this point with the twins so why bother? LOL Might as well get the pain meds and let the drugs work.

 

I was induced at 9am and my girls weren't born until 2am the following morning. It wasn't a hard day for me, I just wasn't progressing until they finally broke my water around 6pm, then contractions finally started. I had all back labor though, which is pretty painful, but I was fine after the 2nd epi, yes, I had to have 2 to get it right, but still SOO worth it. I had NO PAIN during delivery! These are my only kids, so I don't have another delivery/labor to compare to, but I didn't think the pitocin was bad at all. I would just ask for the epi as soon as contractions start getting painful.

 

Ok, I am going to share that I too was induced with pitocin a week ago. I too had a baby A head down and a baby B breech. I totally understand where you are coming from. My babies were supposedly measuring within an ounce of each other. The pitocin was not bad, this is my third time having it to induce labor. Just make sure if you are wanting an epideral you ask when you start to feel a little uncomfortable in case it takes a little while for them to get to you. When it came time to deliver, baby A came out and doctor tried to turn B who wouldn't and had to "go fishing" for feet. I had baby B feet first and she was a 1/2 a pound bigger then her sister. From start to finish there was only 7 minutes between the girls births. Just trust in your doctor and know that he is going to do everything to make it a safe and happy delivery to the best of his ability for you and the babies. Good Luck!

Melissa

 

I was induced with Pit for both of my labors. Both were successful. With the twins, they started by braking my water on Baby A and starting Pit. I got the Epi a few hours later. The Epi failed and there was no one to replace it in the middle of the night....so I labored through increasing Pit - OUCH. But I made it. The finally replaced the Epi after 8 hours and I was at 10cm. Pushed Baby A out in a few good pushes. Baby B was happy and didn't want to come out. 1.5 HOURS later, the Dr broker her water and she was born breech in a few minutes. The whole process took about 12 hours start to finish.

The Mag Sulfate they gave me to combat the pre-e complicated things - slowed up my labor in between babies and caused my uterus to be squishy after delivery. I lost a lot of blood but things worked out in the end.

Good luck with your labor and delivery. I hope things go very smoothly.

 

Pitocin= epidural fast.
Its not a pleasant thing without drugs, and lots of them. My OB wanted me to try a vag delivery I laughed at him and said UH NO. In the end mine was emergency c-section anyway, and one was heads up so I was safe.
No matter what you do its more important that they arrive safe.

 

Ok, first take a breath. Then look up your OB's phone number and tall him what you heard the nurse say, and ask for an explaination of what these things mean. Not so much because she should not have saidthese things and you want an apology, which she should not have, at least not within your earshot, but because you want clarification. Ask him what his feeling is in terms of what he would do if you were his wife and these were his babies. Not from a medical standpoint, but from a personal standpoint.

Also, you mentioned that you used a midwife before, so did I, and the expereinece from my first appoinment to my delivery was 100% different. I did end up w/ a c-section even with my midwife, and it was not what any of us wanted or anticipated, but it was not horrible. As a result I had a c-section with the twins too... To much risk and possibility for complication to try vaginal after the first c-section. I can tell you that if I could have I would have done a vaginal delivery. I can also tell you that I did get pitocin for my first after I had gone into labor, and it did make labor more intense, but it didn't work for us, but that doesn't mean it wont for you. If I had not moved to another state I would have tried contacting my midwife for advice about this delivery and tried to have her be a part of it... I am not sure if you have that option, but you might try calling her to talk about your concerns.

Regardless of your delivery you get to meet your babies. I can tell you that after having had one c-section that was totally unexpected and an emergency the second time with the twins was much better. I think that it is because I had prepared myself for the possibility of needing a c-section. If I were in your shoes I would listen to what the doctors say, most likely try for a vaginal delivery, and prepare for the possibility of needing a c-section for one or both babies. Just know that no matter how hard you try to plan things with birth rarely go the way you plan, but as long as the end result provides you with your babies it does not matter how they arrive! Good luck and congratulations!

 

I have no idea how these girls are going to come into the world. Today at my NST and cervix check, Baby A had shifted to the side and her head is no longer in my pelvis. I'm 1 cm dilated but with no head to push down, all bets are off for an induction. We'll just have to wait and see what's up on Monday. At this point I just want them OUT! LOL