Natural methods of inducing

[Kalamazoo Doula]

Okay, here is my question. I have a client who has had issues with pre term labor this pregnancy. She was on turb and pracardia since 17 weeks. She is now 39 wks and her 'due' date is Saturday. Since she has been taken off the meds for contractions, she has for the past month been experiencing fairly strong contractions that have not done much to her cervix. She was checked and stripped last Friday, where she was a stretchy 4cm with a bulgy bag of water. Her cervix is still very posterior. I spent some time with her at the midwives office yesterday while she had a NST, which she failed, and then a ultrasound, which showed every thing to be fine. She is miserable, she has begged her midwife to do something. She still does not want pit, because she know how awful the contractions are with it, but she can't sleep, her feet are huge and puffy, and she is freaking out a bit because the u/s is weighing the baby in at about 9 lbs. (which she understands is not reliable) the baby's father works two hours away, so she does not have much help, since she also has a 4 year old daughter. She is starting to get a bit depressed, and is ready to have this baby. She is shocked that she has gone this far with this pregnancy, since she had her first dd at 35 weeks, and with all the issues of pt labor. She feels very lonely, and I usually talk with her on the phone for a while almost everyday, so we have bonded pretty well!
My questions is (I know, you were about to go crazy with anticipation, huh?) I remember reading in a past post about some natural inductions and augmentations. She has taken some evening primrose oil by mouth and vaginally, she has both cohoshes. Her midwife does not want to do anything official until she is 42 weeks, which is great, but this momma is miserable, I mean miserable! I remember reading, I think it was Tiffany that wrote it, about some inducing belly massage? I would love to hear more about this! Please Please Please! Basically her midwife thinks, since there is so much water, it is holding the baby's head off the cervix, so it is hard to get anything started, so any thoughts?
And if anyone else has any suggestions, I would so appreciate them!

[heathenmamaof5]

Erin,

Hi! When I was pg with my twins I was on bedrest from about week 31 to week 36. After week 36 they let me off bedrest and we thought I would go into labor right away. No such luck! Talk about miserable! We could no longer measure fundal height cuz my uterus couyldn't grow any higher. We started measuring my girth (around) and that showed their growth. I ended up going 38 weeks 4 days.

My point is that just because she was preterm with her last, doesn't mean she will be with subsequent pregnancies.

My midwifes use evening primrose oil with most all their clients. They start them around 36 weeks. Evening primrose oil is used to ripen the cervix. They have moms take it orally, NOT vaginally. My first thought was instead of inserting e.p.o. they should have sex! She's already 4 and stretchy so her cervix IS ripe. There is a chemical reaction when the sperm hits the cervix that might get her going. It could also help move her cervix to an anterior position.

The other thing I felt as I read this moms story was...What is going on emotionally? Is she worried that hubby won't make it to the birth? What else is she worried about? Childcare issues? Pushing out a 9 lb baby? There can be an emotional block going on.

Once I was working with a mom that kept going into lablor then stopping. She was laboring on July 3rd. I said "Wouldn't it be cool to have a July 4th birthday?" She said "Not really. I had something traumatic happen on July 4th" Seems when she was a teenager her family always had a big party on the 4th. Her mom walked in on her step-dad having oral sex with some woman. That was the end of their marriage. This client ended up having her baby July 18th. She couldn't associate having her kid around the 4th of July. It was just too painful emotionally.

If she's 4 and stretchy but posterior. I would look at what's holding her up. I'm curious about what's up with trying to "manage" this birth. Sometimes we need to just give up and give it to God. I also would keep telling her "If you're a 4, you've already done a lot of work! You'll probably go pretty fast." Imagine starting labor at like a 5 or 6. Wouldn't that be awesome! Think of all those women that struggle just to get to a 4...

Just my

Good Luck and let us know!

Jill

[DL]

Hi Erin,

Jill gave you some great information....I DITTO ALL OF IT! Another thing that I'd like to mention is "nipple stimulation". You can read about it here: http://birthingnaturally.net/cn/technique/nipple.html

Something else I have read about is something called "curb walking"; I read about it on a midwife's board. If she lives near a road that has the concrete curbs on the sides, she can walk for a while with one foot up on the curb and the other down on the road. Walk a ways, then turn around and have the opposite foot on the curb/road. I haven't had the opportunity to try this yet with clients, but I think it sounds interesting! Anyway...it can't hurt to try!

Tiffany posted in the Coffee House that she may not be on here until next week, as her parents are visiting her. So if you don't hear from her, that it why. I'd also love to hear more about her "belly massage". Keep us posted on this momma!!!!!

[1stimestar]

Curb walking can also be done going up and down stairs sideways. This is one of the ways to get baby into a good position if she is ansynclitic or malpositioned. I would not be recommending nipple stim or any other forms of induction. Even natural forms can cause the dominoe effect leading to c-section. Example: I had a client who did nipple stim starting on her due date. It caused unproductive contractions, just enough so that she couldn't rest. It wore her out yet she never dilated past 6. Sex can be good as was mentioned in that the sperm softens the cervix. Orgasms can also be a good jump starter. But still, they might get her going when her body or her baby is just not ready. Emotional dystocia is a good idea, yes. I would focus on her emotional state. A lot of these high needs pregnancies go so wrong because women have lost trust in their bodies. After all, she had pre term labor, her body wasn't working "correctly". What is to say it will now? THAT might be what is going through her mind, even subconsciencely. Why is she swelling up? I would focus on trying to do something about that in order for her to be more comfortable. Is she getting enough protien, 80 grms a day? Is she salting her foods to taste? She should be. How is her b/p? Can she go somewhere for a swim?

[DL]

Quote:

Originally Posted by 1stimestar I would not be recommending nipple stim or any other forms of induction. Even natural forms can cause the dominoe effect leading to c-section. Example: I had a client who did nipple stim starting on her due date. It caused unproductive contractions, just enough so that she couldn't rest. It wore her out yet she never dilated past 6. Sex can be good as was mentioned in that the sperm softens the cervix. Orgasms can also be a good jump starter. But still, they might get her going when her body or her baby is just not ready.

I'm not posting to argue Georganne's point at all, as those things can, and sometimes do, happen. It's not a doula's place to recommend doing these things, but to discuss options when Mom is seeking them (and I find that they seek this kind of information often!); that is why I gave the information that I gave in my first post. Just as with any option, Moms should be given all risks/benefits involved so that she is well informed. First and foremost...a doula should try to encourage Mom to speak with her Midwife/physician before doing anything.

As I understand it, and have additionally been told by the CNMs that I work with, these natural forms of induction will only work if Mom is VERY close to starting labor anyway (most of the time, it's in vain as it's just not time yet!). If she is not ready... neither sex with orgasm, nipple stimulation, nor curb walking will push her into labor (although they can possibly kick in some unproductive ctx's as Georganne mentioned). The same goes for membrane stripping. Years ago (before I knew better...and do not condone it now), my membranes were stripped...baby came a whole week later...guess it wasn't time yet! With all that said....I do think that it's best to not mess with induction, 'natural' or not (I educate my clients that way and probably should've been clear in that view in my first post). Baby will come when it's time. I apologize if it sounded as though I was encouraging induction; my intention was to give options since a Mom was seeking them.

[Tiffany]

Hi Erin! Sorry I didn't get back to you sooner about this, I've had my parents visiting at my house this week. I will be sending you a PM shortly about this!

[Kalamazoo Doula]

Thanks for all the advise! I really appreciate it! I totally agree with if the baby aint ready, nothing is going to bring it (unless you put dinamite behind it, such as pitocin).

She ended up having her baby Friday, and it was a bit longer than we both thought that it would be. She had her first baby in about 5 hours. Well this baby took her sweet time! She labored for 16 hours! I just kept reminding her that this is a different baby and different labor.

I'll post a more in depth story later, my dd wants her momma!
Later

[1stimestar]

Quote:

Originally Posted by Doula_Lori I'm not posting to argue Georganne's point at all, as those things can, and sometimes do, happen. It's not a doula's place to recommend doing these things, but to discuss options when Mom is seeking them (and I find that they seek this kind of information often!); that is why I gave the information that I gave in my first post. Just as with any option, Moms should be given all risks/benefits involved so that she is well informed. First and foremost...a doula should try to encourage Mom to speak with her Midwife/physician before doing anything. .

Heh, don't worry about it Lori. That's what these discussion forums are for, sharing ideas, opinions, viewpoints, different ways we operate, as well as plain ol' information. I know sometimes I come across as blunt and don't always take the time to explain myself fully. I am normally trying to play catch up with my email or keep my 4 year old from cutting the hair of every doll in the house lol.

Yes, clients look for these type of induction methods and we can tell them about them, but I really think that even many doulas (not you personally) are not aware of the full "cons" that are involved. You say they wont do anything unless mom is ready to go into labor anyway and yes, I have heard that from some midwives as well. But even unproductive contractions, meaning they do not dilate the cervix, can force a baby into a position that is less then optimal. They can cause high blood pressure as well as other physical problems. Also they can really make the mother question her body's abilitiy and then you have the whole emotional dystocia thing to work around. Here she is, with contractions, why aren't they working? She goes to the hospital because after all, she is having contractions, the nurse finds she is not dilating and here comes the pitocin. Moms CAN just say no, but in reality most of them don't.

When it comes down to a pitocin induced labor vs. stripping the membranes or other of the more non invasive methods, I DO recommend they consider their options and discuss them. But I certainly wouldn't recommend ANY of them unless the baby was 2 weeks past the estimated due date. Anyway, just my ramblings and opinions.

Quote:

Originally Posted by Kalamazoo Doula She ended up having her baby Friday, and it was a bit longer than we both thought that it would be. She had her first baby in about 5 hours. Well this baby took her sweet time! She labored for 16 hours! I just kept reminding her that this is a different baby and different labor.

Oh 16 hours is not long at all. Of course, compared to a 5 hour labor it might have seemed like it.

Hi

My sister is 40+4, and getting extremely uncomfortable. She thinks she had a show early last week, feels as though the babies head is well and truly down, not sure if waters still intact as the other day she was sat down, stood up and the bed was wet!

She is asking for tips on getting things going, unfortunately her boyfriend isn't willing to participate in sex (scared of poking the baby), I experienced exactly the same with my husband in that field!!

She is eating a large amount of fresh pineapple, going for lots of walks, eating every spicy food going, thai, curries etc.

I am flying to UK from Singapore to suprise her on 23 Feb, and would love to see my new niece or nephew, but there again I would love to be at the birth too, maybe the surprise of me just turning up there would kick start everything. My only fear is her going into labour during my 12 hr flight there and frantically trying to get hold of me, hubby has plotted a story along with our live-in helper, lets hope that they can keep it up if needs be!!

Any tips, gratefully appreciated.

[Need2read]

You know she is doing really everything she can. Not to downplay her discomfort but she is only 4 days overdue, she still has a 10 day period before any medical interventions must happen (if she is worried about that) and mom does know best. If she says baby feels pretty well down there baby probably is. My first client was 13 days "late" and she had done everything your sister has. Just trust that baby will come when ready.

I would suggest she talk to baby, sing, encourage baby to meet mom and dad, use a flashlight and hold it toward the bottom of the uterus. Those things won't definitely get labor started but it will keep her connected with baby, and give her something to focus on if she is really getting anxious for baby.

Castor oil is something that may help, but she should check with her care provider first and really consider this as a last resort. (Castor oil loosens the bowels so it can be rather uncomfortable and is not a guarantee)

I just think that it is important to know that the baby actually initiates labor by sending out a hormone/chemical which then does sort of a domino effect to start things so any other remedy she may try doesn't mean labor is going to happen. Baby will come when ready and the best thing to do is just let baby know that he/she is welcome in the world.

Also, I wanted to congratulate you and I hope things go well!

I will be thinking happy thoughts for all of you, and sending her birth vibes!

I'll also that you get there before baby makes his/her entry into the world.

[Kim Trower]

Quote:

Originally Posted by Need2read , she still has a 10 day period before any medical interventions must happen .

curious as to why you used the word must?

[Luv2bemommy]

Well I happened to have went to 42 with all my children. It wasn't fun. LOL Anyways Here is everything I tried..

Nipple Stimulation
pineapple
Walking
sex
bumpy car rides
EPO
red raspberry leaf tea
spicy foods
walking stairs

I even tried jumping up and down for a certain amount of time with my first cause someone told me it would work! Yea, I was a sucker! The EPO and the tea will be good for ripening the cervix and getting her uterus toned and ready.. My midwife told me sex was the best thing other then waiting it out.. Babies have a mind of their own, they will come when they are ready. lol

I think castor oil was the only thing I didn't try and that was cause I was scared the baby would become stressed and pass meconium and I didnt want that to happen, even though with #3 she did anyways..

Good luck hun! I hope she goes into labor soon!

[Gentlebirthmama]

I personally don't like to share those little tips on helping to nudge labor on until a mom is around 41 weeks. After due dates are only guesstimates and we really don't know for sure when that little baby is ready to be on the outside.

Encourage her to walk (although this doesn't bring labor on necessarily), drink plenty of fluids, keep up on good nutrition, get plenty of rest, drink red raspberry leaf tea throughout the day (great uterine toner), take evening primrose oil to help soften or ripen the cervix, and do lots of relaxation during the day.

I wouldn't recommend doing lots of strenuous activity, other than taking walks. She needs to conserve her energy for labor. And unfortunately, bumpy car rides, jumping up and down and any kind of jostling activities will not bring on labor...they may just make mom sore by straining the round ligaments of the uterus.

Before she knows it the baby will be here...encourage her to be patient...after all that's a great virtue as a parent!

[raspberrymoondoula]

oral sex has been known to encourage labor more efficiently than regular sex and i bet her bf would be up for that lol
also have her check out the ten month momma page on birthlove.com i imagine she'll feel a little less 'late'!
let her know that left unhindered the average woman goes into labor at 41.5 weeks, and primips can even be a week after that. also if she's following the brewer diet those mommas tend to go one to two weeks post dates as well. the 40 week date was set by a doctor back in the late 1800's who took an average of women in his practice. i imagine it stands to reason that with better nutrition we would stay pregnant longer these days?
and i'm curious about the "must" too, if momma and baby are healthy why rush things?

[Luv2bemommy]

I agree, I dont understand why OB's are such in a hurry to induce.. I went to 42 and was induced with all mine, even though I had wonderful birthing expierences I would love to know what its really like to have a labor that is all mine, kwim? At that 42 mark though they start telling you things like " the placenta starts breaking down" or " the baby could get to big" which they actually have no way of knowing how big the baby will actually be until he/she is born. I guess I am so used to getting induced I just gave up and let them do it even though I wanted to wait it out. I do wonder though, how long I would actually stay pregnant.. LOL I knew the day I concieved with #3 and she still went to 42 (a day or two before 42 actually)..