A doula’s guide to Induction: Part 3

This is Part III in my Doula’s Guide to Induction series, where I’ll share lots of tips and tricks for a positive, autonomous induction experience. Make sure to read Part 1 and Part 2 first!

In Part I, we discuss what induction is and how to decide if it’s right for you. In Part II, we talk about how inductions are done, and what to expect and plan for when you’re heading in for an induction.

TIPS AND TRICKS FOR A POSITIVE INDUCTION EXPERIENCE

Inductions can be daunting, but they don’t have to be scary or unmanageable. There are lots of ways an induction can look - it does not have to be a certain way just because you are under the hospital’s guidance. Advocating for yourself (or having your partner or doula ready to advocate for you) is important, as is questioning suggested procedures, and knowing what your options are (use your BRAIN). Here are some additional tips to make your induction experience as enjoyable and oriented to your preferences as possible.

Make your hospital room your own cosy space. 

You are likely to be in the room for a while, so you should plan ahead to make it pleasant and with the comforts of home. Consider: 

• A comfy blanket

• Your own pillow

• Slippers and robe

• Battery operated candles or fairy lights

• Books, magazines, coloring, puzzles

• Your own favorite soap, body wash, shampoo, face cream, moisturizer etc

• Diffuser and aromatherapy oils

• Speaker and playlist

• Your own snacks and drinks

In the same vein, there are actions you can take to make the hospital room less hospital-like. You can:

• Dim lights

• Cover or turn off screens

• Turn down the sounds of the monitors (beeps, alarms, and baby’s heart rate noises)

• Use your own clothes instead of the hospital gown

• Draw the curtain and shut the door

Manage your labor the same way you would had it started on it’s own. 

If you were at home, you’d be using distraction and going about your normal life while in early labor. You’d be moving around, doing things, keeping regular meal times, showering, sleeping. Try to maintain the same rhythm in the hospital. Use movies, books, calling friends or family, crafting - many of the same distraction techniques you would use at home - while in the early stages. If you have the option, go home! Many hospitals can place a foley catheter or give you drugs to start labor and then send you home to rest. This is a great option!

Simply being in a hospital room does not mean you are a patient who needs to lie in bed.

As your labor progresses, you may start to feel uncomfortable, restless, tired or in pain. Use the same coping methods that you would at this stage in normal labor - primarily, by listening to your body and honoring its needs. 

• Use movement to deal with restlessness or discomfort. Use the birth ball, walk around. You don’t need to stay on the bed or sitting down.

• Use massage to release tension and relax your muscles.

• Use heat packs for soreness and comfort.

• Use the bath or shower for pain relief and relaxation.

• Use your breathing, always. To release tension, to get through contractions, to calm down, to focus and center. Always remember your breathing.

• Use the toilet for release and dilation help (the toilet’s other name is the Dilation Station!)

• Make sure to stay hydrated and keep snacking, for energy and sustenance. You can’t do the work of labor while running on empty.

• Help your baby come down and your dilation to progress - use upright positions, movement and stretches that open and soften your pelvis. Breathe baby down. Talk to your baby, encourage them. Tell them it’s time. Work together.

• Rest when you are tired. If you can sleep, take the opportunity. This is important - there’s no point wearing yourself out in the early stages. You need to have energy for active labor and pushing. If it’s only comfortable enough to lay down and not sleep, take that chance too. The nurses or your doula can show you positions to rest in that are beneficial for continued labor progress.

Need a checklist for your hospital bag? I’ve got you.

Get your head in the game.

You know this is going to potentially be a long haul. You know labor is going to challenge you in new ways. Use your affirmations, your confidence and self knowledge to reaffirm what you already know: that you can do this, and that you are doing it. You are strong, and you are bringing your baby into your arms. 

Be real with yourself; you are not going to feel strong and invincible the whole time. You will have moments of overwhelm, you might lose focus or feel exhausted, and you may feel despair or disappointment, or simple frustration and anger. You are human, and the induction experience can be a test of our resolve. It is ok to feel bad - and it is best to let those feelings out. Have a good cry, yell, go to the bathroom and get it all out. Then give yourself a pep talk - or listen to your partner or doula encouraging you - and get back on track. 

Dealing with Pitocin contractions

If you have heard anything about Pitocin already, it is probably that for many people, it makes contractions more painful, to the point of being unbearable. This is true for some, but not for everyone. Each person’s Pitocin experience is individual. Let’s consider the science:

• In spontaneous labor, a huge part of the trigger that starts contractions is oxytocin. This flow of oxytocin is set off when doing happy, loving, comforting things; being intimate with your partner, watching a romantic movie, having a warm conversation with a friend, any positive experience! This flow is backed up by cosy and safe surroundings; dark, quiet bedrooms, warm beds, safe spaces and no mental apprehension or worries. Oxytocin, once flowing, not only sets off and continues the contraction pattern - it acts as a natural pain relief. It blocks your pain receptors so that you don’t feel the intensity of contractions as much.

In this way, it makes sense that a contraction set off by Pitocin can be more intense and felt more strongly - because your body has not had the chance to build up the natural flow of oxytocin beforehand.

So what to do? Try to get your natural oxytocin flowing as much as possible, especially before the Pitocin is started. Cuddle and kiss your partner; talk about fond memories, vacations, special moments between the two of you. Call your sister/mum/best friend/positive person in your life; chat with them about funny or happy moments.  Watch a heartwarming movie. Get cosy; use your blanket and slippers, have a tea and some chocolate, use a heat pack on your shoulders. Really try your best to get loved up and happy. 

If you find you start to feel overwhelmed by the contractions, use all the coping tricks in the book. 

• Water - bath or shower. In the shower, use the flexible shower head to aim the hot water on your lower back.

• Heat - cosy blankets, heat packs on the lower back or lower belly, a hot drink.

• Movement - circles and figure 8s on the birth ball, lunges, swaying, dancing, walking.

• Counter pressure - the double hip squeeze and sacral pressure are very effective during strong contractions.

• Massage - to release tension and relax the muscles in between contractions.

• Mental tools - visualizations, affirmations

Own your decisions and trust your instinct.

You are strong and capable, and you will birth your baby, no question. But you are not super human. If your body is telling you that the pain is too much, if you’re feeling exhausted, if you’re not sure how to continue, or if you simply feel it’s time: it is absolutely 100% ok to say you need help. Help could be:

- An epidural 
- Other pain relief (eg Fentanyl or nitrous oxide)
- Calling in your doula (if they aren’t already with you)
- Advice from the nurse, doctor or midwife 

Making an informed decision based on your instinct is always the right way forward. There is no sense in pushing an exhausted body past its limits, or ignoring your mind telling you that ____ is not an option. There is no failure in induction; any choice you make is for your and your baby’s wellbeing and continued health. It is the right decision if it makes you feel relief, gives you the ability to rest when you need it, or gives you renewed strength or energy. It is also the right thing to listen to your body and your baby; notice the signs they are showing you.

Epidurals

There is a lot of stigma around getting epidurals. Ignore it. Everyone else’s experience is not your experience. It is not a failure to get an epidural, nor is it the “easy way out”. Epidurals can offer tremendous relief, the ability to rest and relax, and even sometimes allow your body to do it’s job of dilating, where otherwise it may have been too tense to do so. Sometimes an epidural is exactly what is needed for your body to progress in labor. There’s no sense being a martyr; if you are considering an epidural and feel that it is the best thing to do, IT IS. Don’t let other’s opinions or your own expectations of yourself get in the way of allowing yourself respite.

At the same time, don’t go into an induction assuming you will need one. You don’t know how your body will respond to the various induction methods; you have every chance of finding that you are able to manage your contractions using other coping methods and tools. Remaining open to however your labor may look is key.

Preserving your energy

The nature of an induction is to be longer and more drawn out than a spontaneous labor. For this reason, it is important to monitor your energy levels and pay attention when your body is telling you it needs to rest. By far, the most energy will be required at the end - during intense active labor, transition and the pushing stage. So if you are worn out too early, you simply won’t have it in you to make it to the finish line. During the initial stages, it’s imperative that you take your rest when you can. Sleep when you are able to, watch movies, take a relaxing bath. If your body offers you a chance to rest, take it. 

Don’t forget that nourishment is also a way to conserve and build energy - make sure you stay hydrated, and keep enough snacks (protein and sugar are best) to keep you feeling good. If you don’t feel like full meals, that’s ok; but small bites (nuts, fruit, honey sticks, crackers) are great, and various drinks other than water (juice, coconut water, Gatorade or broth).

If the induction doesn’t go as planned

In some cases, an induction does not lead to a vaginal birth. Sometimes the baby does not respond well to the induction drugs, and shows distress or a drop in heart rate. Sometimes your own body does not tolerate the drugs well, and you may have side effects or pain. Sometimes, the drugs simply don’t work. There is a limit for how long you can endure rough side effects or how long you wait before you acknowledge that your body is not responding (no improved dilation or baby doesn’t descend). Sometimes a Cesarian Section is the right thing to do, in order for you to bring your baby into your arms. A cesarian is birth, just another variation of it; it can be beautiful, respectful, calm and amazing to see your baby born into your arms after a long time of hard work. It can take time to come to terms with having a c-section be part of your birth story, and might need some processing. This can come in many forms - talking with professionals, journaling, chatting with your doula, partner or friends. Just know that you did what you needed to do to get your baby into the world, and that on its own takes strength and power. You did it, don’t forget that. 

Remember: induction is still birth. 

You are bringing your baby into the world in the way that your body and your baby needs. 

It takes strength, self belief, endurance and persistence, and you can do it. 

You’ve got this. 

Part I - What is Induction? Is it right for you?

Part II - The Induction Process explained

Please note! I’m not a doctor. I’m not here to offer medical advice. The information in this post is to help you build a well-rounded knowledge of inductions so you can make the right decision, along with the advice and guidance of your care provider.

Illustration by Mercedes DeBellard - here’s her instagram and her website