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    May 08
    2009

    Foley Balloon for Induction

    Archived User

    The baby is head down now and I am officially 41 weeks pregnant.  I truly was hoping to avoid pitocin this time and am still hoping, hoping, hoping for it.  They did an ultrasound today and the baby looks great - fluid, movement, etc are all great so they are okay with me going to 42 weeks, but they just don't allow more time than that in this practice.  They really have been wonderful the past few weeks and have not pushed for intervention as a whole.  Most of the doctors in this practice are known to be "slow to cut". 

    So, the suggested method of induciton has been to have me come for an appointment on Thursday afternoon and insert a Foley balloon.  I have never heard of this and this is my fourth child (first three were all induced with pitocin).  They are hoping that it will stimulate labor on its own, but if it doesn't, it will just make me more favorable for pitocin, which they have me scheduled to begn on Friday morning.

    I have never heard of this method and wonder if anyone knows anything about it?  It sounds very natural in comparison to a straight start on pitocin.

     

    Char

    Henci Goer

    Inserting a Foley catheter has been around for awhile. It is a "mechanical means" of cervical ripening and labor induction as opposed to a chemical means. The Cochrane Library, a well-respected database of reviews of the medical literature, has a review on mechanical means of induction. As you can see, mechanical techniques of cervical ripening are less likely to cause overly strong contractions than chemical cervical ripeners/induction agents.

    Here's hoping you go into labor on your own, but if you end up needing Pitocin, once you get into active progressive labor, they can turn the Pitocin drip off and see if labor continues on its own. Oftentimes, especially in women who have had babies before, it will. Pitocin's effects wear off quickly, so it won't take long to tell if you are now perking along on your own or contractions are trailing off. If they are, they can just turn the drip back on. Your care providers may not have heard of this, so it would be best to arrange it ahead of time. 

    -- Henci 

    Archived User

    Thanks so  much for the info., Henci.  I appreciate your reply.

    I don't know whether to say fortunatley or unfortunately, but I never made it that far.  Our son was born on May 10th, our little Mother's day present

    It was a very difficult situation and for the first time every I am thankful for medical technology and intervention.  I ended up with a c-section and everyone involved is convinced he would have never lived through a vaginal delivery.  I went into labor on my own, but only because I had a nasty placenta infection that had also set into his cord (didn't know about the infection until after the delivery).  When I arrived at the hospital, I was running a fever and our baby was in heavy distress - a very elevated heartrate that dropped extremely low with each contraction.  My doctor was wonderful.  She tried to avoid a c-section by breaking my water and speeding labor up.  I had a huge excess of fluid, it was also filled with meconium.  He was also still very high and I was only dilated to a 3.  My doctor said that sometimes when there is stress the mother's body will progress very quickly, so she truly wanted to give it some time before a section.  When she checked me an hour later, even with very hard contractions every two minutes, I had no progress whatsoever.  We didn't know about the infection then, but infections can keep the body from progressing.  This is probably why I had contractions every 2 minutes for hours with not progress.  By this point, His heartrate was not only dropping but briefly stopping at times.  We went ahead with the c-section.  I really don't think we had much time left as he came out with an apgar of 1, was completely blue, unresponsive and barely had a pulse.  Thank God, he recovered very quickly and didn't even end up in NICU at all.  We also found that he had a true tight knot in his cord and his cord was wrapped around his little neck.  He had so many things against him and we are just so thankful to have him with us.  A c-section was not fun, but I feel a peace about it because it wasn't out of convenience or simply because of a slow labor, etc.  I feel that it was truly necessary in this case.  Surprisingly, my doctor is one that is willing to do a VBAC, but by policy I must go into labor on my own by 41 weeks.  They will not allow pitocin with a VBAC.  Since I have never gone into labor on my own by 41 weeks, I doubt it will be an option for me, but I will do some research into it if we decide to have more children.

    I just want to thank you for all your answers to my questions concerning induction. 

    Char  

     

    Henci Goer

    I am glad you and your son are safe and sound but sorry that the birth was so difficult. Thank you for sharing your story. It is an example of the care women ought to get when things go wrong: a doctor who tries to avoid a cesarean, a cesarean where the benefits clearly outweigh the risks, and a woman who is a full participant in the decisions that are made. Your ob sounds like a gem. I encourage you to fill out a survey on the Birth Survey website so that others who live in your community can find her.

    Just in case no one has said this already, while it is true that the most important thing is a healthy baby, it is not the only thing. Feeling grateful and relieved that the baby is healthy does not mean you cannot also feel angry or sad that the birth turned out so differently from what you had hoped. Negative feelings are normal too.

    Also, some women who have been through a birth such as yours experience symptoms of emotional trauma in the aftermath just as a soldier who has been in combat would. Typical symptoms are intrusive memories, flashbacks, nightmares, hypervigilance--feeling anxious and nervous. Unfortunately, few mental health professionals are aware of post traumatic stress symptoms resulting from traumatic births, but one place you can go for peer support if you are feeling the need is Solace for Mothers.

    Speaking of soldiers in combat, I also want to honor your courage and self-sacrifice. We give soldiers who are wounded rescuing a comrade from danger medals. Submitting to surgery to rescue your baby is no different.

    As for needing to go into labor by 41 weeks to have a VBAC, the research does not support that. Your ob is right that inducing labor can increase risk of symptomatic scar separation, but the reason women are more likely to have scar problems after 41 weeks is because they are more likely to be induced. Women going beyond 41 completed weeks who began labor spontaneously are not at extra risk. Hang onto that thought for now, and I'll be happy to provide the research sources that support it when you are ready for it.

    -- Henci

     

    Archived User

    Henci,

    Thanks for the kind words and for the website link.

    I must say, after this experience, I don't see why some women choose a c section.  I had three horribly long, induced labors with no epidural and they were far better than the c section.  I can't imagine going through it as a new mom.  I can see why bonding, nursing etc could be more difficult.  A new mom is already overwhelmed with taking care of a newborn for the first time, I can't imagine adding to that the pain and discomfort of a c section.  Also, for the first time I feel blah - like I could be on the edge of post partum depression.  I never really felt that afer my three vaginal deliveries.  I know that some women struggle with it even after a vaginal delivery, but this is unusual for me.  

    If we decide on a fifth, I will contact you for your research on VBAC deliveries.  I would be interested in the statistics, etc.  Another c section is just not very appealing right now.

     

    Thanks again,

    Char

     

     

     

    Henci Goer

    It makes me so angry when obstetricians "sell" cesareans to women as no big deal, a "chocolate vs. vanilla" decision, because, of course, it is major surgery with everything that entails. I wish you a speedy recovery.

    -- Henci


    All Times America/New_York

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