36+4
I have cold feet about having an induction. Actually, I have cold feet about everything to do with birth. How do people do this?
I just read the MSH policy on induction to get a sense of exactly what will happen (I am a naughty pt) and basically it goes like this:
1. you come in, they do a CTG? and a pessary is inserted, You get vitals 4/24 and a fetal heart 4/24 for 12 hours, and then another vaginal exam. Either your cervix is ripe and your not contracting = you are sent home.
2. If your ripe and contracting and or your water broke you can have a baby.
3. If your still not ripe (oddly, this is the correct terminology : cervical ripeness) or your bishop score is less than ideal, then they will keep you overnight and put in a foleys catheter involving a double balloon (we only use single ones at MSH/SSH - and no pessary) to further ripen the cervix.
If your not contracting after the pessary (and your at home asleep) and or not after the baloon foleys(and your on the ward I assume, as it may have become too late in the night to send you home by the time they get it in (it's the responsibility of the night SRMO or trained midwife to do the procedure) - then at 0600 prompt the next morning they start your IOL. With oxytocin. The rates and fluids of which are not in the policy I read, but I know is something like - their oxytocin is in a bag of saline (odd because we use Hartmanns down the road) and the rates are vastly different - but essentially its the same deal.
There's a CTG
A midwife palps your contractions.
They titrate the rate to your contractions.
Vaginal exam every 4 hours.
That bit is essentially the same more or less.
Apparently all this intervention does not increase the rate of cesarian section but rather, decreases the rate.
Furthermore it states in the policy that more monitoring antenatally - does not reduce the risk of still birth or other complications, rather that having the baby prior to being overdue - especially in older ages(such as >40 yrs old) is what actually reduces the still birth rate.
The policy mentions GDM but does not go into detail there.
I think I feel more satisfied that MICH spends so much effort in ensuring my cervix is ripe prior to commencement of induction rather than focusing only on one thing: can I break your waters? (which I feel is the more SSH/MSH approach with the balloon foleys. There's been times when I've done a VE and the cervix is just hard and thick and I wonder - even though it is 2cm or whatever, and the water is broken, how this would ever turn into a vaginal birth given that we need soft and stretchy.
Also this whole process seems unnaturally drawn out and long. You need to stay "on campus" as the policy states during the pessary insertion - which, with covid, probably means confined to your bedspace/ room. Which sounds helluva boring. I want Pete for the company mostly, rather than anything else.
My cousin's cousin is having an IOL today at SSH and just as I was texting "tell me which midwife and room you have" - my phone literally died -- and I tried to charge the damn thing and it's just not having a bar of it. So I wonder how it all went down. The IOL was for decreased fetal movements, subsequent CTG and 1x dip in babys heart rate, - her cervix wasn't open enough to break the waters and so a foleys was placed and IOL booked for today. Yesterday she was like "any tips Rita" and all I could say was rest up! and get to the hospital early, as soon as they call try and leave right away because the earlier you get there the earlier they can start you.
She's approx 40+2
and then I railed about how we phone women at 6 or 7 am and they dont rock up til 11am and that means we don't start them 'til 1300 which really means PM shift 1315 which means who knows when they'll have their baby.
Oh! and go to bed. You'll need your rest.
She was worried about the pain of an IOL - about being delayed re: epidural because maybe the midwife won't "let her have one".
And today I've been 0 support, stuck at work for 12 hours with no mobile phone just like in the dark ages.
I'll find out what happened when I get home I guess.
I just read the MSH policy on induction to get a sense of exactly what will happen (I am a naughty pt) and basically it goes like this:
1. you come in, they do a CTG? and a pessary is inserted, You get vitals 4/24 and a fetal heart 4/24 for 12 hours, and then another vaginal exam. Either your cervix is ripe and your not contracting = you are sent home.
2. If your ripe and contracting and or your water broke you can have a baby.
3. If your still not ripe (oddly, this is the correct terminology : cervical ripeness) or your bishop score is less than ideal, then they will keep you overnight and put in a foleys catheter involving a double balloon (we only use single ones at MSH/SSH - and no pessary) to further ripen the cervix.
If your not contracting after the pessary (and your at home asleep) and or not after the baloon foleys(and your on the ward I assume, as it may have become too late in the night to send you home by the time they get it in (it's the responsibility of the night SRMO or trained midwife to do the procedure) - then at 0600 prompt the next morning they start your IOL. With oxytocin. The rates and fluids of which are not in the policy I read, but I know is something like - their oxytocin is in a bag of saline (odd because we use Hartmanns down the road) and the rates are vastly different - but essentially its the same deal.
There's a CTG
A midwife palps your contractions.
They titrate the rate to your contractions.
Vaginal exam every 4 hours.
That bit is essentially the same more or less.
Apparently all this intervention does not increase the rate of cesarian section but rather, decreases the rate.
Furthermore it states in the policy that more monitoring antenatally - does not reduce the risk of still birth or other complications, rather that having the baby prior to being overdue - especially in older ages(such as >40 yrs old) is what actually reduces the still birth rate.
The policy mentions GDM but does not go into detail there.
I think I feel more satisfied that MICH spends so much effort in ensuring my cervix is ripe prior to commencement of induction rather than focusing only on one thing: can I break your waters? (which I feel is the more SSH/MSH approach with the balloon foleys. There's been times when I've done a VE and the cervix is just hard and thick and I wonder - even though it is 2cm or whatever, and the water is broken, how this would ever turn into a vaginal birth given that we need soft and stretchy.
Also this whole process seems unnaturally drawn out and long. You need to stay "on campus" as the policy states during the pessary insertion - which, with covid, probably means confined to your bedspace/ room. Which sounds helluva boring. I want Pete for the company mostly, rather than anything else.
My cousin's cousin is having an IOL today at SSH and just as I was texting "tell me which midwife and room you have" - my phone literally died -- and I tried to charge the damn thing and it's just not having a bar of it. So I wonder how it all went down. The IOL was for decreased fetal movements, subsequent CTG and 1x dip in babys heart rate, - her cervix wasn't open enough to break the waters and so a foleys was placed and IOL booked for today. Yesterday she was like "any tips Rita" and all I could say was rest up! and get to the hospital early, as soon as they call try and leave right away because the earlier you get there the earlier they can start you.
She's approx 40+2
and then I railed about how we phone women at 6 or 7 am and they dont rock up til 11am and that means we don't start them 'til 1300 which really means PM shift 1315 which means who knows when they'll have their baby.
Oh! and go to bed. You'll need your rest.
She was worried about the pain of an IOL - about being delayed re: epidural because maybe the midwife won't "let her have one".
And today I've been 0 support, stuck at work for 12 hours with no mobile phone just like in the dark ages.
I'll find out what happened when I get home I guess.