Emails To/From Doula on Induction

Email to Doula; Sent: Mon 8/15/2005 9:52 PM
I just wanted to let you know that I am seriously thinking about letting Dr. P induce me in the next day or two. I’m going to sleep on it and make a final decision tomorrow. I have two main reasons for even considering it. I talked to Dr. P today to ask her some of the questions I think I probably have already ask you like could there be a problem and what is the likelihood that my body will never go into labor on its own. She said while it is odd that I haven’t gone into labor already being dilated to 4 and 90% effaced, likely there wasn’t any problem. We talked about the fact that I think I am probably more dilated now than last week because of the cervical mucus. She said I can come in to check, but really there wasn’t a point knowing how dilated I am unless I was going to induce. The risk is that I will labor fast when labor does start especially the more I am dilated. I’m afraid that if this happens I won’t make it to the hospital on time and I am not prepared, nor do I want a home birth or one on the side of the road. The other consideration is that my cousin extended her trip for a week (she lives in Michigan) to help since it appears that labor will come sooner rather than later. The original plan was that she would go home today (about 1 or 2 weeks away from my EDD), then come back to help after the baby is born after getting her kids started in school and I would have a week or two “vacation” of just me time with the house to myself before the baby arrived. But, since it looks like I could go earlier than planned, my cousin was able to adjust her schedule so that she could stay one more week. Having her here would be a big help because I don’t have to worry about a ride to the hospital if things do start to move fast or get dog coverage or getting a ride home from the hospital, etc. Plus, all the help the first few days home from the hospital. If I am going to let Dr P induce, why not do it sooner rather than later when I can have more time with help here. Anyway, maybe I will go into labor tonight and not have to make a decision. Dr. P said she is surprised that I haven’t gone into labor and still things it will be “soon”. This waiting game is more stressful than I thought and is starting to take its toll. I only slept 3 hours last night because I was worried about all of this. Inducing wasn’t part of my original plan, but I am starting to think it may be the better option at this point. I want to see if I get more sleep tonight and way the pro’s and con’s a bit more. I want to make sure that it isn’t lack of sleep clouding my judgment and to make sure if I go this route it isn’t something I will regret since I know once you start medical intervention you likely have to have more following it, chances of C-section go up. I just wanted to let you know I was thinking about it and why. Debbie

Email response from Doula; Sent: Mon 8/15/2005 11:13 PM
I understand your frustration -- the waiting game isn't nearly as much fun as something with the word "game" in it should be ;-) Welcome to my world!

Ask Dr. P what your Bishop Score is. The 4/90 is a good start. Where's your cervix? Where's the baby? Is he in the right position for birth? Ask her what station the baby is at.

I don't think induction is necessarily a bad choice -- I'd like to see you try some natural induction first. I've had several clients have great success with accupuncture or the chiropractic Webster's Technique, which can help the baby settle into a more optimal position, if he's not already positioned with his spine to the left of your bellybutton.

Sleep on it, write a list of pros and cons, and you'll make the decision that's right for you -- or the baby will make the decision for you ;-)

Let me know what you and Dr. P decide :)

See you soon!

Best, T

Email response to Doula; Sent: Tue 8/16/2005 5:47 AM
Yeah, I don’t think I could do your job with all the waiting and uncertainty. I would be stressed out mess. As a program/project manager used to executing against a plan, this process has made me realize how suited I am personality wise to that with a neat organized routine. I knew that I LIKED the structure. I didn’t realize how much it suits me and how stressed I am without it. What will the Bishop Score and Cervix tell me? I’ll ask in a few hours when the office opens. The baby has been in the right position for birth since I was put on bed rest at 34 weeks, head down, spine back, butt right at my belly button mostly to the left side. Last Thursday the head was in the -1 to 0 positions; She said the head was right there with the bag almost hanging out; I was dilated to 4; and my cervix was effaced to 90%. I’ve been trying TONS of natural induction like walking, twice per day for at least 90 min. with the morning one being progressively harder (more hilly up and down) hikes that I had backed away from later in preg; orgasm; nipple stimulation; shopping; massage; house cleaning; sleep deprivation (okay, I didn’t try that it just happenedJ); pretty much anything that has kept me standing or sitting. I don’t think I could be more active. Maybe I’ll call Denise and see if she can get me in tomorrow. I hadn’t thought of acupuncture. I have been seeing my chiropractor (although not in the last week) to make sure everything was in sync and lined up and asked him about the “Webster” technique. He said he was sure he had learned it at some point, but he had been doing it for so long that one technique blended with another and he just used my body as his guide to what needed to be done in any one session. At the last session, he said things were set and ready to go. Anything else you can think of for me to try? Debbie

Doula's Email Response; Sent: Tue 8/16/2005 8:55 AM
Hi :)

In your packet, you should have an index card with an explanation of the Bishop's Score. From what I can tell (with a few pieces of information missing) your score will fall into the "10% failure" category -- that means that an induction will most likely be successful :)

The one thing I thought of as I was tossing and turning is the abdominal lift. Sometimes the baby's butt sort of falls away from your body when you stand, which lifts his head off your cervix. When you take your walk, you might try either just lifting your belly and pulling inwards with your hands and holding it there -- you can also wrap something around your belly after you get it in the right position. To wrap it, you can lay on your back (just long enough to wrap it). When you're on your back, your belly and baby will be in the "right" position. You can wrap a long piece of fabric around your middle and then stand up. It should be snug, but not tight or uncomfortable (it's likely to feel really good, but if not, it should NOT hurt!).

Let me know if Denise can help -- if not, I know others who might be able to help.

And YES, the waiting is what makes most doulas go back to their office jobs! It can be maddening. I have another client who has called saying she's in early labor a couple of times in the last two weeks and neither she nor you has gone into labor, but another client had her twins last week-end with no advanced warning at all! I just never know what's going to happen next :) It's been good for me to learn to not let it stress me out -- I tend to love the organization myself ;-)

See you soon, T

Note: Emails edited to remove OB and Doula's name