long labours, inductions, etc ... what is normal?

Just wondering ...

My waters broke around 6pm on a Friday, I was booked in for an induction for 7am on the Monday.

Contractions were ongoing from waters breaking, continually painful from 1am on the Sunday.

Induction actually started around 9am Monday.

Bubba was born just after midnight on the Tuesday morning (2.5 hours of pushing with an epidural, then episiotomy and foreceps).

So my questions:-

1. how long do hospitals normally let you go before induction? I was not positive for GBH.

2. how long do hospitals normally let you push?

3. how long do hospitals let you have painful contractions before intervening?

4. how long do hospitals normally try to get your contractions regular via induction before recommending a c-section or something?

would appreciate your understanding/experience/etc ...

thanks :)

Hey Peanutter,
Hospitals have some differences but are usually roughly similar
Most will want to do something 24 hours after your waters break but are sometimes happy to see how things go for 2-3 days, as long as everyone looks healthy and well (mum and bub)
The clock doesn't start on labour in general until "established labour" which is usually after 3cm dilated. Many midwives will delay finding out if you're "established" as long as possible to delay the ticking clock
Once you are in established labour the key for the timeline is that things are happening. So they like to see you "progressing" even slowly. If it is not happening then hospitals will generally suggest induction. Again they like to see you "progressing" and will usuallly monitor bubs after they go down this path. As long as you are "progressing" and mum and bubs is ok they'll leave you be for a few hours. They will keep turning up the syntocinon every 1/2 and hour for a few hours to see if they can get you into "established" labour. AFter about 4 hours most units would be starting to talk C-section if you still weren't having regular contractions. If you had any other form of induction like gels or ruptured membranes they would first try a syntocinon drip. (As above)
Pushing 2 hours seems to get people twitchy and talking about intervening, but once again, sometimes they don't find out you've been pushing for a while, depending on the experience of your midwife or if there is someone aware of your pushing.

This is a rough recollection of my experience both working on labour units and being a patient
I am not at all agreeing or disagreeing with the timeline, just recollecting it!
Hope that helps. And maybe others will have more info.... hope so. My memory is rather affected by baby rearing and sleep deprivation so am very happy to be corrected too ;)

yeah, my contractions never got "regular" at all - not in 78 hours!

the 2.5 hours of pushing was all with a midwife and a student there, coaching.

a c-section was never suggested, but was mentioned a couple of times in the context of "if xyz doesn't work, we may need to consider a c-section."

"progress" seems to be a very grey area ... at one point, the dr said I was 3-4cms, and the midwife said I was 6!! so not sure how they determined whether I was progressing or not ...

Where I work if your not GBS+ they let you go 18hours after membranes rupture before starting antibiotics. They usually start the induction process by 24hours from spontaneous membran rupture although depending on what else is going on in DS irs not always possible and they won't start the drip after about 5-6pm as then your likely to be looking at delivering when there are alot less staff around. They prefer to start 6am ideally (I work in a larger rural hospital) if your under 37weeks they will try and get the pregnancy a little further along before inducing.

Where I work 2hrs active pushing is allowed. That doesn't neccessarily mean from the first push as it can take a little bit to get the hang of it and if the pushing is not what is seen as effective pushing then they won't start the timing straight away. However by 1hr of active pushing you are then reviewed by your Ob or the registrar if you can not see progression. If progression is obvious and you know it wont be much longer then no need to have the lady reviewed. All of this is provided bubs heartrate is reassuring on CTG or doppler.

Question no3 is very difficult to answer as some women experience this well before they are in established labour. If labour is established it really depends on the progression of labour and that it is progressing even if very slowly and how mum is coping.

Question 4 is also difficult to answer. I'll be back to asnwer that as I have to run out.

thanks - would appreciate all replies!

bump bump ...

My experiences are a little different...

DS1 born 30+1 weeks.
1. I was never induced.
2. Pushed for less than 30 mins.
3. Waters broke at 6:30pm on the 10th of Feb first lot of pain relief was given at approx 8:30pm on the 24th of Feb. Contractions were uncomfortable for the 2 weeks before, becoming VERY painful at 6:30am on the 24th. I was on magnesium drip, antibiotics drip and nefadapine (sp?) to stop contractions and reduce risk of infection and also the risk of CP, ect to bub.
4. No idea, mine were regular from waking up at 6:30am on the 24th, prior to that was referred to as "pre-labour" with irregular uncomfortable contractions.

DS2 born 34+3 weeks.
1. Not induced
2. Pushed less than 30 mins
3. Waters were artificially broken approx 2 hours before he was born. Contractions started at 26 weeks and didn't become regular until 34+2 weeks. I was given pain relief after 7 hours of solid contractions.
4. Again no idea sorry.

Both times I BEGGED for pain relief.

I hope that sort of helps :)

wow, Sally - praise God for your little ones!

that was a very different experience, goodness only knows how you stayed calm and kept your babies safe :)

I was so fixed on just getting through each contraction, I never got around to asking for any pain relief, but took it when it was suggested each time.