Upcoming induced labour

I am being induced at 37 weeks as my little boy has gastroschisis, so the countdown has well and truly began for me and my DP.

We have known about this condition since my 18wk morphology scan, so thankfully we have had lots of time to research not only the gastroschisis, but induced labour.

I originally thought I would deliver via C-S so was very happy to hear otherwise. I have prepared myself 100% mentally and physically but the closer 37wks become the more questions I have.

I'm wondering things like, what if the baby has not engaged? Can you still be induced? Realistically, how many days will it take to reach active labour? How much stress will this put on the baby? What if my cervix NEVER ripens with the cervadil? The more I think about these things the more likely a C-S seems...

I would love to hear any/ all thoughts about this.

We are being cared for at John Hunter in newcastle (a 6hr return drive) and we are due there tomorrow for an ultrasound. I've also requested that we meet with the OB's so I can sort out some of these questions, and hopefully get a date for the big day!

Thanks for reading.

August x

I dont have the answers u need, but wanted to say goodluck!!!

From what I've heard, if you are delivering at JHH you will have every opportunity to achive the birth you want. If I was in NSW, I'd make a 6 hr round trip to deliver there any day, and I've already told DH that if our next bub is breech we are moving to newcastle.

I don't know about inductions pre-term, and how/whether they differ from post dates inductions, which is what I had. My baby was already engaged too, so I don't have much to offer on that point either. :(

I was incuded with gel at 41+2 weeks. I had period type pains within a half hour. I went home for a bit and was fine. was required back at hossy by 5pm. things started getting more noticeable but not sore, about 7, and by 9:30 I was in pain, andand went to the bath.

I stayed there til 1ish, which i think is where transition might have been. Started pushing around 1:30-2 after some gas, and DS was born at 3:45am He was big though, with a very large (38cm) Head circumference, hence a lot of pushing!

Maybe Alan might have some advice about the incuction thing, and maybe when you have your appt you could ask whether its OK to try natural induction methods as well/before the gel?

With inductions they generally start with the gel and give you a few doses to get things started. If things don't progress quick enough for them, they often want to put a syntocin drip in to get the contractions going. Once you are on the drip, they will want to monitor you closely. Make sure you ask if you can move during monitoring and find different positions you can do when you are connected to things like IV lines. Also ask if you can be taken off the monitor for a period to be able to have a shower etc. If things don't progress with the drip they may want to rupture your membranes (break the waters) to get things moving.

Have a read of the articles on the main site about inductions, I know that they seem biased against inductions, but sometimes there is a medical reason for it & the more informed you are the more you & your partner can make decisions about the induction beforehand.

Goodluck!

Thanks for your replys and well wishes. Yes we are very well looked after at JHH RayRay and I believe we will be supported in achieving the labour we want once things are underway. They use Cervadil at JHH instead of the gel, which I knew about, and break your waters and start the drip when you have started to dilate. I asked about this awhile ago.

Our trip went well and bubs is doing great at 4lbs and measuring perfect for dates. I found out that if the cervadil does not work they will use the balloon thingy which I will read up about more now, and I dont know what else they do, but I got the impression that they will get me into labour come hell or high water! I told the OB DP and I will be using other methods to help us along when the cerdavil is in too, I have also put this in my birthplan.

Thanks again for your replys.

August x

OH great that they tolfd you about the Folleys cathetar, that is what I was going to mention. Not sure how long they will let you go though after they have broken your waters so that might be a worthwhile question for you too. Generally after they have broken them they will only let you go around 24 hours I think. Don't quote me on that though, all places are different.

I was induced at 38 weeks. I had two lots of gels and had to have my waters broken while cervix was still in the way. Pain extreme.

My baby wasn't engaged either.
I was given first lot gels at 8pm then second lot at 6am next morning, waters broken at 12:30 and at 14:14 my son was born unexpectadly.

Good luck and try to get as much rest as possible.

Cruemum, it sounds awful that they would break your waters when your cervix was not favourable. Downright cruel in fact. It did the job quickly I suppose but I'm sure you would still shudder at the thought of what they put you through. Was this with your first bub? I asked about the baby being engaged or not and the the response was that first babies usually engage early...Funny how they can make it all sound so simple, but not answer the question. :wall:

I read up about the folleys cathetar Trish, it doesnt sound too bad I suppose although it would be uncomfortable walking around with a tube hanging out for hours, as opposed to the papery string of the cervadil, so will have to see what happpens.

Everyone I ask at JHH seems to say something different and I'd love to know who actually makes the decisions when it comes to crunch time...

At my next visit I will be 36 weeks and one person said bring your bags just incase, which I'm not so sure about. I really dont want to go there thinking "this is it" and then have to turn around and do it all again a week later....

I wish you all the best for the upcoming birth of your little man, and truely do hope that he is as healthy as he can be. Not sure if you mind me asking so you can just choose not to answer me, do they know how big the opening is in his abdomen ??

No I dont mind you asking, ask away! The opening is not really big at all I'd say only approx 2cm? and is to the right of his belly button, this is going off the usual presentations of gastroschisis though, and not definate. No-one can tell you how big the hole is or how bad the gastroschisis is until bubs is born.

We always try and get them to tell us something but they never can, and that's fair enough. Only my bubs small intestine can be seen. Sometimes it can be other organs like the large intestine and liver too, and in baby girls it can be the ovaries as well.

The gastroschisis can be repaired by either a primary closer or a staged repair. Primary closer means everything fits in first go and is simply closed up. Staged is that it does not fit and the exposed organs are placed in a silo bag and suspended above the bub to be put in bit by bit over a few weeks. Sometimes there is not enough skin so a graft will be done afterwards. Obviously we are hoping for a primary closure!

Then its a matter of giving the bowel time to adjust inside. The baby will be given TPN (IV food) in the meatime, and then his colostrum and breastmilk once the bowels are functioning via tube feeding. Once this is all tolerated, he can go on the boob and hopefully we wont look back after that and will be able to come home.

Sometimes gastroschisis babies need several operations and longer hospital stays. If there is severe damage to the bowel and some needs to be removed, or if they squish it all in and it restricts their other organs or breathing is a couple of examples. Also if the baby picks up any sort of infection in the hospital than that will delay progress.

But we will cross those bridges if we come to them!

Thanks also Caro! Thats very reassuring!

WOW, thanks for all that info. Well, I am hoping too for a primary closure for your little man. Sounds like his opening is only small, so I am guessing that is a huge plus in itself.

Hoping that in the mean time your little man grows nicely and has some fat on him when he's born. I do know that most gastroschisis bubs are on the smaller side.

Goodluck once again and I will keeping a watch on you :)