How often does induction lead to epidurals?

Just wondering if anyone has a guestimate of how often induced labour (with Syntocinin in my case) leads to use of epidural?

My labour was induced two days after my waters broke (another question - why does labour sometimes not start after your waters break?), I think they used low dose Syntocinin, coz the contractions were still five-minutely after about 3 hours, which was when I asked for an epidural coz I was so tired (after having sporadic contractions for more than two days prior). It seems like this is a reasonably common story.

I guess I'd like to have some hope for having an active labour and unassisted birth if I need to be induced next time around.

Hey firsttimemum2007

epidurals associated with inductions depends on many factors...

• how 'ready' your body is for labor
• your labor support
• your preparation for labor and birth
• availability of epidural

I dont have figures, but alot of women who have inductions (specifically syntocinon) do have some form of pain relief...first time mums in particular have a high epidural rate, as the intensity of labor hits hard and fast, but may still last a good few hours

having contractions every 5 minutes is good...gives you and the baby time in between contractions to chill out and re energise...the hurry to get labor happening and the baby born is what often occurs in a hospital setting and leads to the 'cascade of intervention'

when your waters break...if your baby is an optimal position in the pelvis, their head will sit on the cervix promoting the release of hormones and giving the cervix the helping hand of gravity. If the baby is not in an optimal position, such as posterior, then you dont get these factors to help kick start labor

every labor and birth is different for every woman...so dont worry to much about the what if's :) focus instead on what you want for this birth and make it happen ;) there are lots of posts on active birth etc

hope this helps

xx yogababy

I was induced with my first and didn't feel the need at all to have an epidural. I had gas and peth though(but didnt ask for the peth). Having now had an induced labour and a spontanious one i can see why induced labour can lead to epidurals more because the contractions are way more painful and come on so strong to start with, where as with a spontanious one they ease into it so give you time to get use to them.

Having said that i did have an epidural for my second labour but only because i had been labouring for some 30 hours and was extremely tired, double that with a posterior labour and having to be augmented for the last 7 hours. But i had a trouble free birth which i believe was due to not being induced and also being totally prepared and way more knowledgable. Unlike the one i had induced which was just a spiral of intervention - peth which made me tired, laying on bed, couldn't push because too tired from peth, baby stuck, vacuum extraction, baby needed help to breath...

So having said all that i think it is really all about researching, knowing your options, and just going with what you believe in and want. So if you want to be active then believe in yourself that you can be and don't let anyone take that away from you. Sure being induced can mean minimal activity but you could say you only want minimal time on the bed etc and say you want to move around etc. It's your body, your baby, your choice. they can't really make you not be active in your labour. So just read up on active labours and go in there with your head held high and know in your heart that anything is acheiveable if you believe in it.

ETA: I would also look into getting a doula. You can befefit so much from them and they will help you to acheive the birth that you want.

I have been induced twice with syntocin and have never had an epidural. I agree with antheia's description exactly on how it feels but I survived the 1st one on gas and peth (she was posterior and ended up being forceps too) and DS I just has gas.

Depends how you are induced too.... with the synt your body is pumped full of synthetic oxytocin at an unnatural rate - especially if you are in early labour, your body isnt designed to handle intense and fast labour at that point. Personally I have only supported one client who had synt with no pain relief. The rest had peth or an epi but then again, I haven't supported too many clients who have been induced/augmented with synt. I had synt and an epi with my first (as did a friend of mine) and I know the rates of women who do have an epi are very high.

Your waters may not break first this time - you may go straight into contractions. When labour doesn't start after waters rupturing the first thing that comes to my mind is the baby's position and or the body/baby not being ready.

A great book to read is the Thinking Woman's Guide to a Better Birth by Henci Goer.

I had an induction labour - waters were broken @ 10am and then the syntocion at 11am. They gave me the peth around 11:30 and that was my only pain relief other than my "TENS" machine. During stitches (cheeky bugger came out with his hand on his chin!) I had gas, and that was it.

However I was very mobile - I birthed standing up and had moved around the room, had a bath etc - so don't know much that affected things.

I was induced with syntocin (my waters had already broken), and asked for an epidural a few hours later... the transition from no pain, to full on contractions within an hour or two was just too much for me to cope with...

I was induced after my I had a hind water leak and couldn't establish labour. I had spirous contraction for about 30 hours after the leak before my induction was started. I was given synto and an ARM. I had no pharmological pain relief. I was on the birth ball and lived in the shower.

I was induced early due to pre eclampsia and I did not have any drugs at all. I was 1cm, had ARM and then syntocin in a drip that gave me contractions 5min apart from word go, then they progressed to 1min apart after about a half hour. So it is doable, just depends on the person and the labour itself. I was very lucky mine was quick and managable.

Nothing wrong with having an epidural, esp in a full on fast paced induced labour.

Yes but I know most people would avoid an epidural if they can, as it leads to more likely instrumental birth, more likely posterior babes etc. I don't know anyone who would say that they would prefer an instrumental birth if they could choose so. If inductions can be avoided in the first place that would be great, but of course, sometimes they are needed and its then that we accept it. But the problem is these days, and as you will see in the Ricki Lake doco, is too many consumers being led to believe they need it when they don't.... of course cases like PE yes but I am talking other things.

My waters broke on their, but labour did not start, and my bp was rising, along with Nina's heartrate dropping, so I was induced with the drip. Within 2 minutes labour had started, and I had contractions 2 minutes apart for the entire labour. Nina was also in posterior labour. After 7 hours and no pain relief, I tried the pethadine, which didn't work, then had an epidural. Nina was born an hour after having the epidural go in. As it wasn't in for very long, I was able to walk around an hour after she was born.

ETA: I would have loved to have a drug-free birth, and still feel to this day I caved in with the drugs. I still regret having the epidural.

I agree. There needs to be something put in place to say that you should only be induced if absoltely necessary. Like what they have done with elective c/sections.

My first was augmented with syntocinin (waters broke on their own and everything stalled) and I managed with no pain relief. Definitely doable, but like everyone says, depends on each individual labour. I think being augmented and being induced from 'nothing' makes a big difference, at least I know my baby & body were somewhat ready to give birth coz the first part of the labour had been spontaneous.

Labour this time was very different tho.. was almost twiddling my thumbs between contractions! LOL. I couldn't believe how much time there was between contractions so far into the labour! Very different to having the drip - the drip definitely brings them on close together, you don't really get a break.

Everyone's uterus is different and tolerates different levels of drugs. I was actually augmented with Marisa, my labour stalled at 5cms. I had my waters broken, there was mec so they put the drip up right away. I felt like I was levitating in pain, tears and swearing, so obviously my uterus was very sensitive to it. I don't think I needed as high dose as I was given. But they like to pump it up every half hour... and like my client this week, she got into labour quickly and was having 4 contractions in 10 minutes which is not normal for 1.5cms. So she had to put up with those contrax for hours until they found it wasn't doing anything... then put in the epi and pumped up the drip... she couldn't feel it but the baby could! Got stressed and was sectioned.

Caro this wasn't an attack or judgement on you. This is also not an attack or judgement on those who have inductions for severe depression or anxiety or other psychological reasons. But there are PLENTY of unnneccessary inductions going on and you don't have to look far and you will see many Obs saying in the media that they are being done for litigous reasons. Christine Tippett is one who has just gone down as saying that there are unneceasareans being done for that same reason....

Answer to all this is seeing midwives who are specialists in normal pregnancy so there isn't the litigous reasons going on - then Obs really do see those women who do have problems. They should not be caring for normal birth - as the Ricki Lake doco says, they can see pathology where it doesn't exist. Very complex but anyway, see the doco if you get a chance, because if I am a looney, so is Ricki :) And disclaimer - yes I know - not all Obs are like this. But the vast majority are practicising defensive medicine.

Youve made good points Kelly, I must say my labour was pretty intense (not that I had comparison) and given the option it would have been nice to go on my own. This time round it looks like I just might but with the way things are progressing I will have to make the choice to induce to ensure we both come through this ok if I get close to term. Ive come to terms with the fact that going natural is not the way mother nature intended for my birthings to be but I still have awesome ones anyway!

That said I think alot of the problems have to do with a) people taking the word of an OB as gospel and not being informed enough themselves and b) not choosing the right OB for them. Both my OBs have been fantastic and I cant recommend or thank them enough, it feels weird to me that people are so anti-OB. Guess Ive gotten lucky!

I wish I could see that documentary, even though I have medical, intervened births I agree with what theyre doing and am all for it! It sucks being in the country, always miss out on everything. Do you know if theyre releasing it on DVD at all?

Exactly the same reasons as a c/s Caro.

My last client had a midwife come in and say, 'Well it's been xxx hours now since the waters were broken and there have been no contractions, you have to think about you now, you will be exhausted if you keep going and you go into labour overnight. You have to remember that labour is on average 12 hours. So you could be going all night..'

Well a) don't most people go into labour overnight anyway and
b) if she wasn't actually in labour then it was like any other day for her - not like she was labouring at the time - she could have slept, kept trying to get labour going... but nope... there is this thing the medical system have called 'failure to wait' not 'failure to progress'.... see how it all gets put on the mother and she feels like her body failed? She has a crap experience and thinks its her body that couldn't get into labour? And as a result has that drip and all the rest happened with it - she had the epi and the c/s. Or she now thinks that thank god I was in hospital, I needed all that intervention when it all could have been avoided. Sure could have gone that way anyway - but also could have been completely different too if left alone.

I wouldn't say you need a skilled Ob to avoid c/s - just a supportive one who has the woman's best interests at heart...

See Obs are trained surgeons, and they are great at that and I think they should be to help with REAL crisises - again to quote from the movie, as one woman said, yes we are very grateful to have them - they should be doing it all day, every day on women who need them. But not women who don't. They have too much of a role in the medical system... like I have said before, its like seeing ENT specialists everytime we have a cold. Colds are normal, we all get them, they aren't harmful so it's overkill seeing a specialist.

Also Obs are now in such demand being a mainstream option that they are tired and overworked. Being at births for long hours myself and feeling exhausted, I can see the temptation for them to want to do inductions/epis/caesars... so why don't we ease their load by allowing midwives for primary care where they are wanted? I wish the government would listen.

some great comments here

Jodi
please dont feel like a failure because you had an epidural....we all do what we can at the time and do what we feel is right...I had an epidural with my first, and was bitterly disappointed with myself with the whole experience. @nd time round I worked with what I really wanted...and got it...bit of gas and bath

in regards to epidurals, inductions and c/s I agree that there is a tendency for Ob's to move things along, often before the woman has a chance to even get into active labor...stressing the mother, baby and leading to a range of intervention

but...lets remember that the Ob's are doing what they believe is in the best interest for mother & baby...and the way around all of this of course is for women to be empowered and be informed of what the impact of choices in pregnancy and labor :)...education

I know its hard...remember I work(ed) in the system, so I do really know what goes on...but many couples go into labor and birth without preparing and turn themselves over to the system...I have worked hard on many occaisions to work with a woman in natural labor, only for her to swing immediately to anything the doctor says and end up with a range of medical intervention that was not necessary, because of fear perhaps and the feeling of 'he or she' will make it better for me...sigh

so what am I saying...it is really important for couples to educate themselves about their options of labor/birth...and that often means finding a private educator...once the couple is empowered and confident with their choices, then intervention levels are reduced and rates of natural birth will increase

we need to reduce the fear associated with birth...which is what BB is all about :)...something I work towards every day...birth is birth, its giving women the knowledge and confidence to welcome their baby's with happiness, and enjoyment

:)
xx yogababy

About the govt Caro - yes possibly... but it takes more than a few to make change... and while the majoity of consumers don't think or realise there needs to be change, then things will be slow!

YB - Have you seen the doco? It is going to be in Perth I believe!

no I havent :( and yes it is going to be in Perth...but I wont be able to attend

Oh no!!! Maybe you can contact whose doing it and either hold your own or ask them if you could have a sneak preview :)

Thankyou for this very good discussion on inductions. As I wrote in another thread I had an awful experience with induction last time around (I wrote pictocin because I couldn't remember the name of teh drip stuff and that was what the thread called it, but now remember after reading it here it was definitely syntocin that I had).

Quick rundown of my labour:
* hind waters waters broke naturally two days before inducement
* went in for induction at 41+3
* started with forewaters broken by ob which started gentle contractions
* I was happily wandering around the yard, labouruing actively as I had hoped for when the ob assessed me again and decided syntocin had to be given as things weren't happening fast enough
* no sooner was the drip put in the contractions came hard and fast, no more than 3 mins apart to start with and got closer as the day went on, so that as soon as one waned the next began with about 30seconds to a minute down time.
* cervix started swelling and counterracetd dilation
* pain got intense and by lunchtime I couldn't handle it with just breathing/relaxation techniques. I started throwing up and thought that meant baby was near but lost focus when told I was still just 3cm (as I had been when I came in at 6am that morning).
* I took gas for a while which helped me focus my breathing more than anything - it was turned right down.
* I got told off for moaning (the pain was so intense) as I still "had a long way to go"
* Was encouraged to take pethedine after having wanted only gas if REALLY needed, as they kept turnuing the drip up and my cervix kept swelling
* When the peth wore off, I was told to have an epi or risk c/s under general as my cervix was so swollen and no progression.
* Reluctantly took the epi to try and have bub vaginally
* His heart rate dropped dramatically and the m/w kept prodding me to "make him wake up". They realised that the epi dose had been too strong for me so when they went to top it up hours later, they only gave me 3rd the dose (thank goodness) but bub's heartrate was still very low.
* Finally he engaged and I was ready to push, this bit was quick and really easy - two pushes and he was out, but had the cord round his neck twice so it was cut betwen push one and push two, and he was born at 11pm (17hrs since my hospital admission) with meconium all over him and whisked away for recsusitation and kept in a humidicrib for two days (no taking out for cuddles of bf'ing) as his oxygen levels were too low.

It was a long, hard, painful and scary journey. I had felt I had gone into it fairly educated and without fear (had been practising hypnobirthing techniques and affirmations that when the time came my body would know what to do). I had known it would be painful so when the pain came I told myself that the pain was good as it meant things were happening and my body was birthing my baby. But everytime I was told nothing was happening I was disheartened and started to become weak in myself and my belief in my body. If I hadv'e laboured longer I wonder if I'd still have DS, so perhaps what was done was for the best, but for months after I couldn't help the feeling that my body was a failure, and useless, not even able to do what it was made to do and birth my baby naturally. I am afraid this time around, and know that for natural birthing to be a possibility, I need to release my fears and trust my body, but I find it hard to when it failed me so badly last time. I wish I knew what I could do differently this time to make it work how it should and have a smoother labour and better bond with my baby in those early days. Any advice?

Hi Jgal
Given how slowly you progressed and how intense the experience was, I'm really amazed at how you managed without peth/epidural for so long. It also sounds like you were really well informed and prepared - but unfortunately we can't ever be 100% prepared for this. I think you did a really great job!
How was your support, do you think? You were told off for moaning...!!?? That doesn't sound very supportive to me. If anyone had told me off for moaning I would have hit them, never mind how far along I was.
I really hope you can have a better experience this time round

I was induced @ 40wk and 3 days with syntocin due to high BP and protein and blood in my urine. Within an hour of the syntocin started i had gas, then went to the morphone because I had to wait so long for the dr to eventually do the epidural. Best invention ever I say!! LOL By this time my contractions were less than a min apart and stayed that way until I delivered my dd 18 hours later. If i ever go back again for a second, forget the gas etc i'm going straight to the epidural! LOL

jgal i had a very similiar experience to you. was induced with prostoglandin though (which i had a reaction to and had a hypertonic contraction) and painful contractions that were not doing anything for the cervix.. they called them prosto pains.

i was told off for moaning, the midwife said i would have a sore throat the next day and that i should stop it. also my cervix was swelling and was told i needed to have an epi as it would be another 12 hours or so and it was just gonna get more painful. and was also disheartened each time i was examined and had not progressed from 2-3 cms after hours of labour. i ended up having the epi and a ventouse aided delivery with internal tearing.

needless to say i am also very apprehensive about giving birth again and soooo soooo sooo hope i dont have to be induced!

When I was induced my cervix was long, hard, posterior and closed and I thought my chances of an epi and a caesar were really high (they were, I guess) but I didn't get either. I had a really supportive (and somewhat absent;)) team which made the experience all the better. I had peth, but if I had my time again I wouldn't have bothered, it didn't seem to do anything.

My contractions were pretty intense and immediate as well. They were never far apart, like three minutes, like some of girlfriends' who weren't induced. My contractions were on top of one another for the whole labour.:o I remember my husband telling the midwife about three hours into labour that I was getting a new contraction less than every minute.