Positive Medical Induction

By Natalie

My story

I struggled to find positive stories about medical induction when I was looking for reassurance so I’m sharing mine here.  It wasn’t an easy journey and I had to get comfortable standing my ground at times.  But the healing and empowering experience of my positive VBAC was worth every effort.

My dilemma

In my third pregnancy, blood tests confirmed I was making antibodies against Kell and Duffy antigens on my baby’s red blood cells.  An obstetrician advised this was usually less serious than the more widely known Rhesus disease but because few studies had been done, she recommended early induction at 37 weeks to limit any risk to my baby.  She explained that after 38 weeks, scans could no longer be trusted to measure his anaemia.

 I had a few worries about early induction:

• I was aware that birth before 39 weeks is known to carry its own health risks for babies.

• My previous c-section meant the options available for medical induction would be limited – a pessary or Pitocin drip would increase the risk of a dangerous scar rupture (artificially induced contractions can be more powerful than natural labour).  So if things didn’t progress quickly, the only option would be another c-section, which I was hoping to avoid. 

• I went 11 days ‘overdue’ with my first two pregnancies so worried that neither me or baby would be ready for labour at 37 weeks and induction wouldn’t work.

I’d read about the benefits of the natural hormone cycle in labour for pain-relief, bonding, breastfeeding and postnatal wellbeing so was really hoping for things to progress as naturally as possible.

I asked my obstetrician for her thoughts and she explained that her job was to mitigate the specific risk in front of her; she wouldn’t have enough information to weigh this up holistically against my general wellbeing, or longer term implications and that only I could do that.  This was the most helpful insight she could have given me.  It gave me the courage to make my own decisions about what I felt would be best for my family long term and even to ask for a letter authorising a water birth when the time came, because I knew this was against usual hospital practice for VBACs.

My preparation for a hospital induction

Scans at 37 and 38 weeks showed that despite my own high antibody levels, my baby’s blood didn’t seem negatively affected.  So I chose to wait until 39 weeks for an induction and in the meantime, searched for ways to prepare my body for labour.   Looking back, a few things contributed to my positive outcome:

• Two transformative Acupressure sessions (thanks Lucy Trend).  I welcomed the physicality of the treatment and it helped me release emotions, stress and fear that had built up from previous births and hospital visits.  

• Decades of sports injuries and falls had taken their toll on my body but a traditional private physiotherapist adjusted my pelvis into realignment, creating more space and flexibility for the baby to pass through. 

• I listened religiously to hypnobabies tracks, many times a day and practiced bringing myself to a calm state on demand.  Often, I would experience warm up contractions during these tracks and started to feel quietly confident about what was to come.

• I watched YouTube videos of positive and pain-free natural births, and advice from Debra Pascali-Bonaro (founder of Orgasmic Birth) on the importance of love and intimacy during labour, even in a hospital setting.   I started imagining this for myself and realised how important it would be to build a protected space during labour.

My induction day

On the scheduled day of induction, my doula had a flash of inspiration and suggested I ask for induction by Foley Catheter.  [A Foley catheter induction involves inserting a catheter with a balloon-like end into the cervix and inflating it with saline solution. The pressure from the balloon softens and dilates the cervix, which can start labour or break your water.]  My obstetrician commented that she hadn’t heard of this being used since the 1970s but was happy to try.  It was a pain-free procedure and because no drugs or drips were involved, I was able to return home for 48 hours to allow labour to progress on its own, which it did in a very peaceful way.   When I returned to the hospital, I was a few centimetres dilated but contractions were still irregular. 

We discovered that my baby was lying in the back to back position, which might have been slowing things down.   I embraced this as an opportunity to try some forward leaning inversions I’d learned from Spinning Babies.  When my midwife returned to check me, she confirmed my baby had moved into the best position for labour.

A doctor examined me and explained that because contractions were not regular enough, she would like to break my waters and speed things up.  But she needed me to first agree that if active labour hadn’t established within 3 hours,  I would move to a C-section.  Knowing that my quickest labour to date had taken over 7 hours to establish, we had a heated disagreement at this point and I felt disheartened.  The 3 hour time limit seemed so arbitrary and the stress of the deadline unhelpful.  I called my doula who suggested I agree to considering those options if and when the time comes. Fortunately, this seemed to be enough for the doctor and she left to arrange the procedure.

As the door closed, my midwife gave me a wink and joked that in these moments, we have to do a little dance with the doctors.  She immediately became my trusted ally!  She asked what my ideal birth would look like and reassured me that she would do her best to give me the undisturbed water birth that I hoped for.   She asked to use the  continuous heartrate monitoring machine just to get a trace reading but after that, was happy to just listen in occasionally with a stethoscope to my baby’s heartbeat.

The doctor then returned to break my waters.  Placing a pillow beneath my  hips seemed to improve the procedure, which was somewhat painful up to that point but relaxation tracks helped me through and when it was done, we were then left alone to labour in peace.

My outcome

I’ll leave the details for another post but in a nutshell, it was as undisturbed a labour as I could have hoped for, powerful and swift.  I desired no pain-relief aside from my hypnobabies tracks and reached transition within 90 minutes!  When I felt the strong sensation to push, I realised my dream was finally coming true.   My amazing midwife immediately started filling up the birthing pool before going off-shift and my doula arrived just in time to help me relax through the second stage until I gently pushed out my baby boy and gazed in wonder at him floating wide-eyed in the water.   

I have never felt so powerful, euphoric or grateful as I did in the hours following his birth.   The odds had felt stacked against me but thanks to the care of all the supporters mentioned in this blog, I was able to face the challenges and become stronger in the process.   

This birth was the inspiration behind Birth Supported, to help more families experience the best possible perinatal journey.   We hope you can find the supporters you need here!