Latest / The Birth Lounge Podcast / Ep. 498: Before You Agree to an Induction: 5 Things to Know (Bishop Score, “Pit to Distress,” and More)

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Ep. 498: Before You Agree to an Induction: 5 Things to Know (Bishop Score, “Pit to Distress,” and More) · The Birth Lounge Podcast

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  this phrase is pit to distress, and that means to give Pitocin either so much or so fast that baby becomes intolerant or the mom, and they end up having a C-section.
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  Pit to distress.
• 0:13
  You are given so much Pitocin that you are distressing, you're causing distress for either the baby or the mom.
• Hello, and welcome back to another episode of the Birth Lounge Podcast.
• You guys, we are getting down to the nitty-gritty, the wire of Labor Live.
• I'm so stoked for this challenge.
• This is a three-day challenge where I'm going to actually simulate a labor for you, and you don't need to show up live.
• You can show up just once a day and get all of the action.
• You can see all of the choices, be stepped through the labor.
• And the idea is that before you actually get into the situation of needing to make decisions for your birth, I want you to be able to practice that.
• I don't want the first time that you need to say, "No, thank you" to a doctor about something that they're recommending, but something you absolutely feel confident in declining and know that you do not want, I don't want that to be your birth.
• I think that you should really practice saying no.
• You should practice speaking up for yourself One of the most common things I hear is people say, "I wish I had known what to say.
• All I knew was that I didn't want it, and so I said, I don't really want that, and they convinced me otherwise, and I wish I had known enough to actually say no."
• I'm telling you, this is the remedy.
• This is how you have the confidence to say no.
• It is just like rehearsing any other conversation.
• It is just like thinking through any other scenario.
• But we're gonna do it in real time, in a way that a real birth plays out so that you can truly feel what it's like to advocate for yourself and think through all of that childbirth education that you have been gathering over the last couple weeks and months.
• If you are about to have your baby, get in a final practice right before you have your baby to make sure that you don't have any knowledge gaps in your birth plan.
• And if you're not about to have your baby, then lucky you, you get to practice over and over and over again.
• And it's just like anything else.
• The more that you practice it, the more that this is going to be a muscle that you just get to flex, and that just becomes like an instinct.
• You just will just naturally speak up for yourself because it just has become part of who you are.
• Oh, my gosh, I love it.
• I feel so jazzed by this because I had watched it for years transform the way that women birth.
• The more that you practice saying, "No, thank you.
• Can we have a discussion? Would you mind just clearing the room and giving us a second to think about this? Would you mind answering some questions before we make our final decision?" The more you practice saying those things, which are not hard, I'll give it to you, they're not hard to say, but they are hard to say in the moment.
• They can feel hard to say when a healthcare professional feels like they're staring down your throat, waiting for an answer, and they just told you information that completely rocked your socks, and you're like, "I don't even...
• I can't even think right now, much less make a decision."
• I want you to have a nervous system that has been trained to show up in this moment so that when your brain shuts off, you can shut off.
• You don't have to keep trying to be in your thinking brain.
• Your nervous system can take over, click, click, click, click.
• I've done this before.
• I know what to say.
• I know what to ask.
• Get the information, make a decision, let's go.
• That's what we're doing in Labor Live.
• This is a three-day, in real time birth prep challenge and it all starts on November 1.
• You can go to joinlaborlive.com
• and join me going into labor on November 1.
• See you there Before you agree to an induction, here are five things that I think that you should consider.
• Number one, inductions can be very, very long.
• In some cases, once you start your induction, you cannot leave again until your baby is born.
• Sometimes inductions can be two or three days, depending on how much medication and how long your induction takes.
• Be sure that you are thinking about this and you're planning for it.
• You're bringing things to do.
• Bring a deck of cards, bring an iPad, download movies onto your computer, bring books to read, bring a puzzle to put together.
• You want to have something to occupy your time because one of the worst things you can do in an induction, especially in that slower first phase where we're waiting for your cervix to kind of efface and that dilation to start, you're not really, like, in active labor.
• You're not, like, having contractions often.
• The, one of the worst things you can do in that time is to, like, have an idle mind, is to just sit around.
• You might start to spiral.
• You might start to feel really anxious.
• You might start to feel pain a little bit more intensely because your brain is really hyper-focused on what's going on in your induction.
• Spending that time relaxed, getting your oxytocin flowing, kind of spending this time just doing something that brings you joy is one of the best ways to help your induction move along smoothly Number two, I just mentioned that in many cases you might not be able to leave until your baby is born.
• But something that I don't think a lot of people talk about enough is that there is actually the option to leave once you have started your induction.
• I talk about them on the Birth Lounge podcast because sometimes in some hospitals based on some hospital policies, you might be able to get a cervical ripener, have some monitoring done, and then go home for a period of time only to come back to get another cervical ripener.
• The benefit of this would be that you didn't have to be checked into the hospital and you got to go home to a place where you feel cozy and relaxed and safe.
• And we think that because of that, your labor should progress a little bit easier than if you were in the hospital, a place that you kind of felt on edge, you couldn't fully relax because, you know, the hospital is very different than your home.
• So, just thinking about that.
• Sometimes it's not possible, but sometimes with the right questions and with the right provider, you really might be able to accomplish this.
• I've seen it a number of times, over the years.
• I've been a doula for about 10 years, and I have seen it several times You wanna know something that so many people have big opinions on and I was so not ready for it? Laundry detergent So I knew I was gonna switch to, like, a cleaner detergent in pregnancy, and definitely once my baby was born.
• And I made the mistake of asking the internet, like, "Hey, what clean laundry detergent do you, uh, use?" And boy, the conversations that ensued, I just was dumbfounded, honestly.
• People have so many big opinions.
• People have tried all sorts of detergents.
• I knew there were gonna be so many out there, which is why I asked, and it basically boiled down to two different really big brands, and I'm gonna tell you the one I chose, because I love them so much.
• I'm actually not getting paid to put this out on the podcast.
• If you buy through my link in this podcast, I'll get paid.
• But just to say this, I'm genuinely telling you because this is a conversation that happens a lot in my DMs, and I wanted you to know what our family chose to use for laundry detergent that is truly free Now, if you've never been down the laundry detergent rabbit hole, let me save you some time.
• I'll just tell you what it's about.
• Basically, two really big problems with laundry detergent.
• A lot of them have hormone disruptors, which you obviously don't want if you are a woman, and you especially don't want if you are trying to get pregnant, and then you, like, double especially don't want if you are pregnant, and then you don't wanna put that on your baby.
• Okay, so that's the first problem.
• The second problem is a lot of laundry detergent companies will only give you a little bit of laundry detergent, and the rest of it is water.
• And so there's a question of actually how clean does it get your clothes, and also, if it's disrupting your hormones, should we opt for something cleaner? In our home, we chose yes.
• So I went with Truly Free because their laundry lawn is plant-based, it's dye-free, and it is available in completely unscented.
• I knew that that was super important to me when it came to the laundry detergent that we were gonna wash our baby's stuff in My DMs were completely filled, you guys, and one question just continued to come up and that was, uh, it doesn't clean my laundry, so I can't find one that doesn't, you know, leave a film on my laundry, or I don't feel like my laundry is actually clean, except for one, and that was Truly Free.
• And for me, that is what tipped them over the edge I knew that I wanted a safe detergent.
• I knew that my baby needed to be safe to be wrapped in blankets and sleep on sheets and have their clothes washed in this.
• I wanted it to be unscented, dye-free, and most importantly, it needed to clean our clothes You can use Truly Free as a liquid, or I just use it as a powder And one final thing that I absolutely love is that when you order Truly Free, you get hundreds of loads in your box.
• I've had my box for four months now, and we are only about a third of the way through the box, and I have a baby, so we're doing laundry constantly.
• Honestly, if you're looking for a good, safe option for your family that's gonna protect your hormones and are safe with your baby, go to trulyfreehome.com
• and use the code HEHE to save on your order of laundry detergent right now.
• That is trulyfreehome.com
• using the code HEHE.
• Door three is a little bit of a downer, but it's a phrase that I want you to be aware of.
• And, you know, you never want to assume the worst of things or people, but certain phrases do clue you in to certain, let's call it hospital culture.
• And this phrase is pit to distress, and that means to give Pitocin either so much or so fast that baby becomes intolerant or the mom, and they end up having a C-section.
• Pit to distress.
• You are given so much Pitocin that you are distressing, you're calling- you're causing distress for either the baby or the mom.
• This phrase, I used to really think that it wasn't widespread.
• I thought it was just kind of in the circles that I ran in.
• But as I have learned more and more about hospital culture across the US, I've realized that is a very common phrase in the L&D units, and you really want to avoid that.
• Pitocin has recommendations and guidelines on how it should be administered, how much you should get, how often it should be increased.
• All those guidelines are all laid out.
• If your hospital policy is written in a way that doesn't follow that, you can absolutely ask your provider, A, to follow that or, B, why is there a discrepancy? Having you understand, A, what that discrepancy is, and B, what you can do about it, how you can tailor that care, their recommendations around your induction to your specific situation, will give you so much more control in this situation Number four, know what increased risk come with induction.
• There are a number of different ways that you can actually be induced, and each of those induction methods are gonna come with its own set of risk and benefits that you're taking on.
• Every choice has risk and benefits, so nothing is 100% safe or, you know, 100% dangerous.
• Everything is kind of a mixture of risk and benefits that you have to evaluate based on your own personal preferences, your goals, and your risk tolerance.
• Things that come along with induction are, you know, you have an increased risk of things like hemorrhage and a longer labor.
• People who induce or get induced typically ask for an epidural, even if that wasn't their original plan.
• So if you are someone who is planning for an unmedicated birth but you're choosing to be induced, you should have a lot of flexibility on your preferences around pain relief.
• Because a induction is so much longer and can be more painful depending on the type of medication and your body's, you know, receptivity to those medications, how you feel the effects of that medication is gonna impact your feelings on getting an epidural or not.
• Other things that come with induction, you obviously have the increased risk of needing Pitocin, which comes with its own host of additional things.
• Again, hemorrhage, increased tearing, increased risk of, tachysystole, which means that your uterus is contracting too fast, too often, too fast, too much.
• you have the increased risk with Pitocin that your baby becomes intolerant of the contractions and labor, which means that you have an increased risk of further intervention because of tachysystole or your baby, not tolerating things.
• And then obviously, every intervention carries its own risk and benefits, and you can see how it can just become a slew of things.
• So just remind yourself that if you're going for an elective induction, that, you know, you have the choice also to wait for spontaneous labor.
• So if the risk, the increased risk that comes with induction is not worth it to you and waiting for spontaneous labor is a reasonable and safe option for you 'cause you're low risk and you are a term person, then, you know, think about that And then number five, this is like a secret weapon that I love to throw in there, and it is to grab your Bishop score.
• Now, hardly ever do I hear people talking about getting their Bishop score before they have, their induction started, but I always recommend it.
• In my opinion, it is a way to see exactly the blueprint of what you need to follow in order to mimic natural, spontaneous labor as closely as possible in your induction, which is the whole goal, right? Induction is basically asking your body to do something that it's not ready to do.
• We are trying to put your body into labor, but your body isn't ready to be in labor.
• If it were ready to be in labor, it would be in labor, right? Your body knows how to go into labor.
• And so if we are inducing you, then we're asking your body to do something that it's not quite ready to do.
• If we're gonna do that, we should really follow the process that it is designed to follow in order to birth a baby.
• With your induction, you can do that by getting your Bishop score, and then from there, that will tell you how ready your body is for the medications.
• And depending on where you fall on the scale, you can then choose your method of induction, the medications that they give you, in the order that best matches what your body needs in that moment.
• Now, when to get your Bishop score is always a question, and it depends.
• So if you're looking at a medical induction, it may be worth getting it a few days before and then getting a membrane sweep, which is a method of induction where they sweep your cervix and they cause a increase in prostaglandins and hormones that is, that are designed to soften your cervix, okay? With that, you now have a few days for your cervix to soften and be receptive to those hormones that we just did with the membrane sweep, and then you can come back a few days later, have another Bishop score, see the difference between the two, and then make your decision on your induction.
• If you're choosing an elective induction, it doesn't so much matter because, you're choosing it, and having spontaneous labor would not make a difference, right? Either one is reasonable.
• When it's a medically necessary induction, the option to wait for spontaneous labor is not there.
• So it's almost worth that extra cervical exam and the membrane sweep to help encourage your body to be more ready when you need to induce because that is the option, 'cause it's medically necessary.
• I hope that makes sense Of course, everything that you choose in labor and all of the decisions that you make and all of the options that you think about, they ultimately are up to you.
• Your personal preferences and your goals in conjunction with your risk tolerance and the way that you weigh the benefits and your provider's clinical recommendation will all come together like one big puzzle piece, and it will lead you to the right answer, I promise Thank you so much for tuning in today.
• I love hanging out with you, and it is an honor to be your go-to gal when it comes to preparing for your baby.
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• I'm HeHe, and this is the Birth Lounge Podcast.