Tricks to Make Your Induction Easier

It is no secret that inductions can be long and exhausting. If you just found out that you are having an induction, start with article on everything you need to know first - including what to bring with you.

You don't want to go into an induction lightly, but sometimes it simply cannot be helped. There are many good reasons to get your baby out sooner rather than later. Here are my top tricks for making the process go as smoothly as possible.

1. Try nudging labor along before your induction date, as long as it is safe to do so.

The most common ways to nudge your body along, all of which I go into more depth with here:

• Acupuncture and acupressure

• Red raspberry leaf tea, pineapple, and dates

• Nipple stimulation and sex

• Evening Primrose Oil

Although it is not a specific "nudge" having your baby in the best position possible can also help to get labor going. I don't just mean head down, either. I mean that your baby is putting pressure on your cervix as you walk around, making it more likely that dilation will start a little bit on its own. Ways to help:

• Explore Spinning Babies and do the 3 Balances regularly

• Wear a pregnancy belt to keep your baby tilted at the right angle

• Go see a bodyworker who specializes in pregnancy, like a chiropractor

• Engage with a pregnancy specific fitness program, like Body Ready Method

2. Ask about outpatient cervical ripening and how you can slow walk toward induction, as long as it is safe.

For those who need get their baby out quickly because of a complication, this won't be an option, but for many it is a great way to start more gently. You don't need to walk in and have medications slammed into your body immediately. Your provider should be able to tell you your Bishop Score, which is way of rating how ready your cervix is for labor. You take your score for each row and then it up to get the total. Anything less than 6 is not optimal for labor induction. Anything more than 8 is optimal for induction.

	0	1	2	3
Position	Posterior	Middle	Anterior
Consistency	Firm	Medium	Soft
Effacement	<30%	40-50%	60-70%	>80%
Dilation	Closed	1-2cm	3-4cm	>5cm
Station	-3	-2	-1/0	+1/+2
And many providers unofficially at 2-3 to your score if you have previously given birth vaginally

Your timeline can look like this:

• Monday: Ask for a membrane sweep (as long as you are at least 1cm dilated) or a very thorough cervical check (if a sweep isn't possible yet)

• Tuesday: Get an outpatient foley balloon and go home to sleep which it begins to efface your cervix

• Wednesday: Get some misoprostol, and if it doesn't work to put you into labor - GO HOME

• Thursday: Come in for more misoprostol and stay for other methods (like pitocin) if it doesn't put you into labor

A slower timeline allows your body a chance to realize what you asking it to do, and then to actually join you in the endeavor. You are not fighting your body but rather pointing it in the direction it needs to go. Ideally, over the course of a slower start with lots of opportunities for ripening, your Bishop Score goes up and your body is in a more receptive state.

Staying home for some of the induction process allows you to get more rest because you are not being interrupted for monitoring. You are also in the comfort of your own home where your Fight or Flight is less likely to be activated, so your body may respond more favorably to the drugs. Induction will likely be a long process no matter what, so spending time at home - eating, walking, and being with your partner - might make the process feel better and more satisfying.

3. Strategize a lot about the timing! Who and when matter a lot.

First, if you have to be induced, you can ask about the call schedule and try to time it so that you are around for the providers that you like the best. You can also try to avoid the people you don't like.

Next, is the puzzle of what time of day. There is a hospital in my area infamous for telling people to come in at 2am. My poor clients don't get a single wink of sleep and then are usually up the following night, too. If you get a time that absolutely does not work for you, please speak up and say that to your provider. And if they still don't listen? You can always just... show up late. Oops!

That said, there is some compelling anecdotal data that inductions work better when they are started at night. Most people go into labor spontaneously at night because of hormones (we think night labor served the evolutionary purpose of keeping us safe). Even if you are not a night owl, you may want to consider conceding to a night time induction, but only you can weigh the pros and cons for your individual situation.

If you need to sleep, you can ask for Benadryl or Vistaril (like Benadryl but without the groggy hangover side effect).

4. Minimize cervical exams at every turn, to keep infection low and morale high.

You might want to think that if you had a medication 10 hours ago, SURELY SOMETHING MUST BE HAPPENING?!!?!?!? But if you are not contracting on your own steam, the odds are high that nothing has changed and your cervix is the same as what it was. Inductions can sometimes feel like death by 1000 cervical exams. Providers set some arbitrary, "Ok, we will be back to check you every 2 hours" standard. Do not do that. If nothing is happening with your body, nothing is happening with your cervix.

Once your water is broken, it is even more important to avoid cervical checks. Every single check increases the likelihood of infection. Even with sterile gloves.

The best time to get an exam is if the numbers will direct the decision. In other words, if the new information might change what you do then you want it:

• Your provider has offered to break your water, but you want to wait until active labor

• Your doula is helping with positioning to get baby pressing on your cervix and knowing where baby is informs the next series of positions

• You are feeling like you want an epidural, but if you are close you could hold on a little longer

5. Preserve bodily autonomy at every possible turn and at every possible cost.

By the end of a long induction people often feel completely out of sorts because they have been trapped in one room for days attached to a leash of monitors with very little sleep. Even if you feel like you can just keep going a little longer, it is worth it to make small moves toward some freedom.

• Walk around the L&D ward: it is good for labor progress and gets you out of your room. There are some Chicago hospitals that won't let you walk around, but ask for forgiveness not permission.

• Ask for wireless monitoring: there are battery operated monitors as well as a device called the Monica. Try not to let the cord management of it all keep you in the bed. Cords can get wet! Go in the shower or tub. Your nurse can help cover your IV port so you can get it wet.

• Bring food that you like or order in: you might be there a long time and there is only so much Jello one guy can get in a labor. If you aren't sure about eating and drinking in labor, I've got a whole post here.

• Hire a doula! You are more likely to have a vaginal birth, less likely to use pain meds, less likely for baby to need interventions, and you are more likely to have a shorter labor. If a doula were a drug, it would be illegal not to use it!

• Take an out of hospital class. Even though hospital classes are cheaper, they do not teach you the advocacy skills that you need. You can check out my class or ask me for recommendation.