Most women envision their delivery starting with their water breaking and delivery of their baby shortly afterwards. In truth, labor and delivery seldom happens the way you think it will.
Before you go into labor, you need to talk with your doctor about how much you want to wait for your delivery to progress. Because of the time frame insurances put on deliveries, doctors often declare the diagnosis “failure to progress” and begin induction with Pitocin.
Pitocin is a synthetic version of the hormone oxytocin. Usually, the body naturally produces oxytocin to help with milk excretion during breastfeeding, but it also helps stimulate the uterus for your contractions.
The doctor’s term for the pain caused by Pitocin is “pit pain”. Contractions from Pitocin are undeniably more painful. You will need an epidural to tolerate the pain. Pit pain can instantly spike and feel sharper. In comparison, the contractions of natural labor look more like the classic bell curve. It’s slow building but feels more tolerable and you will likely be able to deliver your baby without an epidural.
If you feel that Pitocin is not for you, I suggest considering misoprostol for cervical ripening.
Cervical ripening prepares your cervix for labor by softening and opening it up. This should be a normal process. Personally, I like to give misoprostol. Misoprostol is a synthetic form of prostaglandin that works well to support prodromal (early stage) labor. This is when the fetal head descends into the birth canal and the cervix ripens and dilates to about 5 cm.
Misoprostol has gotten a bad reputation because it has been used unwisely in the past. A single small dose of misoprostol should bring on cervical ripening. If it does not, you are simply not ready for labor. In the past doctors have given a second dose of misoprostol if the first doesn’t work, and sometimes even a third. If you discuss misoprostol with your doctor, be sure to ask if he administers only one dose of misoprostol. Misoprostol is very good for cervical ripening and a very poor choice for full scale induction of labor by using several doses. Historically, the distinction between using misoprostol for cervical ripening and for induction has been cloudy.
Before your due date, make sure you discuss your options for induction with your doctor. While Pitocin may be the usual choice, there are other options out there that might be more favorable for you. As I mentioned above, pit pain can be sharp and painful, making your labor harder. Avoiding Pitocin might be the best thing you can do to keep your pain at a manageable level.
For more information on pit pain, please see my podcast!