Induction

Loaded up with all our bags, plus a massive v-shaped pillow, we made our way to the hospital at 4pm on the Friday. Thankfully, we were given a private room, which was a huge relief! The idea of sleeping on a ward had filled me with horror, and I waddled into that building quite prepared to beg for a private room if necessary.

When we were shown to the room I was told that I’d be induced soon after arrival, so that the baby wouldn’t be left too long without the protection offered by the waters. We got ourselves set up – I had all my snacks lined up ready to go, my husband got the tablet set up on the wifi so that we could Netflix some random comedies to keep my distracted once the contractions started*.

*Other streaming services are available!

I knew I'd be spending a lot of time in this room!

A midwife popped in to introduce herself and welcome me to the maternity building. She explained that they were very busy so they would start the induction process around 6pm. Yes, it was slightly annoying to have to wait when it’s something so exciting but 2 hours isn’t an awful wait really.

6 o'clock came. 6 o'clock went. No induction.

To be honest, it wasn't the lack of induction that bothered me. It was the fact that nobody came to tell me why it would be delayed, or even that it would be delayed. I pressed the call buzzer a few times and the staff told me that someone would see me ‘soon’.

At this point, the excitement had pretty much disappeared and all I was feeling were the nerves! It had suddenly hit me that I might be in hospital longer than I originally anticipated, and that it was really about to happen. I just wanted them to get on with it!

Eventually, at 9:30 p.m. one of the night shift midwives – Julie – came to start my induction. She explained that there had been a delivery on the ward (which is pretty rare because usually the woman is sent down to labour ward in time) and that this is what had caused the delay. It was totally fair enough, but I still wished someone had popped in to explain, rather than just leave me hanging.

Anyway, induction time!

There are a number of stages to induction, which broadly follow the pattern of monitoring, medication, monitoring, and waiting. This process can be done 4 times, at specific intervals, but not everyone will need all 4 doses to successfully start their labour.

It begins with spending half an hour hooked up to a monitor to see how the baby is doing, which provides a baseline for the midwives to compare to later monitoring. For those of you who don't know, when you are on the monitor you have to sit completely still otherwise the pads of the monitor can slip and they won't be registering the baby anymore.

Now I don't know about you, but when I have nothing to do, I can sit totally still for hours, watching tv, reading a book, or even doing absolutely nothing. On the other hand, when I am told that I HAVE to sit still and not move, I become incredibly restless.

As soon as she put the monitor on, I was pretty sure I’d be able to run a marathon at that moment. I just wanted to MOVE.

Still, it's only half an hour, right?

Wrong.

Because, once that monitoring is over, the next stage of induction begins.

This part is when the midwife inserts a pessary of medication into the cervix. It contains prostaglandins, which is the hormone that the body releases to stimulate contractions. Although it isn’t instant, a few doses of prostaglandins is often enough to kickstart labour.

Then you’re put on the monitor again, this time for an hour, to make sure that the baby is not distressed by the medication, and to see whether any small contractions have begun.

This entire process was repeated 6 hours later, which for me was 3:30 in the morning. Joy of joys.

Before my second dose, I had started to have contractions and although they were only about 30 seconds long and were quite far apart, they were still frequent and painful enough that I noticed them! So you can imagine, when the midwife arrived at 3:30, I hadn’t had very much sleep.

3:30am monitoring - baby was nice and sleepy with a heartbeat of 122 beats per minute!

Again, the baby was monitored for half an hour, a pessary was inserted, and I was monitored for another hour. There was some good news though! When the midwife checked my cervix before giving the prostaglandins, she explained that because my cervix was almost completely effaced and I was having small contractions, she didn’t expect that I would need a third dose! Fantastic!

Effacement isn’t really something we often hear about when discussing labour, or when it’s portrayed in tv/film – we hear about dilation and that’s it, but actually a significant portion of that early labour, the part that seems never-ending, is spent with the cervix effacing. Usually, the cervix is a long tube which points down in the top of the vagina. During the early stage of labour, the contractions are forcing the cervix to flatten, or 'efface'. Only once the cervix is fully effaced can dilation begin. This is why the early stage can seem so disappointing – to have been in labour for hours and hours, to be told you’re only 1cm dilated?! It’s just important to remember that in that time, those contractions have turned your cervix from a 2cm long tube, to being completely flat!

My cervix was checked again at around 10 o'clock in the morning.

1 cm dilated!

How exciting!

When being induced, if you need a third pessary, this takes place 24 hours after the first hormones were given, meaning I was preparing myself to wait until 9:30 on the Saturday evening.
A second midwife agreed that I would probably not need a third pessary, but she explained that the final call on that wouldn’t be made until much closer to the time, so she wanted me to make sure that my progress didn’t stall. I was encouraged to walk up and down the stairs in the maternity building, go to the shop in the main hospital building, and take a warm bath.

Knowing that no more intervention would be taking place until late into the evening, I sent my husband home to have a shower and get some sleep. We’re lucky at our hospital that they do allow a partner to stay overnight, but they don’t provide much in the way of comfort. My husband (who has Chronic Fatigue Syndrome), had spent Friday night sleeping on the floor and was not allowed to take a shower on the ward.

He didn’t want to leave me, but understood that during this part of the induction, I didn’t need him as much as I would while in full blown labour. I needed him to be in tip-top condition, and that meant a shower and sleep! So off he went.

My Mother-in-Law stayed with me, and after a while timing my contractions while I bounced on a maternity ball, we took a slow shuffle to the shop to buy an ice cream (yes, she also shuffled – if you’d seen her recent ankle injury, you’d understand).

50 second contractions, 5 minutes apart. Still not close enough. I was starting to think I’d be having that third pessary after all!

On the way back to my room, we ran into my husband arriving back at the hospital. We returned to the room, to find a Midwife knocking at the door.

I introduced myself.

“Ready to come downstairs to labour suite then?” Was all she said.

I responded, rather foolishly, “What, now?”

“Well that’s why you’re here, isn’t it?” The Midwife replied.

Yes. Yes it was! She gave us a few minutes to gather all our things and then we were off! To labour suite! To have our baby!