If you’re past your due date and an induction is looming, you may wonder if an induction without epidural is possible. Ladies, I’m here to tell you that it is. You can do it!
The birth story that you’re about to read is the raw, unedited version that I wrote down for the scrapbook of Baby #2, back in the days before I was a childbirth educator. (No judgment allowed–you’re getting it just as I wrote it!) And I’ll tell you what, it’s a juicy one! There’s a pitocin induction, back labor, a posterior position, an episiotomy….AND a natural childbirth. Are you ready to dig in?!
Induction Without Epidural: Breaking My Water & Pitocin
“I was 10 days past my due date. I had tried getting my membranes stripped — nothing. I ran laps – nothing. We decided it was time to induce labor on Wednesday. Wednesday morning came with excitement and nervous anticipation. As I left the house, it was bizarre to imagine that I’d be coming home with a baby! Having an induced labor gives you a strange feeling of control…at least until the contractions start!
“Anyhow, we got to the hospital and got checked in at around 8:15am. Dr. M. stopped by and asked if it’d be alright if she broke my water. I’d hoped that would start contractions without pitocin. So I agreed on the condition that I could wait and see if labor would start before they added any pitocin. She agreed to a 2-hour waiting period.
“As she was attempting to break my water, she commented that it was as tough as steel and it wouldn’t have broken easily on its own. It was a bizarre sound to hear her scraping away at it to get it to break — like the sound of scratching a rubber ball. She finally got it to rupture and she said I was dilated to 6 cm! It was 8:45 am. WOAH! That’s pretty cool to be 6 centimeters without feeling a contraction!
“When we could (they had to monitor me in bed for a while to make sure the baby tolerated the procedure well), Seth and I got up and started walking the halls. We only walked from about 10:20-10:55, and unfortunately it didn’t get contractions going. So at around 11:00, I was started on pitocin.
Induction Without Epidural: Early & Active Labor
“We had been watching a movie on the laptop to pass the time. Once it finished, I got up and tried to walk the halls again. They had me strapped up to a telemetry unit so that I could be monitored while I walked. (Learn all about fetal monitoring during labor.) Seth pushed around the IV pole and kept me from tripping on the tubing. At that point, my contractions were coming regularly and felt stronger…more “sensation-ful” :). I didn’t want to walk for too long. It was around 12:30 and the pitocin level had been upped periodically along the way.
“When we got back to the room, I had to clean up because I was starting to leak amniotic fluid. Gross :). My back was hurting with each contraction. From about 1-1:45, Seth then got me on all fours, and I swayed my hips while I rested my chest on the birth ball. That and some deep breathing were effective. And of course, Seth was massaging my hips and lower back and helping me relax. He even read me some relaxation scripts, if I recall. (Let me say now, Seth was INCREDIBLE. This man massaged and pushed on my lower back with all of his strength for hours on end. I love him!)
Induction Without Epidural: Transition & Back Pain
“Around this time, the nurse checked my cervix. I was 7 cm dilated and 90% effaced.
“When kneeling with the ball became less effective, he moved me to sit on the birth ball. That was helpful for a while, too. We probably did this from about 1:45-2:30. Seth helped me lean back into the ball while my mom braced me in the back and massaged my lower back, like this (see below): Nice artwork, huh? Mom helped me focus on different points in the room and breathed with me while Seth encouraged me to stay calm, relaxed, and as limp as possible. At this point, I was 9 cm.
“My arms were getting tingly and I felt like I might faint, so we moved to the bed at around 2:30. Contractions were coming hard and some were piggybacking at this point. I knew that I was in transition, that it would all be over soon and I could start pushing. I was 9.5 cm dilated, and that .5 cm stuck around for A LONG TIME. Every time the doctor checked me, there remained that obnoxious lip of cervix! Labor was getting challenging.
“I just kept thinking that when the urge to push would come, I would feel relief. I kept telling myself to make my body limp and allow the contractions to do their thing. And with the help of Seth and mom, I was able to for the most part. My mom was encouraging me to pick up the pace of my breathing, which I found to be very helpful. Seth kept me physically relaxed. Together, I kept making them massage my hips and lower back. I felt so crampy/achy…as soon as they stopped massaging my back, I felt like I was losing control. The massage really helped ground me and enabled me to get through each contraction.
“I started feeling like I was either going to vomit or go to the bathroom, but it still didn’t have that “overwhelming urge to push” that others had described to me. So, Dr. M. checked me again and said that I still had that “lip” of cervix. However, she said that I could push and she would work the cervix out of the way of the baby’s head. It was 3:10pm.
Induction Without Epidural: Pushing
“Now this is the part of labor that surprised me the most — pushing. I really thought it was going to be a relief, but WOAH. It was painful! I was pushing with every single bit of energy that I had. Seth tells me that I looked like my face was going to explode…Not very flattering! Anyhow, I was really pushing with everything I had — I wanted that baby out more than you could imagine! Dr. M. was stretching me out so hard that I felt like I might rip in half. Yet, she was so energetic and encouraging.
“I was giving it my all when the baby’s heart rate started to drop a bit. She told me to push harder — I did. She tried to suction him out, but the suction popped right off his little head. (I wonder if that hurt him… 🙁 ) At this point, with his heart rate dropping, there weren’t very many options, and she cut an episiotomy. As soon as she snipped, out FLEW the baby. At least to me, that’s how it seemed, that he came out with lots of force. Surprisingly, he came out face up instead of face down. He was born at 3:25pm.
Induction Without Epidural: Birth & Posterior Position
“And then the doctor dropped the F-bomb :0 ! She announced that the baby had been in the OP position (occipital posterior), which is the hardest way to deliver the head because it presents with the greatest circumference. (So that explains the back pain that I had been feeling — back labor! Thank goodness we had prepared for back labor.) Grinning from ear to ear, the doctor told me that I had done ‘f****** awesome!’ and that she was so proud of me.
“And I HAD done awesome! I was exhausted but triumphant. It was such a joy to hold my baby! Here he was — gorgeous and slimy with lots of blond hair! He weighed 8lbs 6oz and was 21 inches long. While the doctor stitched up the episiotomy, I marveled at the gorgeous little one in my arms. It was a VERY good feeling to finally have my baby and to be done with labor!
Induction Without Epidural: Thoughts in Hindsight
Sometimes you just can’t avoid a labor induction. (Learn all about inducing labor pros and cons.) There’s no point in kicking yourself or feeling bad about the need for an intervention if it’s medically necessary.
While you may or may not have back pain in labor, it’s more likely to occur if the baby is in a posterior position. Be sure that you and your partner practice pressure techniques that can help alleviate back labor, such as counter pressure and the double hip squeeze. You’ll learn all about these in the KOPA PREPARED online childbirth class series ($195/$245 or try the first class for FREE). If you experience back labor, I promise you that you’ll be glad you practiced beforehand!
Persistent Posterior Position:
My baby was what they call a “persistent posterior.” This means that he started birth in a posterior position and never turned — he was born face up. This is rare. Evidence has shown us that one way to avoid a persistent posterior position is to NEVER, NEVER induce labor by having your water broken (1,2). (Shoot — I wish I had known that way back when :0)
Why? The amniotic sac provides a layer of cushion between the baby’s head and the pelvis. This fluid layer can help prevent the head from getting lodged in a malposition in the pelvis. Additionally, the layer of cushion enables the baby’s head to rotate more easily in the pelvis.
Lip of Cervix:
A lip of cervix is common when the baby is in a malposition, such as the occipital posterior position. It happens because the head is not pressing on the cervix evenly. The uneven pressure causes a small portion of the anterior lip of the cervix to remain. Changing positions frequently in labor can help this lip melt away.
In regard to the challenges I had while pushing: It’s hard to know why the baby’s heart rate dropped while I was pushing. Maybe I was holding my breath too long? Or possibly his position in the birth canal was compromising his air flow? It could be that the position I was pushing in wasn’t ideal?
The suction, or vacuum extractor, is a form of assisted delivery. You can learn all about assisted deliveries here. Episiotomies aren’t a walk in the park, and should only ever be used if there’s a medical necessity. To me, under the circumstances, I was on board with the intervention. But I’ll tell you truthfully–it made for an uncomfortable postpartum recovery.
Kopa Birth’s online childbirth classes allow you to prepare for a natural childbirth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class to learn more about preparing for a natural hospital birth.
(1)ACOG/SMFM Obstetric Care Consensus: Safe Prevention of the Primary Cesarean Delivery. American Journal of Obstetrics & Gynecology, March 2014.
(2) Cheng, Y.W., Sahffer, B.L., Caughey, A.B. (2006). Associated factors and outcomes of persistent occiput posterior position: A retrospective cohort study from 1976 to 2001. J Maternal Fetal Neonatal Med, 19: 563-568.