I am sure you have heard many birth stories where the women could not dilate past 1 or 2 centimeters, despite hours of pitocin aumentation. I have. In the 11 years I spent as a Chapter Leader for Macomb (MI) Birthnetwork, I have heard hundreds of birth stories, and many sounded like this: Labor began spontaneously with the uterus continuing to contract in a normal labor pattern but the cervix never dilated. OR labor was induced with prostaglandin gel (or cytotec) over night to soften the cervix, with plans for getting pitocin the next day to open the cervix. When the cervix was opened to 2-4 cms, the next procedure is to artificially break the amniotic sac. This would help intensify contractions with the hopes of progressing the labor. Except the cervix never opens. Sometimes, it doesn't open more than 2cm. (Diagnosis: FTP or failure to progress, Csection delivery!)
Some of these women never felt much discomfort from the pitocin, others needed an epidural after hearing they were still 2cms after working so hard with labor pains but no progress.
Some of these women never felt much discomfort from the pitocin, others needed an epidural after hearing they were still 2cms after working so hard with labor pains but no progress.
I had a very similar experience with a doula client recently. She was encouraged to be induced at 40+ weeks for medical reasons. The parents had many questions about the procedures their obstetrician discussed for induction: cytotec inserted vaginally over night to soften and dilate cervix, artifical rupture of membranes when she reached 3 centimeters, pitocin to cause contractions. I explained in more detail what each of those procedures looked like and layed out their options. They wanted to do this induction slowly in order to avoid pain medication - and they had a OB that was supportive of this plan to go slowly.
After one night of prostaglandin gel which DID NOT work to soften or open her cervix, I asked them to talk to their provider about the possibility of her having cervical scar tissue, before they started the pitocin.
YEP, she had it. The following two days of more prostaglandin gel at night, then pitocin during the day did nothing to soften her cervix in order for the OB to break up her cervical scar tissue (the pictocin did not give her much discomfort, either, despite the high dosage)
Here are some things you should know:
LEEP procedures typically create the most troublesome scar tissue. If you had a LEEP procedure,
it is possible you have scar tissue...something to discuss with your provider. If they determine that you do have scarring, ask them to help you during labor by massaging the scar tissue away (this will mean more cervical checks). Once this tissue has been broken up, your subsequent births should be much quicker and smoother. Read more about cervical scarring and how to discuss this with your care provider!
After one night of prostaglandin gel which DID NOT work to soften or open her cervix, I asked them to talk to their provider about the possibility of her having cervical scar tissue, before they started the pitocin.
YEP, she had it. The following two days of more prostaglandin gel at night, then pitocin during the day did nothing to soften her cervix in order for the OB to break up her cervical scar tissue (the pictocin did not give her much discomfort, either, despite the high dosage)
Here are some things you should know:
LEEP procedures typically create the most troublesome scar tissue. If you had a LEEP procedure,
it is possible you have scar tissue...something to discuss with your provider. If they determine that you do have scarring, ask them to help you during labor by massaging the scar tissue away (this will mean more cervical checks). Once this tissue has been broken up, your subsequent births should be much quicker and smoother. Read more about cervical scarring and how to discuss this with your care provider!
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