Pitocin vs AROM???
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Thread: Pitocin vs AROM???

  1. #1
    Prolific Poster rainymama's Avatar
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    Exclamation Pitocin vs AROM???

    Ok, I either wait it out looking at 42 weeks on Monday with another membrane stripping tomorrow...or the OB can break my water tonight, or if I ask for it would probably give me a little Pit. I am declining Cytotec, the hospital's usual route of induction.
    I can't believe it is coming down to this.
    OB is leaving town for the weekend. I would have a complete stranger attending my birth if I don't do something now. Or I would have her, but a truly post-dates baby and all the stress of that.
    What would you do?

    ETA: How about this...neither...and doing the castor oil against their advice. I am so confused. I really want him to come without drugs.

    Edited AGAIN: I am not doing it.
    Last edited by rainymama; 05-27-2010 at 08:06 PM.
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    Posting Addict jooniper's Avatar
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    "I am not doing it"... not doing which?
    I'm so sorry its come to this for you. I'd try pretty much anything, including castor oil, membrane stripping, AROM... before pitocin. Not sure if y'all have noticed, but I'm TERRIFIED of pitocin.
    If they do break your water, I'm assuming you then get put on the clock essentially for fear of infection? Still, this far along, I bet breaking your water would get things going (it is what got my natural labor going with D- though he was much much earlier (technically premie) and I wish we had waited.) Tough choice, though.
    Last edited by jooniper; 05-27-2010 at 09:09 PM.
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    Posting Addict mandi04's Avatar
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    Not sure what you mean by not doing it either so I'll give my input.
    I've had AROM and pit, I prefer the AROM for me, assuming you are already contracting and 'ripe' and baby is engaged. For me, once my water is broke I have a baby quickly, it really kicks things into high gear.
    I had pit and honestly, it didn't do much as far as speeding up labor. My pit labor was 19 hours and it was my 3rd, as opposed to my first two (about 3 hours from AROM and about 1.5 hours from AROM). It wasn't awful, honestly my contractions are much worse after AROM than they were from pit, but I'd prefer AROM because I'd prefer fast and furious over 'being on the clock' anyday.
    That said, that's how my body has reacted to AROM. Sometimes it doesn't kick start anything, and then you are on the clock, most drs don't like you to go much more than 24 hours from AROM especially if you aren't progressing as fast as they would like. Another thing, if your baby isn't engaged there's always the chance a cord or hand or something could drop down in front of the head with AROM, the cord would mean an automatic emergency csection. And if baby isn't engaged and drops into the birth canal head first, there's the chance they could drop down in a bad position and once your water is broken it's harder for them to turn into a good position.
    I always worry about castor oil because of meconium aspiration, so I don't think I'd try that. Plus I have a friend who tried castor oil. At least twice that she told me about and she didn't go into labor until her body was ready (a day she hadn't had castor oil, and no meconium).
    You really have to look at the pros and cons for your own situation, nobody's is the same. Is baby engaged? Are you dilating/effacing at all yet? Are you contracting at all yet? If no to all, I'd just more gentle ways to encourage dilation/contracting before AROM/pit or castor oil. Sex and nipple stimulation would be a good start.
    DD1- July 2004
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    kvo
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    I said this on your lodge, but I'll do it here too. If I end up facing 42 weeks like you are and my cervix is favorable, then I would do this: 1) castor oil, 2) enema, 3) 42+ go into hospital and allow AROM, 4) if no progress after about 6-8 hours, I would allow some pit, 5) if things became too "intense" I would succumb to a light epi and while that would be very disappointing, I would feel okay knowing I really did try everything I could.

    At this point, I think it is unlikely you would get past step 3. Things are progressing for you, just slowly.
    *Kristen*
    DD-Zoe July 2007
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    Prolific Poster Winky_the_HouseElf's Avatar
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    I would do low dose pitocin and increase it slowly. I prefer pitocin over AROM for induction because pitocin can be turned off if it doesn't work or if it causes distress. AROM can't be undone.
    Laura
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    Mega Poster krazykat's Avatar
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    I would never, EVER do AROM again. It is there for a reason IMO and IME. I would rather take the chance of not knowing who my attending OB is and let the babe come on his own. With Pit you will be put "on the clock" and constant monitoring, though it can be stopped as Laura said. AROM has been shown in studies to be very ineffective and inconsistent in reducing the length of labor, so I would bet that the same holds true for inducing labor by that method when baby and body are not ready.
    Ariel & John: Military Family since May 17, 2006

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    Posting Addict AJsmommy's Avatar
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    Quote Originally Posted by Winky_the_HouseElf View Post
    I would do low dose pitocin and increase it slowly. I prefer pitocin over AROM for induction because pitocin can be turned off if it doesn't work or if it causes distress. AROM can't be undone.
    I agree with this. You said in your lodge that you're 3cm, so I'm guessing a little bit of Pit would send you into labor right away. So if you are going to do anything, this is what I would choose.

    I think you've already decided to wait and I think that's great! You are such a patient mama!
    -Shannon-
    Audrey, 3.20.07

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  8. #8
    Prolific Poster rainymama's Avatar
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    Thank you all for the opinions!!! It has been difficult to really think clearly. I am going to post more in my lodge
    -Elizabeth
    Mama to DD 9, DD 8, DD 6 , DS 4 , DS 2, DS new
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    Posting Addict Chimmy's Avatar
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    Quote Originally Posted by Winky_the_HouseElf View Post
    I would do low dose pitocin and increase it slowly. I prefer pitocin over AROM for induction because pitocin can be turned off if it doesn't work or if it causes distress. AROM can't be undone.
    Despite my experience with pit this is what I would do as well. Once my contractions were regular I'd have them turn off the pit & labor on my own.
    Mama to 7 curious, wild & wonderful little ones



  10. #10
    Posting Addict Amber_daisy's Avatar
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    I was facing this exact same decision 2 1/2 years ago. (My lodge link is in the 2008 lodge sticky if you're interested.) I was terrified. I was lucky though to have a great doc who didn't pressure me.

    I agree with those who've said to avoid AROM and go with low dose pit induction. If it doesn't kick things in or babe doesn't react well, you can turn it off and go home. With AROM, you're on the clock. You have your water broken, and you'll likely have multiple VEs along the way...BIG risk for infection. Also, if babe isn't in a perfect position, it could lock him into a really bad position and cause problems getting him to turn anterior. It may stall your labour, cause back labour, dysfunctional labour, and you could end up with a sunny side up baby (which, while definitely possible to birth, is not nearly as preferable as an OA baby). I'll always be thankful I listened to my gut and decided against AROM, which was the doc's plan for induction for me if I decided to go with it. My baby was OP and I have a strong feeling I would have had a c/s if I'd gone with AROM.

    You can always wait it out. If anyone's concerned about baby's health, you can ask for a biophysical profile for reassurance.

    At 42 weeks, I declined induction for the 5th day in a row. I was so terrified, because I'd been saying I'd go to 42 weeks and then consider induction. But my doc just stripped my membranes again, and told me to go home and relax. And I did. I went home, and let go of the negative energy and fear, and I went into labour that night...after having a quicky.

    BTW, if you've been considering castor oil, you might consider this...An apprentice midwife once told me (during my doula training) that "prostaglandins" are more effective if "taken orally" than "applied locally"....IYKWIM.
    ~Amber~
    mama to Jesse, January 9, 2008 and Quinn, March 20, 2011



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