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Being Induced: Steroid Injections and Foley Catheters

Sunday, June 24/18

Sometimes labour just doesn't come naturally, which actually is a nonsense sentence because babies do have to be born eventually, but occasionally labour is brought on with a helping hand when you are induced. Some women are induced if they are very overdue, sometimes for concerns with the mother's health such as raised blood pressure. Other times women are induced because of complications with the baby. It's a process that many women try to avoid, but for the most part it's done with the best intentions for the safest delivery of your baby, both for mother and child.

WHY I WAS INDUCED
My labour was induced because as a Type 1 Diabetic my baby was measuring about 2 weeks ahead of schedule, and the longer that I held on, the higher my risk of having a c-section. There seemed to be a fine line of being induced too early or too late, and in my case anything before 37 weeks had risks of baby's lungs not developing properly and the baby needing assistance after delivery, but risks after 37 meant I could be delivering a whopping baby and requiring emergency surgery. I pretty much begged for an induction at 35 weeks, although it had always been the plan for me to be induced as close to 38 weeks as possible. Despite there being a bit of confusion with multiple doctors looking after me, it was decided I would be induced at 37 weeks and 3 days after a week in the antenatal ward.


THE INDUCTION PROCESS

STEROIDS:
It seems that every induction is different depending on the circumstance that you're in. In my case, I had to go in two days prior to my induction date. On the first day I went in for an OB appointment and a steroid injection. The steroid injection used to help quickly promote baby's lung development has to be administered in two parts, but it isn't typically given to mother's unless they're delivering before 34 weeks. Because baby's of diabetic mothers sometimes have issues with their lungs, it was decided that at 37 weeks I should have the injections, even though the nurses in Triage questioned the decision. The injection is certainly uncomfortable, and although I didn't see the syringe, apparently the needle is quite large. I felt a little sore after it was given, and it felt stiff for a few hours (the steroids are injected into the buttocks, but it feels a bit more like it's being injected at hip-height). On the second day I went in for another dose of the steroids and a foley catheter insertion. The steroids I was given (very common for pre-term deliveries) is called Betamethasone, and is typically given in 12mg doses 12-24 hours apart, which is why I needed to go in for a second dose.

FOLEY CATHETER:
I was 1cm dilated prior to being induced, but it was recommended that I had a Foley Catheter inserted to get me to 3cm, and the idea was that it would mean when I was called in on day 3 for the actual induction I would be able to have my water broken right away. These catheters aren't used very often for inducing labour, but was chosen for me for several reasons. Firstly, it's a drug-free way to begin tricking your body into thinking labour has begun. It also has decreased rates of c-sections and fetal heart rate abnormalities (although neither were true in my case!) and these were the main concerns for my particular induction. When the catheter is inserted it sort of just feels like what a PAP test would be like, although as the balloon is filled with saline things get a bit more uncomfortable. It's a similar discomfort to cervical checks during labour to check dilation. When it's been inserted, the tail end of it that sort of hangs out of you (pretty unpleasant) is taped to your thigh. I was kept in for an hour afterwards for monitoring and as the hour progressed I felt increasing pain. A few times I felt as though the catheter would fall out (it is expected to fall out once you reach 3cm, usually within 12 hours) but it didn't until 6 hours afterwards when I was at home. The pain I felt was identical to contraction pain during labour, which makes sense because you're dilating, it's just a bit more forced and rushed. After being sent home for the night I did actually call the hospital when I was in the parking lot because the pain was so intense, but I was assured it would stop within the hour and when the catheter had fallen out (it did). I was instructed to gently tug on the end of the catheter each time I went to the bathroom, and it came out about 6 hours after it was inserted. I got home at about hour 2 after insertion and immediately went to bed because it was so painful, I thought sleeping through it was the only way to go. I slept for about an hour and a half and when I woke up the pain was much more bearable. By the time the catheter had fallen out the pain reduced dramatically, and I felt comfortable to do pretty much everything I usually would, although they recommend you take showers instead of baths, which was kind of a bummer because it's all I really wanted to do.


MY EXPERIENCE OVERALL
Overall, the induction process was totally fine. I don't imagine it would ever be a totally comfortable experience, but it helps to ease your body into labour before the Oxytocin and water-breaking commences. I know there is quite a lot of fear surrounding inductions, but for me it was very positive even though it wasn't always pleasant. I hope this post gives you some sort of knowledge regarding the experience, and I hope it doesn't scare anyone who might have to experience this! Thanks for reading!

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