Will induction cause labor to hurt all at once or gradually? Can I still get an epidural?

It sounds like you're going to be induced in a couple of weeks and first of all, congratulations on that, that's so exciting. You have some really good questions. Is it going to hurt worse if you're induced? When can you get the epidural? In order to explain how it's going to feel during labor let's talk about the natural progression of things if you're not induced first. Up to the days and weeks before delivery your body starts to release hormones called prostaglandins that act on your cervix that actually ripen and prepare it for labor, very similar to how a fruit ripens. If you take a cervix that's not ripe and ready for labor it usually won't start to dilate or change or do much even if you have regular contractions. Your body starts to do some prep work leading up to the time of the delivery and then if you spontaneously go into labor your brain is releasing a hormone called oxytocin that acts on the little cells of your uterus and tells them to the contract. Then you start to have regular and intense contractions and that leads to cervical dilation and ultimately delivery. If you're coming to the hospital for an elective induction then your body has already done that prep work, it's already ripe and ready. All we have to do is start an IV, put Pitocin in your IV, Pitocin and oxytocin are the same thing, your body doesn't perceive a different between the two, and it causes your uterus to contract. Ultimately those contractions get more intense and more frequent leading to cervical dilation and delivery. A lot of people are afraid of Pitocin because they've heard that it hurts more than spontaneous labor. Actually it doesn't hurt more it just hurts faster. What I mean by that is if you go into spontaneous labor there is a nice curve. You start with very irregular uncomfortable contractions and you work your way up slowly to the ones that are every two to three minutes and really, really intense. Pitocin just takes the beginning stages out of that and you go from 0 to 60 faster and your body doesn't have time to acclimate to the pain. The perception is that it hurts more but ultimately whether it's spontaneous labor or induced labor it's going to hurt just the same in the end, contractions need to be every two to three minutes and be intense enough to get your cervix changing. Some people do say yes, Pitocin makes you hurt more but if you're planning on an epidural you don't really have to worry about that. The beauty of an epidural is that it takes pain away, not pressure sensation, you might still feel pressure but you won't feel pain. You can get it as long as you're having regular contractions. They don't need to be super intense. I always tells my patients the right time to get an epidural is about the time when you feel like you would take a Tylenol for a headache. We ask you a lot at the hospital on a scale from 0 to 10 if a 10 is surgery with no anesthesia. Maybe you're a four or a five if you have a headache and you're deciding if you want to take some Tylenol so it's not going to get worse, that would be about the right time to get an epidural. There have been lots of studies done to prove that epidurals slow labor down and there are lots of studies out there that show that labor speeds it up, it depends on the circumstances. In real practice I've probably seen more instances where epidurals speed labor up. It's really not going to slow you down as long as you're having good, regular contractions. If we gave you an epidural the second you walked in the door and that was the first thing we did to you and we started Pitocin after, we would have a hard time getting your body started. The best thing to do is wait until you've been on Pitocin for a little while, you're hurting just a little bit about to the point where you take a Tylenol for a headache, then you should be just fine. Your labor should progress nicely. Of course your doctors and nurses are going to be there to help you and answer any questions you have. I hope the very best for you and congratulations ahead of time. If you have any other questions for me in the future feel free to ask them on our Facebook page at Facebook.com/IntermountainMoms and recommend us to your friends and family too.

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