stretching the cervix

Tamara - posted on 05/01/2009 ( 14 moms have responded )

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hey
my due date was yesterday and yet we still have no baby. if he doesnt come before tuesday the i have to go to the hospital and they are going to stretch my cervix. umm how painful is this i have never heard of this process. my whole pregnancy i have not been scared of giving birth. but the thought of them doing that to my cervix is scary.

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[deleted account]

Don't worry too much. Most of the time they start with putting cervadil in you cervix. You shouldn't feel a thing. If that doesn't work, they might try Pitocin. This will cause hard, fast contractions. You might want an epidural if they do it. As the baby presses down on the cervix, that is what hurts. As you push at the very end the doctor normally will stretch the cervix, but you won't feel that. It just helps keep you from tearing. I am a NICU RN and see lots of births. Each one is different and amazing. Just go in with an open mind and do what you need to do to have a safe, healthy delivery and baby. Congratulations!

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Brenda - posted on 05/06/2009

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And btw, the drug that is used off label for labor induction is cyotec, NOT cervidil. They are two different drugs. Cytotec is labeled as an ulcer medication and is often used to induce labor.

Brenda - posted on 05/03/2009

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And just a note on cervidil, if the drug is not FDA approved for this use why does all the information on the drug indicate that is its usage?



"Cervidil Vagl Uses



This medication is used to help prepare your cervix (the lower opening of the womb) for labor and delivery. It is used in women who are having a normal pregnancy and who are at or near their delivery due date. Dinoprostone is a natural substance that your body makes in preparation for labor. It relaxes and softens your cervix (cervical ripening) to allow the baby to pass through the birth canal during delivery.



"How to use Cervidil Vagl



This drug is inserted high in your vagina next to the cervix by your doctor or midwife. You will be lying down while the medication is placed, and you will usually need to continue lying down for 2 hours after insertion. Your doctor or midwife will tell you when you can get up and walk around.



This medication should only be used in a hospital setting with trained medical care available. You will be monitored for changes in your cervix, for signs of active labor (e.g., water breaking, strong sustained contractions), and for your baby's condition. Your doctor or midwife will remove the insert if there are side effects, after 12 hours, or when it is no longer needed. The drug's effects wear off quickly after the insert is removed."



And since you've heard the "scary" vesion of the side effects, here are the official side effects list: (The Prozac I take daily has more...)



"Cervidil Vagl Side Effects

Side effects such as fever, nausea, vomiting, diarrhea or abdominal pain are uncommon and usually mild. If these persist or worsen, notify your doctor or midwife immediately.



Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.



Tell your doctor immediately if this uncommon but serious side effect occurs: strong contractions that are very close together (uterine overstimulation).



This drug has rarely caused injury to the womb (uterine rupture), which may require emergency surgery. Symptoms include severe pain in your womb and an abnormal heart rate in your baby. Your doctor or midwife will be monitoring for this and for signs of uterine overstimulation.



A very serious allergic reaction to this drug is unlikely, but immediate medical attention is required if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.



This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.





Contact your doctor for medical advice about side effects. The following numbers do not provide medical advice, but in the US you may report side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088. In Canada, you may call Health Canada at 1-866-234-2345."



ALL this information is from WebMD.com, the website my doctor specifically told me to check out if I had any questions about drugs or procedures or even worries. I hope this helps you hon, just in case they want to use it.

Brenda - posted on 05/03/2009

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I had cervadil and pitocin with my induction with my first (I had pre eclampsia). The cervadil is a pain but it some cases its effective. My doctor this time is waiting until 41 weeks before we induce (I'm due weds and have gest diabetes this time but no pre e). However, this time, if she induces, she may start with breaking my water b/c I'm almost 3cm this time. Last time, when they applied the cervadil I was at a tight, high, thick 1cm. They broke my water at 2cm several hours later and then I had to go on with the pitocin because my body never really took over for the labor and I think they had me on the highest dose pitocin possible. Lets just say I had Stadol and an Epidural before I was done. However, the cervidil didn't really hurt (other than the application of it being uncomfortable). Mine was a tough one though because my cervix wasn't that ready for birth, and if it hadn't been for the pre-e I wouldn't have been induced at all (but my son was 8 1/2 pounds almost so he would have been huge if I hadn't been).



They might be talking about something similar to having your membranes swept. Sometimes, when they mess around with the cervix it can start it dialating just from the gell they use. Did they call it an induction or just say they were going to try stretching the cervix a bit to see if they could encourage it to dialate on its own? I had an exam and that night had some bloody show just from the gell causing my cervix to dialate a little more. If they're already talking about this, you must be pretty soft, and close to going.



A lot of times they try to get the ball rolling after 40 weeks in case of overgestation. As long as your baby is doing well, and around the 40 week mark, it should be fine. While I believe in waiting as long as possible, they have to pay extra close attention after 40 weeks, because of some of the stuff that can happen if they're too far overdue, so they'll usually watch you close. The biggest fear with an overdue baby is passing meconium (sp) in the womb, which is why some docs don't like to wait till much after 40. I have my appointment for 40 weeks Tuesday, and if baby is still stubborn, I'm sure I'll be scheduled to go in the following week for an induction with hopes it isn't necessary. And remember, no matter what pain you have, it will all be over very fast (though at the time it might not seem that way).



Good luck! And maybe you'll have surprise labor before then, I know I'm hoping to as well! :)

[deleted account]

Quoting Kathy:

First, remember that you have a say in this -- it's *your* pregnancy, *your* body, and *your* baby. If you don't understand what they're wanting to do, you should ask for more information, so that you can truly give informed consent. Right now, it sounds as if you're consenting, without being truly informed.

First question to ask your doctor -- *why* is it so important that your baby be born now? Most inductions are not medically indicated, which means they just introduce unnecessary risk for no medical benefit. The typical reason given for induction is the fear of stillbirth; however, studies show that there is no increase in the rate of stillbirth until after 42 *completed* weeks of gestation -- you're still in the middle of your 40th week. [And even then, the rate of stillbirth goes from something like 1/1000 to 2-3/1000.]

You need to understand the risks of induction. It sounds like they're going to use either a foley catheter to slowly stretch your cervix (sometimes midwives or doctors or labor nurses will manually stretch the cervix, in a few instances -- and yes, that can be painful). They may also give you prostaglandins to dilate or efface the cervix (cervidil or prepidil). I saw that someone below mentioned a pill placed in the vagina or in/on the cervix to induce. You need to know that this pill is not FDA-approved for labor induction, and the drug's manufacturer has specifically said it should not be used in this way (but doctors are still using it anyway). This pill's brand name is Cytotec; the generic name is misoprostol, frequently called "miso". It is contraindicated in pregnant women, because it causes uterine contractions which can induce a miscarriage or abortion. This drug is frequently given to induce abortions, even though it can cause uterine rupture if the woman is past 9 weeks along -- this includes full-term women, particularly those who have had a C-section. It can ripen the cervix, and also can induce labor -- but some women have died, some children have died, some women have ended up needing a hysterectomy, because of this drug.

It doesn't sound as if you really need to be induced. Your body hasn't gone into labor because you're not ready to give birth! Your baby isn't ready to be born yet! (Most first-time moms will go into labor at 41 weeks 1 day, btw.) You have the right to be fully informed of all the risks and benefits of the course of action your doctor is suggesting AS WELL AS any alternatives, including doing nothing.

It's okay to be a pain in the butt to your doctor. :-) You're the one who is going to have to live with whatever happens for the rest of your life; your doctor may not even remember you in two weeks!


From reading your post Kathy, I understand that you are well informed and well educated.  But are you TRYING to scare the shit out of her?  About 2/3 of what you said, in my opinion, is unnecessary at this point.  If she were wanting advice about NOT inducing, your post would be perfect.  But that's not what her question was about.  She wants to know what stretching the cervix entails.  From someone who's had it done, first of all, having the cervix stretched doesn't hurt nearly as much as contractions do.  Have you ever personally had it done Kathy?  Didn't think so.  I appreciate all of your medical knowledge....don't get me wrong.....but Tamara (the original poster) was only asking how painful it is. 



Tamara, by the time they do that to you, IF they have to do that to you, you will be in labor...FULL ON LABOR.  Trust me, you may feel it, but it won't feel any different than any of the other times they will come in and stick their hands/fingers in you through out labor.  Don't let too much info scare you.  You'll be ok no matter what they do...just remember that YOU are in control of your labor and delivery and NO ONE....not even a doctor, can dictate to you a single thing.  It's all about you Momma!  Just breathe, hum, moan or whatever you have to do to get through it.....best of luck to you and  your soon to be brand new baby!  Also remember that half of what you hear is BS when it comes to you and your baby.  The best thing you can do is listen to your gut.....you're a mother even though your baby is still inside you....listen to that voice inside and you'll be ok and so will your baby.

Cristina - posted on 05/02/2009

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For the record, I had every intervention possible - Cervadil, pitocin, stripping my membranes, epidural, and an episiotomy - and both my baby and I were fine and well. The bottom line is you are not a doctor, and although I agree with some of the statements above about being informed, your doctor knows what's best for you, and it would be legally and morally irresponsible for your doctor to tell you to do something that would harm you and/or your baby. So I wish you the best of luck with everything, no matter what you decide.



P.S. And just like some women have died from using Cervadil, I am sure an equal amount have died from doing nothing.

[deleted account]

First, remember that you have a say in this -- it's *your* pregnancy, *your* body, and *your* baby. If you don't understand what they're wanting to do, you should ask for more information, so that you can truly give informed consent. Right now, it sounds as if you're consenting, without being truly informed.

First question to ask your doctor -- *why* is it so important that your baby be born now? Most inductions are not medically indicated, which means they just introduce unnecessary risk for no medical benefit. The typical reason given for induction is the fear of stillbirth; however, studies show that there is no increase in the rate of stillbirth until after 42 *completed* weeks of gestation -- you're still in the middle of your 40th week. [And even then, the rate of stillbirth goes from something like 1/1000 to 2-3/1000.]

You need to understand the risks of induction. It sounds like they're going to use either a foley catheter to slowly stretch your cervix (sometimes midwives or doctors or labor nurses will manually stretch the cervix, in a few instances -- and yes, that can be painful). They may also give you prostaglandins to dilate or efface the cervix (cervidil or prepidil). I saw that someone below mentioned a pill placed in the vagina or in/on the cervix to induce. You need to know that this pill is not FDA-approved for labor induction, and the drug's manufacturer has specifically said it should not be used in this way (but doctors are still using it anyway). This pill's brand name is Cytotec; the generic name is misoprostol, frequently called "miso". It is contraindicated in pregnant women, because it causes uterine contractions which can induce a miscarriage or abortion. This drug is frequently given to induce abortions, even though it can cause uterine rupture if the woman is past 9 weeks along -- this includes full-term women, particularly those who have had a C-section. It can ripen the cervix, and also can induce labor -- but some women have died, some children have died, some women have ended up needing a hysterectomy, because of this drug.

It doesn't sound as if you really need to be induced. Your body hasn't gone into labor because you're not ready to give birth! Your baby isn't ready to be born yet! (Most first-time moms will go into labor at 41 weeks 1 day, btw.) You have the right to be fully informed of all the risks and benefits of the course of action your doctor is suggesting AS WELL AS any alternatives, including doing nothing.

It's okay to be a pain in the butt to your doctor. :-) You're the one who is going to have to live with whatever happens for the rest of your life; your doctor may not even remember you in two weeks!

Nancy - posted on 05/02/2009

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I had 3 courses of cervadil (36 hrs). I'm a type 1 diabetic who had started showing signs of preeclampsia. I had made my Doc promise me that she would do everything under the sun to help me avoid a C-section. At 40 weeks and 3 days I went in to start a slow induction. The only thing that hurt was when my doc tried to strip the membrane before she put the cervadil in...she has really abnormally short fingers and it felt like she was putting in her whole hand! I was allowed to be taken off the monitor for an hour after the 3rd treatment was almost done and allowed to go outside for a good walk with my hubby and sister. I did the stairs and 2 hours later my water broke. 18 hours later I delivered my beautiful 10lb 11oz daughter and no C-section!!!

Holly - posted on 05/02/2009

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On the day I was to be induced I was told that I was actually beginning labor - 6 hrs later (not all hard labor thank god) I had my son. Here's what my family Dr. told us to do - take long hot baths (as many as I wanted) and drink 1/2 to 1 glass of wine (no more than 1 in a day) to relax my muscles, and go on bumpy car rides. Sounds rediculous but I was terrified of being induced (was told horrific stories) & my gyno said he didn't know if it would help but told me at this stage it would not hurt anything (especially not the baby). Good Luck and Grats!!!

[deleted account]

Quoting Cristina:

That pill Joy was talking about is Cervadil, and it doesn't ALWAYS work, but it did for me! If it helps, my labor was a breeze, even with being induced. With all the horror stories that people will tell you about labor, please know that it is not that bad and it is SOOOO worth it



When they told me they were going to induce me I was TERRIFIED of the Pitocin!  The doctor came back into the room with the pamphlet for Cervadil (thanks for refreshing my memory!) and I was SOO relieved.  It took longer than it probably would have if I had taken the Pitocin, but I was ok with that.  They put the pill in at 7am and I walked the halls until my water broke at 3:30 (finally).  From there, labor was not nearly as bad as I thought it would be.  And I'm glad my doctor didn't jump right to Pitocin like some doctors do.  I've heard that labor with Pitocin is fast and harder than "normal" and that the chance for tearing is greater. 

Cristina - posted on 05/02/2009

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That pill Joy was talking about is Cervadil, and it doesn't ALWAYS work, but it did for me! If it helps, my labor was a breeze, even with being induced. With all the horror stories that people will tell you about labor, please know that it is not that bad and it is SOOOO worth it

[deleted account]

I was induced at 41 weeks. Not with Pitocin...can't remember the name of it but there is a pill that they place on the cervix to induce labor. Anyways, the nurse didn't start stretching my cervix until I was in active labor, fully dilated and pushing. I think it has something to do with helping the baby's head out once they are in the birth canal. By that time, I was so concentrated on breathing through the contractions that honestly I didn't even feel what she was doing down there. My husband watched her though and describes it like taking the two fingers on each hand (the middle and pointer) and slowly stretching a thick rubber band or a hair tie. That's how he describes it lol

Lee-Anne - posted on 05/01/2009

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no i have been induced and its not as scary as the giving birth i think they strech it because it got somthing to do with 10cm dialation or somethink like that any way hope baby comes soon and all the best

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