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Topic: Induction

RC: Hello everyone, this is Liz Harvey coming to you from our studio in New York City where we are dedicated to bringing you cutting edge interviews from many of the leading industry professionals across the United States.

In today’s episode, we are speaking with Stephanie Heintzeler. Stephanie is a German educated midwife, a U.S. educated doula, an acupuncturist and she is a certified lactation counselor (CLC). She is known as The New York Doula.

Stephanie has delivered over 1200 babies and has experience with twins, triplets, breech babies and water births. She also works with newborn parents in their postpartum stage and holds classes and seminars for moms and dads to be.

With a wealth of experience and knowledge in her field, Stephanie Heintzeler is widely considered to be one of the top doulas in the country. She is also a contributing member of our national network of industry professionals.

Today we are going to talk about a very important topic: Induction

RC: Hello Stephanie. How are you today?

Stephanie Heintzeler: I’m very well. How are you?

RC: I’m doing great. Thanks so much for joining us.

Question 1: Can you please explain what Induction means as it relates to a pregnancy and why it might be necessary?

Stephanie Heintzeler: Induction means to either naturally or artificially bring the body into labor so that the baby will be born, either before the due date, around the due date, or after the due date. It just means to do something to bring the body in labor.

Question 2: What are the steps involved in the induction process in the hospital?

Stephanie Heintzeler: It depends. There are a few things that can be done at home. For example, in the hospital we have several reasons why an induction is recommended. For example, if a mother is going overdue, like if she’s way too overdue and her water breaks and she does not have any contractions, she has illnesses like preeclampsia or some chronic illnesses and depending on what the mother has there are different medications that will help the mother in labor. What is important to know that induction can easily take two days. Induction doesn’t mean that the mother will have the baby today. It means they will try to bring the mother in labor and then once she’s in labor it might take another 24 hours because you took medications to bring the mother there, when, in fact, her body wasn’t ready. Therefore, there are steps that will be taken to bring the mother in labor. There’s about four different things that can be done that they start with such as Foley catheter. Meaning, they will put a catheter, they will insert a catheter into the mother’s cervix, which unfortunately is incredibly painful, and then that balloon will be blown up from the inside and slowly stretch out the cervix so that the cervix opens up from the inside.

Once the cervix is opening up, then they would start with so-called Pitocin which is artificial contractions. Maybe also they will use prostaglandin, which is a gel that will be put in front of the cervix, or the mother will swallow Cytotec, which is a medication that is given so the mother goes in labor. This medication though is not allowed in Europe, so it’s not approved by the FDA here as well, but hospitals still use it. It would be important to discuss with the doctor or midwife what medication and what certain procedures are used to induce a mother.

Question 3: Are there any risks involved with inducing labor?

Stephanie Heintzeler: Yes. The main risk is really that the mother ends up in a C-section. The risk is about 50% as high as she would go in labor normally. The reason is that her body was not ready. Some mothers never go in labor even with all this medication. Some babies don’t like the medication so suddenly their heartbeat gets funky so the team decides to do a C-section. The main thing is that with an induction the mother usually gets a lot of pain medication because the contractions are not her own contractions. With all these medications that bring a mother in labor, often times the mother says pretty early on in labor, she’s like, “I can’t do this.” Way too much and way too fast. She unfortunately needs an epidural. At the same time, she’s tired because in most hospitals, in New York City for example, the mother gets induced at midnight, which I find the most ridiculous thing ever because it’s easier for the hospital to induce at night so the mom will be in labor in the morning so the doctor can be there during the day for the birth. It’s really a scheduling thing. You’re in labor. You’re starting to go in labor at midnight, you’re tired. You’re not allowed to eat. Therefore, you need a lot of medication and so with all this medication, labor can’t really progress.

Sometimes just because labor stalls or the baby can’t really take on all this medication, the mother ends up in a C-section or in another kind of birth with vacuum or forceps birth. It is generally a much more medicated birth once there’s an induction but it doesn’t have to be. Sometimes the body was ready and just needed a little push and boom the mom is in labor and the baby comes out without any other medications – just that you push. It kind of depends on how ripe the cervix is, like how ready she is, if she has a few contractions beforehand. Those are all signs of how big is the chance that she’s going to have a vaginal birth.

Question 4: Does acupuncture help induce labor?

Stephanie Heintzeler: Yes. What the mother should have done though is do acupuncture throughout pregnancy. Acupuncture can help tremendously to go in labor especially once you’ve had a few treatments in the last weeks of pregnancy and then more points are being used to kind of strengthen the uterus and soften the cervix. The other thing that can help is a chiropractor visit to bring the baby in a good position. There are a lot of other natural remedies that can help to get a mother in labor. Doulas have a huge list of things that can help from certain foods, certain positions, certain natural remedies, always back up with your obstetrician, up to little things like keep moving, move a lot, do a massage, see what’s going on with yourself like is she ready mentally to go in labor. Some mothers even say, you know, I don’t feel I’m ready. Baby’s not ready. I’m just really comfortable. I don’t feel there’s anything happening the next days and usually mothers are right. That’s something to look into as well and maybe discuss with obstetrician or midwife if it would be possible to stay pregnant a few more days.

Question 5: People say that if you eat spicy food or drink castor oil that you can induce labor. Are these old wives’ tales or are there some natural at-home methods that might actually work?

Stephanie Heintzeler: There are a few things that work. It always depends on how ready the body is. Castor oil, for example, it gives diarrhea. It’s like a massage from behind basically. It’s soft intestines. It’s the same muscle, a soft muscle. It’s the same kind of muscle that the uterus has. Let’s say the mother has diarrhea, chances are she’ll go in labor just because everything’s kind of coming out, everything is moving. There’s certain foods, spicy foods for example. There are certain recipes like eggplant parmesan. Eggplant has an enzyme that can help to go in labor. The eggplant parmesan is a crazy recipe and I’d be happy to share if someone contacts me. It’s a recipe with certain kinds of herbs and cheeses that will just help the mother to digest a really long time. Therefore, it can also help.

Sex helps tremendously. There are prostaglandins in sperm. Prostaglandin is a medication that is being used to go in labor. There are a lot of little tips and tricks that can help and I’ve certainly had quite a lot of moms who went in labor that their body needs to be ready. You can’t do that two weeks before your due date if the hormonal levels are not really accurate, but it can help when the mom is kind of contracting a tiny bit and she just feels more tense, the body is just ready. In communication, I talk with my clients, to be a helpful midwife to really see what works at this point. What does she have? What signs does she have? Then we use those signs and just help them, bring them out a little more.

RC: Well, this has been great advice. Thank you, Stephanie. We know you’re busy, so I just want to thank you for your time and your help today.

Stephanie Heintzeler: You’re very welcome. Thanks for having me.

RC: For our listeners across the country, if you are interested in speaking with Stephanie Heintzeler, you can either go on line to www.thenewyorkdoula.com, or call 917-399-2031 to schedule an appointment.

On behalf of our entire team, we want to thank you for listening. We look forward to bringing you more top quality content from our country’s leading industry professionals.