This is the story of Isabel's birth. I was several days past my due date (about 80% effaced but not dilated), and despite doing pregnancy aerobics and gaining only 19 pounds (I was 115 when I got pregnant) I had developed gestational diabetes. My blood sugar was successfully controlled by diet, but my doctor and midwife wanted to "ripen" things up a bit to in hopes of initiating labor. I had tried several natural induction methods: nipple stimulation in 1 hour increments for 3 hours a day, evening primrose capsules, and oral doses of 5W, that contained black cohash and squaw vine to tone the uterus. Since these methods didn't produce concrete results, I went into the hospital on Tuesday night to have prostaglandin gel applied to my cervix. My midwife Joy was optimistic that my cervix would dilate enough so she could strip the membranes. The gel did bring on contractions and by early Wednesday morning, they sped up to 2 minutes apart. My doula, Robin was with me, as was my husband Art, and with their support, the contractions were quite manageable. I used my Bradley relaxation techniques and they really helped. My cervix dilated to about 1 ½ cm so Joy stripped the membranes. The contractions continued until about 11:00 that morning, and then gradually tapered off. To my disappointment, I hadn't dilated much beyond the 1 ½ cm. Since we did not want to try pitocin at this point, Joy suggested I go home and see if labor would start on its own.

During the day on Thursday, I remained active and tried blue and black cohash tinctures. Some contractions did result, and when I talked to Joy that afternoon, we agreed that I would come back to the hospital on Friday and try induction with cytotec rather than pitocin. We hoped that one oral dose would be enough to start labor on its own. Unlike pitocin, cyotec is given orally, so I wouldn't be attached to an IV the entire time.

We arrived at the hospital at about 8:00 am on Friday. When Joy examined me, she told me I had dilated to 3 cm while I was home. I was optimistic that the cytotec would kick things into gear. While induction was never part of our birth plan, neither was gestational diabetes. Both my husband and I didn't want to be so rigid in our birth plan that I ended up with a c-section because the baby grew too large to fit. We both wanted to try for an unmedicated, vaginal delivery if possible. I was given an oral dose of cytotec and a heparin lock in case I needed an IV at a later time. By 1:00 pm, very little had happened. I had some very mild contractions, not as intense as those caused by the prostaglandin gel. We decided to try another dose. By 5:00 pm, still nothing. Joy checked my cervix and I was still at 3 cm. I even got dressed, went outside with Robin and Art and sat on the patio outside the hospital and enjoyed the beautiful August weather. Not exactly the hoped for result.

I returned to my room, wondering how my body could be so resistant to induction. Didn't my baby want to come out? I'd had an easy pregnancy despite the diabetes, so part of me was content for him or her to stay in there. The hours ticked by with little developments. Robin and Joy decided to go to Joy's house (about 10 minutes away) to get some sleep, and we would reassess in the morning. Art and I decided to go to bed early.