Why You Might Want an Induction with Juli Pyle CNM — Episode 156

Let’s talk about why you may WANT an induction, especially as you get towards the end of your pregnancy.

Today’s guest is Juli Pyle (she/her) a certified nurse midwife who practices at a community hospital in rural Pennsylvania. Juli was a stay at mom for many years to five children before deciding to return to school to pursue a degree in nursing. She graduated from Colorado Mesa University with a bachelors of science in nursing degree in 2016 and then began her nursing career as a labor and delivery nurse. She quickly discovered that this was her true passion (as she had suspected since having her own children) and quickly gained a reputation for professionalism, compassion and expertise among colleagues and patients. She then returned to Frontier Nursing University to complete a Master’s degree in Nursing with an emphasis in midwifery. In 2020, she graduated and began as a certified nurse-midwife at a small community hospital in central Pennsylvania where she has been since that time.

Her focus as a CNM is to provide evidence-based education to all birthing families, give true autonomy and informed consent throughout their time with her and to share love, understanding, empathy and true shared-decision making. When not immersed in the birthing world, she enjoys spending time refinishing furniture, gardening, raising and breeding different types of chickens, hiking and vacationing with her family.

This episode was inspired by my induction mini class.

Big thanks to our sponsor The Online Prenatal Class for Couples – if you want to create your confident hospital birth it is the class for you. It has a whole chapter on induction that I think you’ll love!

In this episode

Different types of midwives

Why people want inductions

Why someone can and can not get an induction

Why you might NOT be able to be induced

Other things that might interest you

My Induction Mini Class

Induction at 37 weeks

What to do the night before an induction

Producer: Drew Erickson

Check out my other pregnancy podcasts:

Transcript

[00:00:00.190] – Hilary Erickson

Hey, guys. Welcome back to the Pulling Curls Podcast. Today on episode 156, we are talking about why you might want an induction. Let’s untangle it.

[00:00:19.050] – Hilary Erickson

Hi. I’m Hilary Erickson, the curly head behind the Pulling Curls Podcast: pregnancy and parenting untangled. There’s no right answer for every family, but on this show, we hope to give you some ideas to make life simpler at your house. Life tangled just like my hair.

[00:00:40.210] – Hilary Erickson

Okay, I am super excited for today’s guest. She is a certified nurse midwife. Now, that is different than a lay midwife, and I know a lot of people get confused about that. So I’m going to put my post that explains the difference between the two in the show notes. But she’s a certified nurse midwife in Pennsylvania. I want to introduce today’s guest, Julie Pyle.

[00:01:00.830] – Hilary Erickson

Do you feel prepared for your delivery? In just three short hours, you can be prepared for the confident, collaborative delivery you want. You’ll know what to expect and how to talk with your health care team. And there are no boring lessons in this class. I’ll use humor stories from my 20 years in the delivery room to engage both of you. I love how Alyssa told me that she found herself laughing at things that used to sound scary. Most of all, you guys are going to be on the same page. From bump to bassinet, join the online prenatal class for couples today. You can save 15% with coupon code UNTANGLED. You can find the link in the show notes.

[00:01:35.490] – Hilary Erickson

Hey, Julie. Welcome to the Pulling Curls podcast.

[00:01:38.040] – Julie Pyle

Hello. How are you?

[00:01:39.590] – Hilary Erickson

So good. I think this is such a great thing because I have so many early pregnancy moms who are like, I don’t understand why you’d even want an induction. Right? Yeah.

[00:01:49.840] – Julie Pyle

The first visit we have with moms, often, they’re like, oh, yeah, I definitely don’t want to be induced ever. So it’s always a conversation we have.

[00:01:56.000] – Hilary Erickson

Yeah, I was just talking to Julian. It’s kind of like when you don’t have a boyfriend and you’re a Christian and you’re like, well, I’ll never want to have sex before I get married. Right.

[00:02:04.610] – Julie Pyle

And then things change.

[00:02:07.470] – Hilary Erickson

Right. Things change. Okay, so let’s talk about why. Because I think all these women see 39 weeks pregnant. Women who are like, I think I do want to be induced. And they’re like, why on earth would you want to be induced? So what do you see in your practice, Julie?

[00:02:22.740] – Julie Pyle

Most of the time, people want to be induced or either scheduling reasons or because they’re just sick of being pregnant. So they just have a lot of discomfort. Things are not happy at the last few weeks of pregnancy, and they are just ready to have a baby. They want to have the end in sight.

[00:02:40.020] – Hilary Erickson

Yeah. And I will say, though, I had two babies not induced, and my third one, I got induced twelve days over. Thank you. Labor and nurse going twelve days over. But it is so much easier to schedule it because we didn’t have family in town, so we were relying on friends to, like, hopefully pick a kid up. So scheduling can be really an important factor when you have or I’ve seen moms who have spouses in the military and they’re home or two weeks. Absolutely, yeah. And I would hope all of us understand that we want dad to be there. That’s an important part of labor as well. Yeah.

[00:03:11.320] – Julie Pyle

I try and let my patients know that there are some real reasons that scheduling is a big factor in the birth of a baby. I have five children of my own and was induced with one and not the other four. But I remember the end of pregnancy, waking up every morning and thinking, well, I didn’t have a baby last night, and then going to sleep that night and going, I didn’t have a baby today. And you’re just wondering, when is this going to happen?

[00:03:34.060] – Hilary Erickson

Right? And it’s hard on kids, too. Like, he was nine, eight, nine, and every night it was that question, are you going to be here in the morning? Who’s taking me to school? He feels that anxiety as well, so it’s hard.

[00:03:47.840] – Julie Pyle

And none of us have the answer to that question.

[00:03:50.490] – Hilary Erickson

My mom always thought I did. She’s like, you do this for a living. And I was like, if I knew how mom, I would be so much richer.

[00:03:56.730] – Julie Pyle

Exactly.

[00:03:58.230] – Hilary Erickson

And don’t forget scheduling your doctor, because a lot of people are in big practices. Their doctor only covers call for one or two days a week. They may only want to be done by that doctor. And that’s your choice. I mean, yeah, absolutely.

[00:04:11.960] – Julie Pyle

I think, like we talked about, family reasons are big child care, who’s taking care of the other kids while you’re having a baby? Who’s going to be in town? Military certainly a big deal.

[00:04:22.180] – Hilary Erickson

Or even just business. Like some husbands, like, they got to get back out on the road.

[00:04:26.230] – Julie Pyle

Or your own maternity leave, or your spouse’s maternity leave. Like, you might need to try and plan that so you get the most.

[00:04:32.980] – Hilary Erickson

Time off looking at your teachers. Teachers especially because they’re like, it’s spring break.

[00:04:38.370] – Julie Pyle

That makes sense to me. In the society we live in, figuring out our lives ahead of time makes a lot of sense for most of us.

[00:04:46.810] – Hilary Erickson

Okay, let’s go to the second one. You mentioned just being miserable, and I encourage you guys to not get induced as much as I can, but it is miserable at the end, and when you see just like a whiff of pitosis might just push you over the edge, it’s tempting.

[00:05:02.310] – Julie Pyle

Absolutely. Yeah. I think you probably heard this phrase, and sometimes we joke about to tired of being pregnant, so we laugh about that as midwives. And doctors like, oh, this person is just to BP. But it’s true, because those aches and pains your hips and your back and maybe you’re contracting, but it’s just you’re not in labor yet. Heartburn gosh, everything contributes to just feeling kind of crummy.

[00:05:26.810] – Hilary Erickson

Now, we should say these two reasons that we just discussed, that’s a 39 or after option. Right. Do you induce anybody before 39 weeks anymore?

[00:05:35.690] – Julie Pyle

Not for any of these reasons that we just discussed. Yeah.

[00:05:38.280] – Hilary Erickson

Now, if you’re talking to your older sisters or your mom, I mean, I had a doctor who tried to induce everyone at 35 weeks when I was probably eight years into my practice. So that would have been that’s probably.

[00:05:49.210] – Julie Pyle

Why we have this new 39 week rule.

[00:05:51.170] – Hilary Erickson

2008, I think about she was like, I don’t want them to deliver on the side of the road. I’m like, what? 35 weeks?

[00:05:59.070] – Julie Pyle

Probably not going to happen.

[00:06:00.670] – Hilary Erickson

Yeah. So moms sisters may have been induced before this, but anymore they really stick into 39 weeks. Both the hospitals sticking to 39 weeks. Like, we ask the due date, we make sure that they’re within the range. Some of our doctors like to flip it by before we schedule them.

[00:06:18.380] – Julie Pyle

Yes, absolutely. There’s a couple of checks and balances that way now, which is better for a healthier mom’s, healthier baby kind of situation.

[00:06:25.910] – Hilary Erickson

And now, obviously there are other reasons why you might want to get induced, and we’re not going to talk about all those reasons, but you might have a medical reason, and it may sort of be on the edge. So how do you counsel people with that? Like, your blood pressures are high. I don’t think it’s like all the way high. And so that can be really hard, too, where it’s kind of like yeah. What do you want to do?

[00:06:43.790] – Julie Pyle

Yeah. There’s a few different medical reasons, true medical reasons that have a pretty significant range. It might be a ten day range that we should induce somewhere in this window. So deciding that can be a little bit of a discussion with your midwife, with your physician and your family, your spouse, whoever might be involved, to figure out the best case for you individually.

[00:07:04.560] – Hilary Erickson

Yeah. So what comes into play with that? Obviously your cervical exam. They’re probably going to want to check you and see what your cervix is doing, because if your cervix is closed thick and high, that’s going to be a long induction sometimes necessary.

[00:07:15.370] – Julie Pyle

Right, right. Yeah, definitely. Is the cervix looking like it’s ready for labor also? Are we talking about just barely 37 weeks versus almost 39 weeks? Like, that baby is going to have a different response to life after delivery if it’s a little bit later, and then possibly what the hospital census is like, is it really busy? Do we have a spot where there’s nothing going on that day that might make sense? There’s a few things to consider.

[00:07:42.010] – Hilary Erickson

Yeah. And we should say that with the elective inductions when we were talking about. So an elective induction is just when it’s an induction that you want versus a medically indicated would be one that we could do before 39 weeks. But the elective inductions go at the bottom of the line. In the hospital, we obviously would take somebody who’s got a medical reason to be induced ahead of that. So it’s just not like reservations at a restaurant, sadly.

[00:08:01.970] – Julie Pyle

I do try and really reiterate that when we talk about that with patients, it’s like, okay, we have you on for this day and time. However, if the pregnant bus shows up and everybody in labor comes in, or there’s other medical reasons for people to be there, you’re probably going to get postponed a little bit.

[00:08:17.720] – Hilary Erickson

Yeah. Or frankly, in this day and age, there is no staff or there’s no staff.

[00:08:21.250] – Julie Pyle

Absolutely.

[00:08:21.980] – Hilary Erickson

Because you got to have a nurse. We can’t induce people without a nurse. You can try that at home, I.

[00:08:26.600] – Julie Pyle

Guess, which probably hasn’t worked before if we’re having this conversation. Right.

[00:08:32.310] – Hilary Erickson

All right. So making the decision. I think what we took from this episode is that it is a viable option. A lot of people get their panties in a bunch, especially on TikTok, that no one should be able to choose an induction. Like, it shouldn’t be a choice only if it’s like the life of the mom or the baby is in trouble, and I don’t agree with that. Where do you stand, Julie?

[00:08:52.310] – Julie Pyle

Yeah, well, I think we don’t live in a world that that makes sense anymore. Right. There are so many other factors in our life that we have to talk about, we have to plan for. And I think on both ends, somebody should not feel guilty if they really want to be induced and they really are tired of being pregnant. Like, they should be like, this is my decision, and it’s okay. And on the other side, if somebody is reaching 42 weeks or whatever it may be, they should be supported in the decision to wait for labor to start on its own. So we really just have to be happy with our own decisions and our values with that, and hopefully have a provider that is on board as well.

[00:09:27.230] – Hilary Erickson

And you have to listen to your provider because I didn’t want to be induced. So many tears, but I had had a nine pound baby last. I had a fourth degree tear. There were all these reasons that she was, like, sat down, she held my hand. Hillary, it’s really time, and I had to be open to that. Hillary wasn’t in charge. That’s sad.

[00:09:45.210] – Julie Pyle

That’s one of the most difficult things right in our brain, is to not be in charge anymore.

[00:09:50.190] – Hilary Erickson

Yeah. Not in charge of your own body is hard. Okay. Julie, anything else you think people could learn about inductions? A quick tip about inductions.

[00:09:56.440] – Julie Pyle

I think the reality is that people have to realize that an induction is not going to look the same as natural labor. It’s going to be different. And you should anticipate bumps in the road or things you haven’t thought of and the length of time of inductions. We just can’t anticipate how that might look. I’ve had plenty of people that the induction is way faster than any of the other labor and then vice versa, where they think it’s going to be fast and it’s just not. So you have to take all of those things into consideration and really make the best informed choice for yourself.

[00:10:24.520] – Hilary Erickson

Yeah, all we can do is make a guess off of all the other labor we’ve seen that had a similar service to you, but that’s really all it is. That’s really all medicine is just yeah.

[00:10:33.440] – Julie Pyle

One of my favorite preceptors, one of her sayings she always said to me was, it’s one of the ten right ways to do things in OB, which is so true. And there’s probably at least ten different ways that people will induce the labor, so it’s not going to be the same for everybody and every place.

[00:10:48.860] – Hilary Erickson

Yeah. Great advice. All right, thanks so much for coming on, Julie. I appreciate it.

[00:10:51.780] – Julie Pyle

Absolutely. Thank you.

[00:10:53.580] – Hilary Erickson

Okay. I love that episode. I hope you guys really enjoyed it. I think we need to support women in all their different kinds of labor choices. I see so many people out there who think there is only one way to give birth to a baby, but the best way is to take the advice of your provider and what’s going on in your home life and decide what works for you. There are hard stops, like we mentioned, like 39 weeks. We are not going to electively induce you. That’s a hard stop at the hospital. But after that, we’ve given you guys some leeway, and so I would just encourage you to take it and see what works best for your family.

[00:11:23.620] – Hilary Erickson

Now, if you guys are looking for more information on inductions, I have a whole mini class on what happens at an induction. It’s cheap, it’s available. I will put it in the show notes if you’re looking to just learn more about what happens at an induction to get prepared.

[00:11:37.260] – Hilary Erickson

Thanks so much for joining us on today’s episode. The Pulling Curls Podcast grows when you share us on social media or leave a review. If you do, please tag us so that we can share and send you a virtual hug, which, frankly, is when a favorite kind of hugging. Until next time, we hope you have a tangle free day.