Hi, induction was a big deal for me and I learnt all that I could about it as I nearly had to go through the process at QMH. My best advice is to listen to what everyone has to say about QMH, but be prepared for things to happen completely different as, in general, the practices vary greatly between different midwives and different doctors.
'Gel' actually contains the same medicine as the pessaries - prostaglandins - so it's not suprising that you've heard of people not receiving this. They defintiely do use pessaries. I actually arrived at the hospital for my induction already in early labour, but all the same I was given a pessary while being examined. However, I know someone else who had her waters broken and and her pitocin drip started at the same time without pessaries being tried beforehand. She asked about the pessaries but didn't insist on it as she was assured that, although she wasn't dilated, her cervix was already ripe so they weren't necessary. The end result was that she got really, really painful contractions two minutes apart right from the start and then was given such a strong epidural she ended up pushing for three hours before her baby was plucked out with forceps. Therefore, if they try to induce you without prostaglandins say NO!!!!! Even if you need petocin/oxytocin later, at least you'd have had a chance to get some endorphins going and I read in one magazine (not the Lancet I know!) that they will kick start labour in 90% of cases.
Rupturing your membranes has the duel effect of putting direct pressure on the cervix and causing a big flow of natural prostoglandins so if you can, try to get your doctor to perform an ARM and then give you some time to see if that works before bringing on the pitocin you will hopefully be able to move around still, which will also help things along on their own. It all depends on what doctor and what midwife you get though, as some won't have you anywhere else but on the bed and it is difficult to argue with the people who you're entrusting so much with.
I'm sure the only reason I escaped my induction was because I managed to induce labour naturally. I used to be very sceptical of alternative medicine but faced with induction I was willing to give anything a go! I did everything in Zita West's Natural Pregnancy book - acupuncture, homeopathy, sex, walking loads etc - to get things going and I'm sure what clinched it was getting acupuncture induction points marked on me by a TCM which I was then able to strap my TENS machine on to. Osteopaths are also meant to be very good at starting labour by stimulating certain points, but I ran out of time to try this route.
Since you asked about policies I should warn you that they're very keen on stripping your membranes, which is fine and a good 'natural' way of inducing labour, but they don't ask your permission first. My doctor told me she was just examining my cervix so I got a shock when she started doing something very painful all of a sudden down there. The same thing happened to a friend while being examined by a different doctor, so it seems to be their modus operandi. Before any vaginals, I'd just ask your doctor to warn you if he/she planned to do a sweep as well so that you're prepared for the discomfort. The same thing happened with the pessary, which was a real bummer as I wasn't allowed to go home after it was inserted. By the way, before they worked out that I was in labour, I insisted that they perform an ultrasound to make sure that I really needed the induction. This caused a bit of bother for them as they had to find a spare machine, but I'd made my OB promise me at our last checkup that she'd do so, so it happened. You could ask to what your 'Bishop's score' is (
http://www.mother-care.ca/bishop.htm), just to reassure you that they are not just following the calandar or being gung-ho.
If at the end of everything you do need to be induced, don't worry as you will get through it and will have a lovely baby to hold at the end. In addition to the pessaries, you can also give your body a chance to build up some endorphins by hooking up a TENS machine as if you were in labour before the pitocin starts. TENS machines actually work in labour by blocking pain signals and stimulating endorphins so it's worth a go. Keep in mind too that usually on monitor printouts pitocin contractions measure much, much larger than 'normal' contractions. Therefore, there is no shame in taking the epidural!
You're already 34 weeks and are being watched closely so you will be both safe.
