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How soon would you let dr strip membranes?

post #1 of 13
Thread Starter 
Ok, here's the story. I am 34 weeks with my third, new dr as mine retired. First pg was CS due to frank breech, but dilated to 10, tried pushing, etc. had Vbac with 2nd, very quick, 8 days early, natural childbirth. It's been 11 years since I gave birth.

Ob today tells me that he will do the strep b test at 36 weeks visit. then at37 weeks, he wants to start checking my cervix and when it feels ripe, he wants to strip my membranes. He said he wants to be proactive in trying for a VBAC and getting labor to start, so that I don't go overdue (Apparently the hospital has some rules regarding VBAC, overdue, medications, etc.) He wants to have 4-5 weeks to work on getting labor to start rather than just 1-2 at 40. In my head, this makes sense to me, but I was kind of hoping just to 'go.' Like the other two times.

Are there risks for this? Would you do it? Why or why not? Just wanting to hear some opinions while I decide if this works for me. Thanks.
post #2 of 13
If it were up to me, I wouldn't go there. The risk of infection increases the more people are in your "business", kwim. I can't tell you offhand any statistics, but I'm pretty sure even with membranes being stripped, labour won't really start until the baby is ready anyway. I would look into the restrictions for overdue vbacs though. There isn't any reason why a overdue vbac should be treated any differently than anyone else. Unless he's talking about a restriction on inductions for vbacs, which is fine and makes sense (though I know where I live, they have no problem giving pitocin to vbac'ers).

I really wouldn't worry about that until it started becoming a problem though. If you need things to get going, there are other things you can do when the time comes.

Just my opinion!



Quote:
Originally Posted by goodmomma76 View Post
Ok, here's the story. I am 34 weeks with my third, new dr as mine retired. First pg was CS due to frank breech, but dilated to 10, tried pushing, etc. had Vbac with 2nd, very quick, 8 days early, natural childbirth. It's been 11 years since I gave birth.

Ob today tells me that he will do the strep b test at 36 weeks visit. then at37 weeks, he wants to start checking my cervix and when it feels ripe, he wants to strip my membranes. He said he wants to be proactive in trying for a VBAC and getting labor to start, so that I don't go overdue (Apparently the hospital has some rules regarding VBAC, overdue, medications, etc.) He wants to have 4-5 weeks to work on getting labor to start rather than just 1-2 at 40. In my head, this makes sense to me, but I was kind of hoping just to 'go.' Like the other two times.

Are there risks for this? Would you do it? Why or why not? Just wanting to hear some opinions while I decide if this works for me. Thanks.
post #3 of 13
Personally, I considered a membrane sweep at 38 weeks, but when I got to 38 weeks I still had so many things to wrap up at work that I decided I wasn't ready for the possibility of going into labor, so I pushed it back to 39 weeks. As it turned out, it didn't matter anyway - I was high and closed at 39 and 40 and 41 weeks (baby was born at 41+2). I was very very afraid of going too far postdates (my first baby was a c/s due to breech and I never went into labor at 39 weeks). It sounds like in the past you've gone early, and there's a good chance you will not go much past 40 weeks with this pregnancy. Given your history, I'd probably hold off until 39 weeks and then start a sweep if you want. But that's just me.

I don't get the sense that sweeps work to induce unless you're close anyway, so sweeping at 37 weeks seems like a waste of time and energy to me.
post #4 of 13
My OB absolutely will not do a membrane stripping until 39 weeks at the earliest. He said it like it was some sort of official rule. At least it's a rule for their practice, because one of the other OBs metioned something similar.

I had the membrane stripping at 39w0d with my second vbac (first vbac was premature twins; reason was I have clotting issues so they didn't want me going to 40w. Plus he was probably sick of my usual third trimester whining lol). I was already 2-3 cm dilated and 80% effaced. So it didn't take much. DS was born about 24 hours later. With my third vbac I went into labor spontaneously at 38w0d, so it never became an issue.

If I were in your shoes, I would not be doing a membrane stripping until I was ready to deliver, i.e. probably 39w and with a rather ripe cervix. My understanding is that if it works, it works right away, as in within a day or two. And there is the risk of breaking the bag.

If you delivered at 38w before (albeit years ago), why is the doc so concerned that you're going to be late? Why not just cross that bridge when you come to it? You may well not need any stirring of the pot.

It seems to me that the doc is a little nuts to think he/she can make little weekly adjustments that are going to put you on a path to earlier labor. It just doesn't work that way, at least not in my mind. Either you'll go on your own, or you'll be so ripe that a little push (like the sweep) will send you over the edge, or you won't be ripe enough, and I fail to see, beyond the little push to put you over the edge, what the doc can possibly do so far ahead of time to put you on a path to early labor. I don't think I've ever heard of that before (and I am one to get the cervix checks every week when they start at like 36w).

Well, it's an interesting approach to say the least, though I doubt that some sort of tinkering would really add much to whatever your body is already doing on its own. But I certainly would not be keen on a sweep prior to a time when you are absolutely ready to deliver. What else does he/she have in mind besides that??

that's my two cents - good luck!!
post #5 of 13
Messing with membranes is a standard practice, as are epidurals, inductions, and the whole "cascade of interventions"
That said, they aren't likely to help you get the result of a natural birth.

I can recommend www.hencigoer.com as well as www.vbacfacts.com and www.ican-online.org as the best sources for info.

Believe it, your body does know when to go into labor on its own. The fact that plenty of women don't start labor until 42 weeks is a reflection of the fact that 38-42 weeks is the NORMAL range for fullterm gestation. The idea that something should be done about it if a woman hits 40 weeks and labor hasn't started yet is peculiar to American obstetrics and that of countries that emulate it. If you were in the Netherlands right now, no one would be wanting to sweep your membranes, and no one would tell you there was something to worry about if you are 42 weeks along. You would just be another pregnant woman living life until labor started, when she and her baby were ready.

Artificial rupture of membranes is very common here, despite the fact that it is a huge risk factor in getting babies stuck in asynclitic position and thereby increasing likelihood of a cesarean. But here, we don't seem to consider pregnancies ending in cesareans anything to worry about. That's probably a big reason why despite spending more on maternity care than any other country, we rank 43rd worst for outcomes, in the world.

So I do hope you will visit those sites, because you may be very surprised by what you find, but pleasantly surprised that you have more choice and power than the common assumption would indicate.

-Meg
DD 8 lb c-section 2004
DS 10 lb Homebirth VBAC 2007
"once you HBAC, you never go back"
post #6 of 13
Well, I actually requested a sweep of the membranes in the OB's office, but only because I'd already been laboring naturally w/ctx 5 min apart for 32 hours and was 1 cm dilated. And I got my unmedicated VBAC...after 68.5 hours of labor. I think a membrane sweep is too risky unless you're already laboring.
post #7 of 13
I got my midwife to start at 37.5 weeks with me. I've had two so far and will have another this week (I'm 39 going on 40 weeks). I actually found it reassuring to know how dilated I am and to feel that I'm helping to move things along. I don't think it will trigger labour until my body and baby are ready but I was happy to be encouraging my body to release the right hormones etc.

Considering the interventions that could await if I go too far overdue (no induction for me) I felt this was a good choice. It also helped relieve some of my feelings of craziness when nothing was happening to know actually it was! But it was totally my choice and something I requested not something that was forced on me. Plus my midwives are obviously women which is different again, I wouldn't want a man examining me in this way.

Just my perspective!
post #8 of 13
I had sweeps starting at 37wks with both my vbacs. I'd do it again because it seemed to work for me. But really you have to decide what YOU are most comfortable with, regardless of what anyone else thinks or says...
post #9 of 13
I'd only consider it close to 42 weeks.
post #10 of 13
Thread Starter 
Thanks, I feel better knowing there are others out there in my boat! My first PG was overdue 5 days, and second was 8 days early, so I really have no idea about this one!! And it's a different dad this time, so who knows if that makes a difference, but anyway, I trust this doctor. So I trust his advice, and he won't push me to do anything I don't want, it was just his idea. He wants to do what he can since I told him I DO NOT WANT ANOTHER CS. Not shouting at him, but I made it very clear and he wants to do that for me if he can.

I love MDC.
post #11 of 13
I had my membranes swept at about 40 weeks 5 days. My midwife doesn't really do it until someone is close to term. It wasn't the nicest experience either..
post #12 of 13
I say NO NO NO.

37 weeks is tooooooo early for stripping, for one thing! They can accidentally break your water doing that and then you get to deal with a baby with possible respiratory distress!

My doctor with my first stripped my membranes (without asking me first) when I was 39 weeks. I promptly developed a nasty infection of the amniotic fluid which caused a 104-degree fever, and my daughter and I got to be hooked up to antibiotic IV's for 3 days after her birth. It triggered some contractions that weren't strong enough to be considered "active" labor, which led them to hook me up to Pitocin so I could "get moving along" and one thing led to another... I was put to sleep for my emergency c-section.

I don't in any way advise that you do this stripping until you're at least 41 weeks, if ever!
post #13 of 13
Everyone's going to have a different experience and a different set of priorities. Really, you need to just trust your instincts and hopefully you have a care provider you can trust as well. Honestly, OB's and midwives really do just want to do a good job and have healthy mother/baby outcomes. So if you trust yours, that's what you have to work with. KWIM?

I'm in the same situation. My midwife started talking membrane sweep around 38 -39 weeks if my cervix seemed ready. I'd really rather not have this done. I, too, am concerned with infection, problems, etc., but I'd also at least give labor a try to start before I have to be sectioned at 41 weeks. I"m going to start EPO around 36 weeks or so and hope that helps a bit. I've actually started a thread (WWYD?) on this board with similar questions and my situation is a bit different as I have to move across the country the beginning of June and my baby is due May 12. I obviously don't want another section, but I definitely do not want one ten days prior to moving. It's a tough situation, in a way and I imagine your first VBAC is a little intimidating. At least that's how I feel, although I am confident I can do it if I actually get to labor this time (DS was breech, sectioned at 39.5 weeks - scheduled).

Sooo, what are you going to do? I guess with any other birth, have confidence in yourself, and hope for the best.
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