Should I strip my membranes tomorrow?

[sammyloo]

My OB has made it clear that I do not have any medical reason to strip my membranes - he is just going to be out of town all next week (I am due on Saturday 9/26) and wants to be available for the birth. I am 3 cm, 60% effaced and -2. I lost my mucus plug yesterday. I was 5 days late with my son. I am at the tail end of a horrible virus and don't have much strength but am also anxious to see that the baby is healthy - I lost significant weight over the last week from the virus. My doula says she doesn't really mind if I do it because if my body isn't ready, it won't work - it will just be really uncomfortable and irritate my utereus. I doctor hopped forever and will be disappointed if this doctor can't do the birth - there is one other doctor in the practice that delivers and he is alright and then they have contracted out to some other doctor that I know nothing about. My OB is concerned about my birth plan being followed if he doesn't do it - I know it is a matter of medical record, but this is not an intervention-free-friendly hospital or city. Should I strip tomorrow morning?

[2boyzmama]

Ooh, that's a toughy.

I mean, you're definitely a good candidate, it should be easy to sweep the membranes. And if your body truly isn't ready for labor, then it probably won't do much.

BUT...you also might need just a few more days to recup from that bug you had. Your baby might not be in a good position which is why labor hasn't started yet. You could be pregnant all of next week still and not deliver until your OB comes back anyway. Plus, he could accidentally break your water while sweeping your membranes, and that could lead to all sorts of other interventions.

I'd be more inclined to not sweep, and take your chances of delivering when your OB is gone. If that happens, try really hard not to go to the hospital until the very end, that way they CAN'T do too many interventions. Discuss your birth plan with your husband, rehearse what you will say "thank you for offering the IV, I am choosing to decline unless medically necessary" "I am choosing to labor in whatever position I want, you are welcome to monitor baby's heartrate with a manual doppler" or whatever.

I've also made signs to hang up in my room that say things like "NO CIRC!!" "NO HEP B!!!" "NO FORMULA!!" etc in big red letters, and if somehow I end up in the regular hospital, I'm going to hang those on the outside of my door, above the head of my bed, ON the computer screen they write their notes on, and on the baby's bassinet. That way I worry just a little bit less, you know?

[~Laura~]

If it were me, I wouldn't sweep. It's an intervention that could lead to more (ie. if your water breaks by accident when your body isn't ready to labor and you need to be induced because the time 'ran out.'). If you were late and facing an induction, I would be more inclined.

Just my thoughts, though! There are so many things to weigh that we won't all think the same things.

I hope whatever you decide works out exactly as you planned!

Laura

[seashells]

I would not, and I'm surprised your doula didn't warn you of the risks. It's true that it won't send you into labor unless you're close to ready anyway, but if your water breaks (common risk of sweeping membranes) and you are having a hospital birth, you are on the clock. So not only your risk for infection increased, but your risk for cesarean. Plus they might even give antibiotics "just in case" and they have risks, especially to a newborn gut.

On top of that, you are sick and not even in ideal physical condition for the hard work of labor.

It's nice that your doctor wants his fee, but I wouldn't risk it.

[coldandsleepy]

So, I did research on this yesterday morning in order to make a similar decision myself. Membrane stripping is just like anything else related to pregnancy-- people will give you anecdotal evidence every which way.

Here's the scoop on the organized scientific research that's been done on membrane sweeping: it's been pretty limited. There have been a handful of studies looking at a sum total of about 2000 ladies (not really a large amount, especially considering that this is spread out across several studies!) comparing membrane sweeping to leaving totally alone OR comparing membrane sweeping to leaving totally alone to using a chemical induction agent.

NONE of the studies showed a conclusive connection between membrane sweeping and going into labor earlier. There is one where it seemed to have cut down the average wait time for labor by about a day (woo woo, right?) but overall... nothing significant.

On the other hand, the studies that have been done have also shown that membrane sweeping does NOT seem to lead to further complications or interventions-- no increased PROM, no increased infections, no increased meconium in fluid, no increased c-sections.

Basically, the biggest observed risk seems to be the pain and discomfort it causes you. For me, I figured... I'm not exactly basking in comfort here as is, y'know?

Good luck with whatever you choose! I hope your baby comes soon, one way or another!