Stripping membranes at 41 week appointment

[lovelymama2]

My 41 week appt. is this afternoon and I'm considering having my membranes stripped. I have nothing really going on except for a little crampy feeling. My cervix might be too high and closed in which case I won't have them do anything, but if it's opening up a bit, would it be a good idea to get them stripped? I'm getting desperate

[fruitfulmomma]

IME it doesn't do anything. The only time it "worked" I was already 3-4cm and had been having prodromal labor for a couple of weeks. It also increases risk of infection.

[alegna]

I wouldn't allow it without medical reason for induction. All too often water is "accidentally" broken when stripping membranes.

Babies come when ready. Ds was 43 weeks 5 days.

-Angela

[nashvillemidwife]

Can you quantify exactly how often "all too often" is? Do you have a source for it?

[alegna]

I don't have a source I just have a lot of anecdotal stories.

-Angela

[Lineymom]

I'd do it. Both my ds were born after a labor that started within 12 hours of a membrane strip. The first was by my midwife at 41 wk 2 days and the second by dh at 39 wk 4 days. I was about 2cm with both.

[nashvillemidwife]

Originally Posted by alegna

I don't have a source I just have a lot of anecdotal stories.

-Angela

So no actual evidence? Thanks for answering.

[columbusmomma]

Could you start on some evening primrose oil? Just a thought...

[soposdedi]

Please keep in mind that Angela is not a medical professional of any kind, and merely has anectdata and what she has decided is true, as 'evidence'. If it would make you feel better, do it. Babies certainly do not always come when ready, despite her magically long pregnancy. Sometimes things do happen, and sometimes a little help is necessary and beneficial.

[Liquesce]

I see this was yesterday ... if you had it done (or even if you didn't), lots of good labor vibes your way.

[fruitfulmomma]

Huh, I wasn't aware the OP was asking for professional medical opinions and quantified studies.

Yes, our experiences are anecdotal. That doesn't make them false.

If it would make you feel better, do it.

So, she should make the decision based on how she feels about it? You're not going to offer up any studies which show a true benefit of membrane stripping in her situation?

Babies certainly do not always come when ready, despite her magically long pregnancy.

I have "magical" pregnancies too. 4 out of 5 of my babies have been born after 41 weeks, 2 of those were at 44 weeks. I have tried all the "natural" methods, including membrane sweeping. Whether they did anything or not is totally questionable in my mind. I WILL NOT submit to a membrane sweeping again. It is not worth it in my opinion. It hurts, it makes me crampy, and it is incredibly stressful because I am basically expected to perform some magical feat and go into labor automatically and when it doesn't work I am assumed to be broken, that something is wrong with my body and it just isn't! And not only that, there are SO many variables from woman to woman, unless the OP was charting and knows exactly when she ovulated, she has no way of knowing whether or not she is really "late".

[nashvillemidwife]

Originally Posted by fruitfulmomma

it is incredibly stressful because I am basically expected to perform some magical feat and go into labor automatically and when it doesn't work I am assumed to be broken, that something is wrong with my body and it just isn't!

If you're seeing a practitioner who really puts that kind of expectations on you then it's time to find a new one.

[Mccmama07]

Originally Posted by alegna

I don't have a source I just have a lot of anecdotal stories.

-Angela

Within the anecdotal stories, did their membranes rupture immediately?

My own anecdotal evidence (my own births...I've had three) show no link between membrane stripping and membrane rupture. 2x it did nothing-my membranes were broken during the second stage of labor, and with DD, my membranes ruptured a good 55 hours after a "strip."

I'm just curious as to how you measure stripping membranes with rupture? How close in time proximity do the events need to occur in order to for the rupture to be blamed on membrane stripping?

Just curious.

[roxyrox]

I think it's a good idea. A sweep at 41 weeks is standard in UK midwifery care. I had a sweep at 41 weeks (which didn't work). I then had one at 41+4which did work. They were both painless.

Originally Posted by alegna

I wouldn't allow it without medical reason for induction. All too often water is "accidentally" broken when stripping membranes.

Babies come when ready. Ds was 43 weeks 5 days.

-Angela

Why is "accidentally" in inverted commas? Maybe in a very, very small number of cases sweeps may accidentally break someones waters but that would be very rare. Do you mean you think midwifes break women's waters on purpose? I really highly doubt they do. Why on earth would they, what would they gain by doing that?

[fruitfulmomma]

If you're seeing a practitioner who really puts that kind of expectations on you then it's time to find a new one.

It is has nothing to do with my practitioner, whom I love dearly and wouldn't trade for anything. There are numerous pressures a woman who carries longer than "normal" faces from outside forces such as the law which demands I transfer care after a certain point and friends and family, all of whom assume something must be wrong when you don't fit the norm. As a matter of fact, my husband got an ear full from a fellow homebirther during my last pregnancy because this woman assumed my midwife was "doing nothing" and that I needed a new one, that something was wrong with me and we just weren't doing enough.

Do you mean you think midwifes break women's waters on purpose? I really highly doubt they do. Why on earth would they, what would they gain by doing that?

I suspect she was talking about doctors. The American birth model has a lot to gain by starting the chain of interventions, including convincing a woman that she now needs a medical induction if the stripping doesn't "work" because now the baby is in danger of an infection with the waters being broken. Do I think that it is the norm to do this? No. But it does happen.

ETA: 41 weeks isn't late. Why are we suggesting medical interventions for a mother who isn't even postdates yet? Why is this intervention part of the norm in the UK midwifery model???

[roxyrox]

Originally Posted by fruitfulmomma

ETA: 41 weeks isn't late. Why are we suggesting medical interventions for a mother who isn't even postdates yet? Why is this intervention part of the norm in the UK midwifery model???

NICE guidelines recommend offering sweeps because they make spontaneous labour more likely and reduce the need for formal inductions. They are also not associated with any increase in maternal or neonate infections. I guess there is the small risk of AROM, but really, it is a very, very small risk. I think the risk of an actual induction is far greater (suggested from 42 weeks). They suggest women are given "every opportunity" to go into natural labour. You don't have to have one, but they are offered.

[HappyMommy2]

I would NOT do it. I will never again get on that slippery slope of interventions that end is c-sections. Also - I heard it hurts really bad a couple hours later. Baby will come when the time is right for the baby to come.

[fruitfulmomma]

NICE guidelines recommend offering sweeps because they make spontaneous labour more likely and reduce the need for formal inductions.

I guess we have a different opinion on what constitutes spontaneous labor.

They are also not associated with any increase in maternal or neonate infections.

None at all? I find that hard to believe since vaginal exams themselves increase the risk.

I think the risk of an actual induction is far greater (suggested from 42 weeks).

True enough. But maybe it is policy towards women who are "late" that needs to change, rather than trying to force babies out before they are ready.

[finn'smama]

Here are my experiences with sweeps, fwiw OP.
With #1 I had one at 40 weeks on the dot and ds was born approx. 12 hours later at home.
With #2 I refused one at 39 weeks and then my water broke a few days later and I didn't have any contractions, so I allowed a sweep to see if it would get contractions going. Again, ds2 was born about 8 hours later.
Talk to your cp. If you feel comfortable letting things go longer and baby is fine, than leave things as they are. If you feel well informed and want one, than go for it.
Whatever you decide I hope you're holding your new baby in your arms very soon!!

eta: just wanted to add to my story about ds2. When my water broke it was THICK with meconium and he had done some crazy acrobatics in utero the night before, which ultimately ended up with us giving birth in the hospital (completely intervention free). I often wonder if I'd had that sweep maybe we could have avoided the hospital. But probably not, since I personally don't think a sweep does anything if baby isn't ready.

[pumpkinhead]

I probably wouldn't do it at 41 weeks myself, but mostly because I've had it done (twice with my 1st pregnancy) and it did zippo. Ds was born at 43ish weeks after a pit induction. It did hurt a lot and I bled lots but no labour.