After membrane sweep on Monday, possible HB!! - Page 3

[Baby~Braatens~Mama]

Hey. Still crampy feeling, but no spotting during the night. I did a lot of reading on membrane stripping last night before I went to sleep and all of the information I could find said that it is not always effective and that if the body is not ready nothing more will come of it. I hope this is the case, as much as I would love to hold my little man in my arms.

If something is to happen, it appears that it typically will do so within 36-48 hours of the procedure. So... I will wait until tomarrow morning at 11 and if my symptoms have not gotten more progressive I will assume that my body and my baby rallied together and said, "No, we are not ready!"

There is a lot of debate as to whether or not membrane stripping is effective at all, however I found much information that seems to indicate that many doctors and midwives use this technique during vaginal exams and that a lot of the time the patient is unaware that it has even happened. Though spotting and clotting is "normal" it is not common. The crampiness, however, is both.

The technique is commonly called membrane sweeping. I could find very few articles that talked about a doctor/midwife performing this procedure on a woman less than 38 weeks with no complications. But I did read several that not only assured me that it is common, but that it was hard to know HOW common because the patient is not always aware that it has been performed.
"Sweeping of the membranes may occur with or without the patients knowledge and consent."

My DP wasn't really understanding what had happened and this was the article I found for him.

And here are a few more that seemed educational:
http://www.storknet.com/cubbies/childbirth/excf5.htm
http://findarticles.com/p/articles/m...9/ai_n7180132/
http://www.gynob.com/stripmem.htm

I am still extrememly frustrated that I allowed this to happen. There was no way for me to know that it could, and that makes it even more frustrating. I am very appreciative to all who read, responded and supported me! You have been unbelievably helpfull.

[HappyMommy2]

Mama, I am so mad for you!! I can't believe he did that - esp w/o your consent. Please keep us updated.

I am guessing you won't be allowing any more vaginal exams this pregnancy!! (many of us think they are unnecessary ... but didn't use to know that we could refuse!)

[Baby~Braatens~Mama]

Not allowing any more vaginal exams. I did know that they weren't necessary and could be denied, but I did not think that I needed to deny that "simple" exam. Live and learn...

[spatulagirl]

[HulaJenn]

I just wanted to add that if it was just a miscommunication between the doc and you with what is his routine procedure, any good doc would have warned of the after effects - like the heavier bleeding and cramping and giving the heads up that it can potentially induce labour!!

My doc did a sweep without consent (I was 39 weeks and 2cm but still....) - I think it was because he was going on vacation and wanted to be there at the birth. I bled and cramped and had DH on standby at work because I thought I was in early labour, but a shower and sleep helped. My body was not ready. So he went on vacay and the lady that was taking over checked me out at 40 weeks and offered to do a sweep with my consent since I was dilated and due and had been suffering prodromal labour for a while....so i consented and she said actually I had no more membrane to sweep! That was the only reason I knew that my doc had done a sweep the week before!

I wouldn't let this go with just a simple okay of the birth plan for the future. I would confront him even if it meant having an ER doc catch the baby - cuz really, the nurses do all the work and the doc only shows up to catch and siign off the forms.

[Baby~Braatens~Mama]

Originally Posted by HulaJenn

I just wanted to add that if it was just a miscommunication between the doc and you with what is his routine procedure, any good doc would have warned of the after effects - like the heavier bleeding and cramping and giving the heads up that it can potentially induce labour!!

My doc did a sweep without consent (I was 39 weeks and 2cm but still....) - I think it was because he was going on vacation and wanted to be there at the birth. I bled and cramped and had DH on standby at work because I thought I was in early labour, but a shower and sleep helped. My body was not ready. So he went on vacay and the lady that was taking over checked me out at 40 weeks and offered to do a sweep with my consent since I was dilated and due and had been suffering prodromal labour for a while....so i consented and she said actually I had no more membrane to sweep! That was the only reason I knew that my doc had done a sweep the week before!

This is exactly why I have a hard time getting over this! Because I am not the only woman this was done to, and I believe that it is so wrong! Did you confront your doctor?

[Calleiah]

Ugh, I just had a similar fight with my doc that ended with me firing her. I declined a CE. She informed me she WOULD be doing one next week (after laughing at me) and then proceeded to tell me all these bogus reasons why she NEEDED to do one. It was insane. I feel sure if I had allowed her to do one, I'd be in your same shoes. So, I have no doctor now, but I also havent had anyone violating my will or my body the last two weeks either! Honestly, it's been bliss.
You need to put your doctor on notice. Call his office manager too. If you choose to keep him, let him know under no uncertain terms that failing to get your permission for anything will result in medical assault. Im sorry this happened to you.

[goldfinches]

Originally Posted by Calleiah

You need to put your doctor on notice. Call his office manager too. If you choose to keep him, let him know under no uncertain terms that failing to get your permission for anything will result in medical assault. Im sorry this happened to you.

Before threatening him with assault, just double check with your doctor that he really did strip your membranes. Like a pp said, it's pretty much not something that can be done unless you're already dilating, and you said you weren't. And, I just had mine done Monday at 40+1 and it felt nothing like you described. I wouldn't just go on the word of a nurse. He may have just had some trouble finding your cervix and given you a rough exam. (mine's retroverted and that's how my exams go.)

[HulaJenn]

Originally Posted by Baby~Braatens~Mama

This is exactly why I have a hard time getting over this! Because I am not the only woman this was done to, and I believe that it is so wrong! Did you confront your doctor?

well, it is easier to support someone else and tell them what they should do than to do it myself! LOL
Unfortunately my doc was not there to deliver the baby so then i didn't see him until my 6 week post partum check up, and by then I had all but forgotten about it (sleep deprived brain and happy to not be pregnant anymore maybe?) I really should have said something. In his defense too, he has always been my doc and delivered my other 2 children with no incident as such.

I do agree that confirming that is indeed what he did (although from your symptoms I would say it sounds possible) before any threat of legal action is a good idea.

I am glad you are feeling better physically and that baby stayed put for now!

[Baby~Braatens~Mama]

I am not willing to persue legal action, at the most I would file a comlaint with the hospital so that they can confront him on the unethical practice of assumed consent. As frustrated I am that it happened, I am sure that he did it with my best interest at heart and really did not think that I would object. Though, if he had taken the time to inform me of the procedure I would have waited until at least week 39 before consenting. It does not always work and the spotting/clotting, though normal, are not common. And it does not work at all if the body is not prepared for it, so in the context inwhich he did it, it was to hopefully soften and ripen the cervix. I will be talking to him about his actions, and will be refusing any further VE's. I suppose, if he becomes hostile/agressive during our talk I may become emotional enough to seriously consider legal action. Until yesterday he had given me absolutely no reason to not trust him. He is really a very likable doctor.

[the janet]

WTF. This is appalling.

You need to speak with your OB ASAP:

• To clear up whether or not he swept your membranes. As has already been mentioned, I don't see how that is physically possible if you weren't dilated but a quick Google search came up with results that said it is possible but that it would be really unpleasant.

• To tell him that you will not allow any further procedures to be performed without your knowledge and consent. The only time they can legally do this is if it's an emergency, if your or the baby's health is at stake. Unless there is something else going on that you didn't mention, I can't see what the problem would be at 36 weeks!

As you and all of us already are aware, this is unusual and potentially harmful behavior on his part. As much as you may like him, this doesn't bode well for what he may do (or instruct the nurse to do in his likely absence) when you are actually in labor.

Please take this as a warning sign and try to protect yourself. I would hate for him to continue to perform unnecessary interventions on you.

[the janet]

Originally Posted by Baby~Braatens~Mama

I am sure that he did it with my best interest at heart and really did not think that I would object.

If he had your best interest at heart, I don't think he would've dared attempted to strip your membranes, especially not without informing you.

If he had told you what he was about to do and said that it was to try to "speed things up" (which is what I am inferring), would you have consented? EDDs are guesstimates...and babies don't finish growing in the womb exactly on a 40 week schedule. How in the world would he know if you needed to induce labor this early? I just don't understand the logic.

[CraftyMcGluestick]

I am so sorry, Mama. I am sorry you were violated, no matter whether it was possible to perform this procedure or not. I hope you will let us know, after you talked to him, what actually happened. It is so frustrating to constantly, constantly have to fight to be left alone and have a natural, normal pregnancy and birth. This is true with my midwife, as well.

I'm glad the spotting has slowed and I hope you will take refuge in the fact that if your body is not ready (and why would your doctor think it would be at 36 weeks?!), your body will override all and protect your little one while he still needs to be inside.

Thinking of you.

[MegBoz]

Originally Posted by the janet

• To tell him that you will not allow any further procedures to be performed without your knowledge and consent. The only time they can legally do this is if it's an emergency, if your or the baby's health is at stake.

(emphasis added)
Wrong.
The one & only time it's legal for a medical procedure to be performed on you without your express consent is if you're unconscious - and therefore it's totally impossible for you to give consent. In such a case, it's assumed you'll consent to treatment to save your life.

I shudder to think of how much worse hospital maternity care would be if it were legal for them to do procedures without mama's consent "if the baby's health is at stake." I mean, HCPs say that ALL.THE.TIME - "We have to induce at 41W because baby could die, you can't try VBAC because baby could die, you can't labor in water or keep laboring with broken membranes because baby could die. You can't labor without cEFM because baby could die."

Now, it is absolutely totally NOT legal for them to act without consent "if baby's health is at stake."

& I totally disagree that this is "unusual." Remember, most women WANT any interventions that can get them giving birth ASAP - and most women don't even question a doc's recommendation, let alone decline a suggested intervention. So I can totally see how he became accustomed to just going forward with routine membrane sweeps. Don't get me wrong - I'm not saying that makes it right or excuses his behavior - because it does not! But I disagree that membrane sweeping without notice is "unusual." Quite the opposite - I figure it's common.

[Baby~Braatens~Mama]

Originally Posted by MegBoz

& I totally disagree that this is "unusual." Remember, most women WANT any interventions that can get them giving birth ASAP - and most women don't even question a doc's recommendation, let alone decline a suggested intervention. So I can totally see how he became accustomed to just going forward with routine membrane sweeps. Don't get me wrong - I'm not saying that makes it right or excuses his behavior - because it does not! But I disagree that membrane sweeping without notice is "unusual." Quite the opposite - I figure it's common.

This! And I have found so many documents and articles that confirm!
Usually a routine membrane sweep is not painfull and feels very like a routine cervical check. The spotting and clotting I experienced was extreme though "normal". Most women experience only slight spotting and are told it is because their cervix is sensitive after the exam. The women whose bodies are ready experience bloody show and soon (36-48 hours) after enter early labor. They assume it is their body working, and why would they ever think otherwise?

Crafty: Because he did it so early I am assuming he did it to help ripen/soften the cervix. Not necessarily to induce labor this week. He probably assumed that the my body would fight it, but that the prostaglandins released would still "help" with my "tougher" than he had liked to feel cervix. I found many "studies" which showed a woman who has her membranes swept weekly has less of a chance of going past term with her pregnancy, and he is of the generation of doctor that would have been taught this "non-invasive" procedure as part of his training. Not justifying what the he did, just accepting. And still wishing I would have heard about this before my VE so that I could have addressed the doctor about my feelings on the matter.

Maybe this thread will draw the attention of other women who may not be aware of this procedure or the fact that it may be used preemptively, so that they may talk to their HCP before it is done.

[southernmommie]

Of all the membrane sweeps I've had, I always go into labor within 24 hours. So with the last 2 pregnancies, I decline internal exams until I'm around due date. and I will refuse them again with this one.

[ein328]

I am so, so sorry for you, mama! It is horrible that you feel so violated, both in terms of how your body was (mis)treated and how you truly felt you could trust your doctor.

I have to agree with previous posters in saying that what you're describing sounds more like a rough exam- I've had my membranes stripped, and it was more than a little uncomfortable-and I was already 3 cm dilated. I had the same type of discharge you are experiencing, and went into labor a few hours later. And I could be wrong, but it is my understanding that it takes more than an in-and-out motion- it's more of a circular thing- like engaging and then running the finger around the cervix.

Regardless of whether your membranes were stripped or it was a "rough" exam, your feelings are absolutely understandable, and I'm glad you're not afraid to voice your feelings.

[karmab]

your doc was wrong on so many levels. in addition to the biggie- the trust and ethics that have been brought up by so many of the previous posters, the american college of obstetrics and gynecology issued a bulletin last year stating that elective induction's should not be considered before 39 wks, due to risks to the baby. stripping membranes - or a "rough exam" which is part and parcel the same thing, is considered one of the "natural" methods used to induce labor, along with nipple stim -it is unquestionably done with the goal of starting labor- there is no other reason to do it. but another thing is, it only works once. once membranes are stipped, you cant do it again, so if you get to 40 or 41+ wks and maybe there is an issue like decreased fetal movement and you were to decide you want to try to encourage labor to begin in this way, now it's not an option, your options are limited (it may actually be possible in your case, if you were only say a fingertip dilated and he couldnt get much membrane off, and you were to be like 3 or 4 cm then.) i think the biggest issue is that no doctor should ever do this without the mom understanding what is happening and agreeing to it, but even ACOG would condemn this doc for doing this on a preterm pregnancy. it's absolutely inexcusable.

[MegBoz]

Originally Posted by karmab

but another thing is, it only works once. once membranes are stipped, you cant do it again, so if you get to 40 or 41+ wks and maybe there is an issue like decreased fetal movement and you were to decide you want to try to encourage labor to begin in this way, now it's not an option, your options are limited

Actually that's not true at all.

Stripping membranes repeatedly can help induce labor. One of my MWs (CNMs) even said, "With first-time mamas, it seems to take two times." My doula said as well to go back & have it done again if it didn't send me into labor within about 12 hours the first time.

The amniotic sac will rest back down onto the mouth of the cervix, so it can be lifted back up away from it again (which is all that the "stripping/sweeping" procedure is.)

Truthfully, there are some studies showing repeated stripping brings on labor earlier & some studies showing it does not - so the science is divided, but there ARE some studies showing it works when done repeatedly.

[Baby~Braatens~Mama]

Originally Posted by MegBoz

Actually that's not true at all.

Stripping membranes repeatedly can help induce labor. One of my MWs (CNMs) even said, "With first-time mamas, it seems to take two times." My doula said as well to go back & have it done again if it didn't send me into labor within about 12 hours the first time.

The amniotic sac will rest back down onto the mouth of the cervix, so it can be lifted back up away from it again (which is all that the "stripping/sweeping" procedure is.)

Truthfully, there are some studies showing repeated stripping brings on labor earlier & some studies showing it does not - so the science is divided, but there ARE some studies showing it works when done repeatedly.

THIS! And I spent a LOT of time researching.
I also found information that showed that some HCP feel that routine membraned sweeping during the weekly VE will help prevent a woman from going post-term, which is still what I feel my practitioner was expecting... not that I am happy with the way things proceeded. I will find out for sure on Monday when I talk to him, but at least for now I can feel a little more at peace, knowing that he did not necessarily place my child in danger.