mucus plug. ugh

[brokentail]

hi all, i am in this ddc i just never post because every question i have i see on here already and it answered!

so here goes - i had a dr appt yesterday, dreaded strep b test and the nurse informed me from this appt on i will be getting internals. ugh. so i get naked waist down, tie my sheet as a mini skirt and wait, and wait.. 20 min for dr to come in.
first thing she says is 5 lbs in one week!! are you swollen i said well i cant recognize my feet and hands, they dont look like mine at all. she takes my bp and says your bp is high....do you have headaches blurry vision? no. no. ok, she does strep b swab and then says now im going to check your cervix, she says your dilated 1cm and your cervix is thinning thats good for your first baby. i said ok. she says lay on your left side takes bp again, still high 130/90 which i am always perfectly normal. so wtf. ok she says you have to relax this week no work nothing, sorry you have to be on bed rest. and im going to give you rx for blood work. ok so i left got the blood work went home and layed around all day.. today woke up ate breakfast layed around just went to take a shower, peed wiped got some brown old blood i figured from the internal yesterday... wiped again got a big ole hunk of mucus with a big ole brown blob in it. ugh. wtf. i know it comes out with cervical changes... meaning i may be dilating some more.... but im 35w6d not too ready to have baby yet. please calm my fears. i go back to dr. tomorrow to check my blood pressure. sorry for rambling !! stressed & dont want to tell husband he will freak the f out.

[CherryBomb]

The internal might have dislodged it some. Don't worry, it will probably still be at least a few weeks!

[brokentail]

thanks, it felt like she dislodged it from my nose. i have had the most normal uneventful pregnancy and now this hbp crap... oh and i completely forgot to mention that 3 appts ago there was sugar in my urine so they made me go take a blood test for that, but the last appt the other doc i saw didnt mention the results and there was no sugar in that urine so i assumed it was ok. then yesterday there was sugar in my urine again. wtf! she said did you go for that sugar test??? i said yes weeks ago.. last week my pee was fine....... didnt you get the results? she said i don't see it here.......ugh. this is why i hate dr's.

[Melly24]

Sounds like the internal could have dislodged it some.

Just throwing this out there, but you are well within your rights to refuse internal examinations. They give no useful information in pregnancy. None. Some women can be dilating and thinning like crazy and still be weeks and weeks away from birthing. Some can have tightly closed and thick cervix's, and be in labour an hour later. Internal examinations during pregnancy are not even performed routinely here in New Zealand (we have a very very different maternity care model to the US though....).

Your BP could have been elevated due to the uncomfortable situation you were in at the time. There's nothing wrong with resting more, but if your BP isnt even elevated it could be causing you unnecessary worry. Is there a pharmacy or something somewhere where you can have your BP checked without seeing a doc. Maybe a local midwife? Have you considered using a midwife for your prenatal care and birth if you hate doctors?

[southernmommie]

I agree. You could still go another couple of weeks before labor begins. I am one of those people that walk around dialated to 2 and 50% effaced before going into labor a couple of weeks later. You are almost there to full term so that is good news. I mean, if you were only 32 weeks like me and losing your plug, I'd be a little worried.

[brokentail]

I see one midwife and 2 drs, they all rotate you have to see them all a this practice so they all know you when it comes time to have baby.
How do I say I dont want you to check me? I know
Just say it but won't they think I'm some difficult b? I feel like theres nothing drs hate more than an informed patient.
And why do they do cervix checks so often if there unnecessary?? I read in one of my books they increase chance of infection, so I was totally caught off guard when nurse said I'd be getting them from now on.. I was thinking f!! That's like 4!!! I seriously wasn't expecting it til I was in Hospital! Do you think I should tell them tomorrow that I lost my plug or just keep it to myself..I'm just going in for bp check and blood results.

[Melly24]

Originally Posted by brokentail

I see one midwife and 2 drs, they all rotate you have to see them all a this practice so they all know you when it comes time to have baby.
How do I say I dont want you to check me? I know
Just say it but won't they think I'm some difficult b? I feel like theres nothing drs hate more than an informed patient.
And why do they do cervix checks so often if there unnecessary?? I read in one of my books they increase chance of infection, so I was totally caught off guard when nurse said I'd be getting them from now on.. I was thinking f!! That's like 4!!! I seriously wasn't expecting it til I was in Hospital! Do you think I should tell them tomorrow that I lost my plug or just keep it to myself..I'm just going in for bp check and blood results.

You can tell them pleasantly and if they take offence then that's their problem. In your situation I'd use the dislodged mucus plug as my reasoning for no more. So tell them when you were last checked some mucus plug came away and because of that you wont consent to any more vaginal examinations until you are in labour.

Here is a great recent thread about vaginal examinations late in pregnancy, and some theory's about why doctors insist on them - http://www.mothering.com/discussions....php?t=1246345

[Eresh]

You can pick up an automatic blood pressure cuff at a drug store to keep an eye on your bp at home. It's not as accurate but it would be in the general ballpark and give you an idea if you have "white coat syndrome" elevating your bp at the OB's office.

[FtMPapa]

Another tactic to decline the exams is just to ask why.

When the nurse says "the doctor is doing a vaginal exam" just say "Oh, I'll talk to the doctor about that..."

when the doctor comes in, ask what the purpose is, and say "Oh, why do we need to do that?" and if she says "to tell your dilation" ask "why is that important?"

And then say No, if you don't get an adequate answer. Do you have a doula or someone to go with you to appointments to help advocate for you?

Also, 130/90 isn't particularly high. Mine is always 120/80 and has been since before I got pregnant. That's not high. They don't like to see it over 140 or over 90, but 130/90 is kind of borderline, and it's likely totally fine.

[PieKat]

I would just let them know you're not interested in the examinations and are refusing them. My OB is fine with that, although she's super gentle and never hurt me/caused spotting or bleeding in my last pregnancy (unlike the DR who checked me when I was contracting from a UTI about 3 weeks ago). I would actually like to have a baseline right now of where I am, and will probably be OK with being checked again in 3 weeks. Last time I walked around at 3-4 cm for 2 weeks before I was induced with high blood pressure (labs were fine). The only reason I agreed to the induction is because I figured my body was starting to work on its own. It would have taken a lot more convincing for the induction if I'd been closed tight and high at 39 weeks. . . .

[happysmileylady]

DDDC,

As far as declining internals...you just politely say you would rather not. Just tell them you aren't comfortable with that.

I am always shocked when I read on here about docs who just make the assumption that you are going to have dialation checked...Both this pg and the last I was always asked if I wanted to be checked. And haven't had a problem just saying no. In fact, last week, the doc asked if I was having lots of contractions. I said yes, she asked if I wanted to be checked to see if they were doing anything. I laughed and said that I knew the contractions were not doing anything, that last time it took me three days just to get to one cm. And she said she was relieved to have a patient with realistic expectations.

Which, kinda OT, made me wonder how much of the "docs pushing interventions" is the result of there being too many patients requesting them.

Anyway, back to the OP. While it's true I was asked instead of told, I haven't ever had a problem declining. They are sticking their hands in your private parts, I should hope they don't get upset if you decline to allow someone to do that! Yeah, they get to see it eventually, but really, it's your private parts, of course you have the right to determine when and who sees them or touches them!

[corban's mum]

it all sounds a bit weird to me, in the UK they don't check you at all until you're in labour. so don't feel like you're doing anything dangerous or wrong by declining them. unless of course they have a valid reason why in your personal circumstances that you need to be checked.

[Magali]

Originally Posted by Melly24

Sounds like the internal could have dislodged it some.

Just throwing this out there, but you are well within your rights to refuse internal examinations. They give no useful information in pregnancy. None. Some women can be dilating and thinning like crazy and still be weeks and weeks away from birthing. Some can have tightly closed and thick cervix's, and be in labour an hour later. Internal examinations during pregnancy are not even performed routinely here in New Zealand (we have a very very different maternity care model to the US though....).

Your BP could have been elevated due to the uncomfortable situation you were in at the time. There's nothing wrong with resting more, but if your BP isnt even elevated it could be causing you unnecessary worry. Is there a pharmacy or something somewhere where you can have your BP checked without seeing a doc. Maybe a local midwife? Have you considered using a midwife for your prenatal care and birth if you hate doctors?

Yes to all of this. I was getting high BP readings from the Dr. so I stopped seeing a Dr. and have been doing my own prenatal care and my BP is just fine. It doesn't matter if *they* don't like you. What matters is that you are happy with the care you are recieving and that you feel good about what happens at your prenatal visits. You can absolutely 100% just say "no" to what you don't feel comfortable with. Try it...but if you are anything like me, it will probably raise your BP a bit.

[ILovePie]

Your blood pressure is likely no big deal, but at 140/90 (either number) doctors start to become cautious - and especially since you put on a good bit of weight in that week and had swelling. And even moreso if you had lower blood pressure than normal to begin with (I don't know what your pressures were) - they're concerned about the trends. They're right to watch you closely and be cautious.

I lost my mucous plug at 34 weeks with DS and he wasn't born until 39w 2 days. I was also contracting regularly, he was at 0 station, I was 90% effaced and a fingertip dilated. All that for 5 weeks (really - NO CHANGE for 5 weeks, even with the pretty regular contractions!).

[Magali]

Originally Posted by corban's mum

it all sounds a bit weird to me, in the UK they don't check you at all until you're in labour. so don't feel like you're doing anything dangerous or wrong by declining them. unless of course they have a valid reason why in your personal circumstances that you need to be checked.

It seems that in the US and Canada (where I live) they just need to get their hands up there as much as possible . And sometimes they use it as an opportunity to strip membranes w/o permission.

[ILovePie]

Oh - and on refusing internals....just say "they stress me out."

Seriously, last time I was having all those contractions and MY CERVIX WASN'T CHANGING. I had been admitted for pre-term contractions and MY CERVIX WASN'T CHANGING.

It was crying and apologizing to DH that I wasn't making progress, despite his having to take off work, my being on bedrest (2 months of strict bedrest), etc.

It was, in hindsight, really stupid. I probably will not have an internal until I'm about 39 weeks, which is when DS was born. And the only reason I want one then is to have a sense of how much progress I'm making once labor starts. And the only reason I want to know that is to have some small sense of whether I should consent to Pitocin if I end up on magnesium again.

[Metasequoia]

DDCC - I always walk around 4-5cm dilated, 90% effaced, babe at 0 station for 3-4 weeks prior to birth - routine internals are SO worthless. (I only ask at 36 weeks because I think it's pretty cool to know the baby is "half-way out" for so long. )

Good luck mama, sounds like there's a big lack of communication at your OB office.

[oliversmom7213]

I'm 34 weeks today and have lost my plug the last two days. (well really it was coming out in pieces for the last 2 weeks but huge globs the last two days). I might meantion you lost it but tell them you don't want to be checked. Until you are feeling contractions (unless you are like me and don't until way further along in labor) or your water breaks you should be fine. I'm already 70% effaced and 1.5 dialated so I'm watching my mucous a little more closely (plus i'm almost 2 weeks behind you). And really it doesn't mean you will be going into labor anytime soon even if you had begun to dialate some. Some people dialate slowly over a month.

[JessieBird]

Originally Posted by Magali

It seems that in the US and Canada (where I live) they just need to get their hands up there as much as possible . And sometimes they use it as an opportunity to strip membranes w/o permission.

Another Canadian here - standard practice at my birthing centre (MWs) is no internals until labour and even then it's only if I request it. They are very hands off and actually tell women who request a check prior to labour starting that this early it's usually meaningless and always stressful. My friends who go with OBs have reported back similarly so I think the tide might be changing on internals, at least in my area. Anyway, I agree with all those who've advised you to decline. Unless you are confident that your CP is going to be gentle and you do it merely because you are curious, knowing full well that it means almost nothing at this stage (and even during labour things can change so quickly) and won't get stressed out. Otherwise politely decline. I'm sure you won't have been the first. Good luck and I hope you feel better about all this soon!