I didn't know I had an expiration date...help natural induction

[dakotablue]

I am a primary VBAC. I was under the impression that I had until 42 weeks, but after talking to my MW, who was concerned she said they don't let VBACs go past 41 weeks and that is generous because the OBs they work with won't go past 40 week.

Now I'm feeling pressed, I'm 38 weeks and 5 days sooo basically they are thinking induction with pictocin in a week and a half maybe two.

MW recommended starting EPO 3000mg vaginally at night.

I also downloaded hypnobabies Come OUT baby.

I would concern just letting things happen (ie forget to go in for induction) BUT I found out same appointment I am GBS+ (never saw that one coming)

Any help or advice would be appreciated.

I'm so pissed because I chose this MW over another hospital because they don't let you go past 40...I could have sworn I had asked earlier and it was 42....

[SGVaughn]

my GBS knowledge is really limited...im sorry...so i dont know what kind of protocol you have to follow to get around that

I'm unpopular enough around here but here goes

here are some suggestions from the susan weeds wise womans herbal book as labor initiators

visualization...youre covering that

caulophyllum 200x every half hr for two hours

nipple stim...think breast pump

castor oil....from personal experience I recommend the rootbeer method of castor oil delivery...it will cause intense cramps tho...

there are a lot of variations of castor oil dosing...google it..go with the smallest dose

blue cohosh tincture 3-8 drops in warm water or tea, repeat every half hr for several hours until contractions are regular.if labor is not underway in four hrs use a droperful under the tongue every hr for up to four hours

commercially available labor tincture...there are several..

this is all from the book and aside from the rootbeer add on I can't promise anything, nothing will really work unless everything is kinda right...which makes you wonder if any of it really works at all you know?

use at your own risk

 I wanted to add...maybe try borage oil orally instead of EPO..its supposed to be stronger

[GOPLawyer]

Just refuse the c/s.  The choice belongs to you...not them.  There is no "let". 

[Marissamom]

Sex. walking (especially with one foot on the curb and the other not)

no natural induction method is going to get you into labor more than a couple days earlier than you would on your own though. 

if you do go to 41 weeks, make sure they give you every day possible before inducing you (so not at 40w5d) to increase your chances of either going into labor yourself, or only needing pit to get things started and being able to turn it off or really low after things get moving. 

[Turquesa]

Originally Posted by GOPLawyer 

Just refuse the c/s.  The choice belongs to you...not them.  There is no "let". 

This.  You can refuse the induction, too, albeit passive aggressively, (i.e. calling to cancel your scheduled induction "appointment.")  You don't need ANYBODY'S permission to be pregnant. 

How does GBS make you a candidate for induction?

[Tumble Bumbles]

Yes to these. Natural induction methods won't do a thing unless baby is ready within a couple days. Heck, a lot of the time UNNATURAL induction methods (cervical gel, AROM,  pit) won't get labor started if baby truly isn't ready --then you''ll get sectioned again -- which is what you're trying to avoid. It's happened to many an acquaintance, sadly.  Castor oil IS NOT recommended for VBAC mamas. Heck, I wouldn't even take it and I'm not a vbac.

It really gets me going when docs and midwives talk about what they will or won't "let" or "allow" a woman to do. Let's not forget who's body this is - yours.

 Quote:

Originally Posted by Turquesa 

Originally Posted by GOPLawyer 

Just refuse the c/s.  The choice belongs to you...not them.  There is no "let". 

This.  You can refuse the induction, too, albeit passive aggressively, (i.e. calling to cancel your scheduled induction "appointment.")  You don't need ANYBODY'S permission to be pregnant. 

How does GBS make you a candidate for induction?

[dakotablue]

Thanks

The problem is with GBS I need to be at the hospital long enough for the antibiotics to work, otherwise they will keep the baby for at least 48 hours. We are hoping to be home in 12. So if I show up pushing past the dates they want then that will happen, but If I show up in labor past the dates they want early enough for antibiotics then they will push for c/s.

What I really don't get is that if its true the chance of UR is higher after 40 weeks, why would they then use a drug that increases chance of rupture?

If it weren't for the GBS I would seriously consider UBAC if I go past dates...but GBS scares me.

I'm just hoping we can get this bean moving soon. BUT DS was an induction at 41 weeks that failed (My body was NOT ready).

Trying to stay calm...

[AnnieNimIty]

There are threads out there about a wash for Group B Strep you can search for. They will want to give you an IV. But the thing is that it might not be "flared up" at the time of birth.

You just need to find out what GBS is and what they are concerned about. Knowledge is power.

Speaking of which, educated yourself on the complications they are concerned about. Not just that they might be there, but the actual numerical risks. Often you aren't getting the whole picture from your care providers. Have you been referred to the ICAN group?

Please also remember, they work for you. They have to explain what will happen if you don't agree with them, or what will happen to you if you choose to do something differently.

They can't very well refuse you medical attention, also they can't strap you down and force a c-section on you. You have every right to accept or reject whatever their recommendations are. As much as it feels like they are running the show because they are so confident, they are only human. They aren't you or your body.

Yes you want them on your side in case something bad happens, but they have to take care of you to the best of their medical ability whether or not you get along with them.

[Tumble Bumbles]

GBS is weird in that you can be pos one week and neg the next.  Have you considered the hibiclens protocol for GBS+? I am not trying to underplay the potentially dangerous effects of passing it to baby, but it's extremely rare. I'm sure it doesn't seem rare if it's your child -- just saying, the chances of being sectioned again are so much higher than the chances of babe contracting GBS, and there are risks to baby and mama with a section as well.

Here's a ton of info on GBS, some of which may be reassuring to you.

Of course, you've got to do what you feel is best for yourself and your baby but we all know that mama's experience matters. Yes, the "most important thing" is a healthy baby, but I believe a healthy baby AND healthy mama can be had here without sacrificing one or the other.

Stay calm, you're only 38w 6 days. I know it seems like you're on a time clock but you're not, truly. This is your body, your baby, your decision. Always yours, no matter how huffy anyone wants to get.

[phathui5]

Doing the evening primrose oil won't hurt anything and it might help get your cervix ready to go into labor. With you being only 38 weeks, I wouldn't stress yourself out with lots of trying to get labor going. Labor will start when your body and your baby are ready.

The first doula client I had went well past her due date and her doctors weren't happy about it. They kept offering to induce and she kept saying no. She went into labor on her own and had a healthy baby.

[amaayeh]

I agree with Hibiclens protocol.  From everything I have read, it is much more effective than antibiotics anyway.  Maybe try the peri-wash for a few days and ask them to test you again?

I know that when everyone is pressuring you, especially at the end, it is stressful.  However, you really, really need to take a step back.  I truly believe that the baby will not come if you are worried about how things will go.  Like pp said, they can not *make* you do anything, including a c/s.  I would stay very nice about everything, but confident that you can (and will) be making your own decisions when it comes to care.  If you end up going past 41 weeks so be it.  Show up in labor and refuse the c/s unless there is a true reason you need one.

I hope things calm down for you and you can get to a peaceful place with the birth.  Good luck!

[MegBoz]

Quote:

Originally Posted by dakotablue 

The problem is with GBS I need to be at the hospital long enough for the antibiotics to work, otherwise they will keep the baby for at least 48 hours. 

This happened to me. Of all the options, it's not the worst thing in the world. Assuming you're not planning to birth in a horrific hospital that does stuff like required nursery time (and I believe such things are VERY rare now), it's not all that bad. Sure, it wasn't ideal, but it was fine. Definitely preferable to induction, if I were to weigh those 2 scenarios.

That being said, I actually believe in the risk-based protocol they follow in the UK. If I test GBS+ again, I won't bother to do anything about it at all unless I develop a 2nd risk factor (& the positive swab is only 1 risk factor.) & if I were worried, I go with Hibiclens anyway. (I'd personally only go with antibiotics in the case of + swab combined with either prematurity or maternal fever.)

Of course, the hospital is NOT going to be cool with you doing hibiclens instead of antibiotics. I was also told by this UAV nurse in my hospital-based MW's office that, "There is no point in getting retested. Even if you test -, they are still going to treat you as if you're +." (Her exact words.)

No, sweetie, what you mean to say is, 'They are going to recommend you be treated as if you're + anyway.' They can't just do whatever they want and pump whatever drugs they want into my veins without my consent, you #&)@."

But I digress. I suspect that view is common - since GBS comes & goes, if you test + at 36W and retest - at 38 or 39W, they still might think antibiotics are in order. Obviously, as we've all said, you certainly can decline, just be aware it's something they're likely to disagree with you on. If you have a supportive team - hopefully at least 2 people like a DP and doula - you just have to stand up for your bodily integrity. (Oh, also in that case be prepared to fight against preemptive treatments & tests for baby.)

I also wouldn't stress too much about being worried about going late. I went to 41W4D & was kinda freaking out & I remember my doula saying, "Try to relax. Stress inhibits labor." & I felt like she was saying, "It is sorta YOUR FAULT you're not in labor if you don't stop worrying about it." Which really made me seething mad. While I believe it's true that extreme stress absolutely will inhibit labor, I don't think feeling stressed because you desperately WANT to be in labor is quite the same thing!

So I wouldn't beat yourself up. The wait sucks. Plain & simple - it's miserable just waiting & waiting - knowing you're going to face induction pressures (sure, you can say 'no' but it's still something you have to face). The last thing you need is to feel guilty for being frustrated on top of it! I think we're all perfectly entitled to be frustrated at the end- just try to 'be gentle with yourself' & not beat yourself up.

[suddenlyamama]

This is what birthday looked like for us:

Sex, 2 tbsp of Castor Oil in a cup of OJ, diarrhea, contractions, Baby born 6 hours later!!  I felt pressured to, thus the reason I chose to try the CO

[noahs.mom06]

Originally Posted by MegBoz 

Quote:

Of course, the hospital is NOT going to be cool with you doing hibiclens instead of antibiotics. I was also told by this UAV nurse in my hospital-based MW's office that, "There is no point in getting retested. Even if you test -, they are still going to treat you as if you're +." (Her exact words.)

I think this is fairly standard at any hospital. They really don't care if you re-test and are negative. I have been told that even if you were GBS+ in a prior pregnancy, they will want to treat you as if you are + in subsequent pregnancies, even if you test negative.

That said, I also have a lot of faith in the hibiclens protocol, and if I were comfortable with a potential UBAC and only worried about the GBS, that is probably the direction I would take.

Otherwise I agree with pp's who said to just refuse the induction (I'd just not go and then play dumb, "oh shoot, I KNEW I was supposed to do something today!"), and refuse the c/s without necessity if you go into labor past the dates they want you to have the baby by...

[MegBoz]

Originally Posted by noahs.mom06 

I think this is fairly standard at any hospital. They really don't care if you re-test and are negative. I have been told that even if you were GBS+ in a prior pregnancy, they will want to treat you as if you are + in subsequent pregnancies, even if you test negative.

Well, I also think it is common that they don't care if you retest negative. Ha - but I "really don't care" what they care about or not. ;)

It was the way she phrased it that I took great exception to. "THEY ARE GOING TO TREAT YOU..." as if I had zero say in the matter. That sort of thing really ticks me off.

Actually if you had a BABY who became infected with GBS in the past, I do believe it's evidence-based to treat you with antibiotics in a subsequent pregnancy, regardless of whether you test negative or positive.

But to automatically treat you as positive because you had a positive SWAB in a past pregnancy? That is beyond ridiculous.

[kltroy]

Just wanted to offer you some encouragement.  Yes, many doctors and midwives will have some "standard policy" that they would like all moms (not just VBAC, although occasionally they will say especially VBAC) to deliver by 41 weeks.  This is based on the evidence that stillbirth rates double from week 41 to 42.  That is... they double from around 1.5 / 1000 to 3/1000. 

There is NO evidence that being a VBAC mom increases your risk of stillbirth. The two are simply unrelated.  There is NO evidence that your risk of rupture goes up after 40 or even 41 weeks.  Even according to the newest ACOG guidelines published last August, there is no reason that moms who go post-dates should not be offered a trial of labor.  On an epidemiologic scale, there is some evidence that moms who go past 41 weeks are less likely to actually succeed in  having a VBAC, but this has nearly nothing to do with how YOU will do with YOUR birth.

I was in this exact situation almost 3 years ago.  I had several conversations with my family doctor, who was going to attend my VBAC birth, and I told her under no uncertain terms that unless there was a valid MEDICAL reason that we needed to get the baby out, I would wait for labor to come naturally, or until 42 weeks, whichever came first. 

I did have her try a membrane sweep at 40 weeks (cervix was high and closed, barely fingertip dilated, so she was unable to do that).  We scheduled a Non-stress test for 41+1, with the assumptoin that I would make it that far (I did).  I went into labor the morning of my NST, but wasn't sure it was real yet so I kept my appointment.  I had my baby at 41+2.

Anyway, my point is, I'm betting you have more wiggle room than you think.  Ask about a non-stress test.  Explain that you do not want an induction unless the baby is in trouble or until 42 weeks.  Explain that you understand the risks.  Your doctor cannot drop you at this point in the game.  You cannot be forced to be induced or to have a RCS. If they get openly hostile and try a power play, I say just sit tight at home, **oops!** "accidentally" miss whatever appointment you had for an induction/RCS, and wait for labor.  I would do your best to reduce your risk of GBS playing a role (ie hibeclense or whatever others have suggested) if your impression is that they will truly be hostile and not allow you to labor.  But first, I'd try and talk it out.  Best for everyone to come to an agreement rather than have to fight while you're in labor.

In the mean time, be proactive about getting labor started.  If you're GBS+, membrane sweeps are out, but sex is still in.  Aside from that, you can always try that castor oil.  That was my plan if I actually made it to 42 weeks.  (thank God I didnt!)

Best of luck.  Give your local ICAN chapter leaders a call and/or try and get to a meeting if there's one coming up between now and your EDD.  They can be really, really helpful.