Game Plan for going past EDD?

[Taryn237]

So my EDD is tomorrow with nothing happening yet.  I'm fortunate that my MWs will induce at 42 weeks but I'd rather not get to that point.  DS was a failed induction turned unnecesarean at 41w6d, and DD was a VBAC born near my EDD but I had PROM (due to nipple stimulation from pumping because of insufficient glandular tissue) and a very long augmented (castor oil, nipple stim, and finally pitocin) labor.  If it weren't for the PROM I don't know how much longer she would've cooked for.

Right now I'm taking EPO orally (since 36w) and vaginally (since 38w) and enlisting DH's help every other day or so.  I had my MW check me at my last appt (curiosity got the best of me, I know it doesn't mean much) and I has not dialated at all but soft and 50% effaced.

If I get close to 42 I'd rather get things going as naturally as possible.  I was thinking accupuncture?  What else can I do?  At 41w6d I would try castor oil and nipple stim again but DD's birth was pretty awful and I don't want to have a do-over of that experience.

[Monkey Keeper]

There have been several thread about this lately.  Here is my response to one of them.  I started getting some pressure to induce at 41w even due to "big baby" and polyhydramnios, both found and routine monitoring. So I took action on the advice of my doula and her partner (also midwives). While I did not have acupuncture to start labor, it took my contractions from 7-9 minutes apart to 3 minutes apart as soon as the last needle was in. I believe that if you are close to ready, it likely will "tip" you into labor. Definitely it is one of those "can't hurt, might help" things.

[kltroy]

I was told by my accupuncturist that it wouldn't necessarily immediately send you into labor - it may take several sessions.  I did 2 sessions right around the time I was 40 weeks (on the theory that I didn't want to feel too much pressure to go into labor right away if it didn't work immediately).  Actually gave up on the accupuncture since I didn't perceive that it accomplished anything at all, except that it was time consuming and sort of a pain.  I ended up just waiting it out and went into labor on my own at 41+1.  If your cervix is getting softer, try some membrane sweeps instead.

[~Amy~]

I"m 40w 2d today and also a VBAC-hopeful.  I have a profile u/s scheduled for Monday and depending on how fluid levels are, how baby's looking, etc, we'll go from there.  My doc is happy to wait for labour as long as things look good on Monday.  I'm hoping I'll go naturally before Monday, though.

[Taryn237]

40+1 and still not dialated at all.  Now the plan is to try to induce naturally if I hit 41 1/2 because if I have to go for the overdue ultrasound Mon. May 2nd and I have low fluid the hospital will recommend a repeat cesarean instead of a VBAC (since ACOG does not recommend inducing VBACs).  So I don't have to 42 weeks after all... Praying labor happens before May 1st on its own.

[Monkey Keeper]

Hang in there and remember that vag exams don't mean diddly!  A lot of us here have gone just past 41w and had successful VBACs.

Have you personally read the ACOG position?  Because I don't think it's as black and white as your statement. I know at 42w I would have had the option to induce, first mechanically then by other means based on my hospital (large teaching hospital). It's  a tough position to be in, and I'm sorry you're in it.  

[~Amy~]

Originally Posted by PinkBunch 

Have you personally read the ACOG position?  Because I don't think it's as black and white as your statement. I know at 42w I would have had the option to induce, first mechanically then by other means based on my hospital (large teaching hospital). It's  a tough position to be in, and I'm sorry you're in it.  

This.  I will have the option to induce as well.  I'm in Canada so perhaps the SOGC has a different position than the ACOG does, but my doctor is very comfortable with a closely monitored trial of labor induced by pitocin as long as my cervix is favourable (and it is currently).  She said that because the half life of pit is so short, if there's an issue, it can be stopped quickly.  

[Ms. B. Sprout]

Would your OB be willing to try a Foley catheter induction? Big hugs and labor vibes to you!

[Taryn237]

Yeah the plan would be to take a couple doses of castor oil at 41w4d hoping that would be enough to start labor.  If not then nipple stim.  I'd like a good labor pattern before heading to the hospital.  If I get there less than 4cm we would do a cervical balloon (it wasn't the foley cath though, I forget what she called it).  If all that wasn't enough possibly AROM and/or pitocin.

I'm going to ask about going for the ultrasound somewhere besides the hospital (like a small radiology place) because then there isn't that 'OMG we need to admit you now' panic if my fluid was very low or something else was wrong.  It would only buy me a couple of days though so I don't know if its really worth the effort.

[Ms. B. Sprout]

In my town the midwives have a small radiology place that I can go to for an off-the-radar u/s (I am getting parallel OB and MW care for now). Perhaps asking the midwives where they send their folks would be a good option. Sending you good labor vibes!!

[Ammaarah]

Membrane sweep?  I went into labor about 36 hours after one.  It didn't hurt all that bad either.

[Taryn237]

Originally Posted by Ammaarah 

Membrane sweep?  I went into labor about 36 hours after one.  It didn't hurt all that bad either.

She tried.  My cervix is very high and posterior.  My MW was able to reach it (I can't) and she said it was very soft but closed and she couldn't get her finger inside.  We will try again at my Thursday appointment.  I'm feeling rather depressed and just trying to gear up for some yummy castor oil next weekend.

[Ms. B. Sprout]

Big hugs. I am thinking about you! I have done the postdates thing twice before so I know how awful it can be. You have my full sympathy!

[Taryn237]

41+1 and still pregnant.  Hoping for a membrane sweep today.  Unfortunately I also now have a yeast infection so aquiring those nice natural prostogladins compliments of DH is out.

[Ms. B. Sprout]

Thanks for the update! I have been wondering how you're doing. Sending you good vibes!

I know anecdotal evidence is useless (and when I was in your boat, I got really sick of hearing optimistic stories, because it seemed like none of it applied to me!), BUT -- with my last pg, I got a membrane sweep at 41+2 and was in labor on the night of 41+3.

I hope you're in labor soon!!!

[Monkey Keeper]

I went into labor at 41+1! Thinking birthy thoughts for you :)

[Taryn237]

Feeling a bit better after today's appt.  Baby should be arriving Saturday!  I am 3cm and 'VERY favorable' to castor oil so my midwife thinks I just need to get labor going and I should be holding baby 8-13 hours after the first dose of castor oil.  DH is bring the kiddos to my parents tomorrow and then taking me out for our last date night for awhile.  I plan on having my castor oil, OJ, vanilla ice cream smoothie for breakfast Sat. morning.  The end is in sight :)

[kltroy]

Good luck!!!  Thinking happy thoughts for you

[Monkey Keeper]

Wonderful news!  Maybe she'll just c'mon out on her own with that kind of progress in the last few days...  Hope everything goes very smoothly!

[Ms. B. Sprout]

Thinking about you today mama!