Going Past Due...whats your plan? (LONG)

[mad4mady]

So, today is my due date. No sign that labor is starting anytime soon. I have some time but, have started thinking about the upcoming week or so. I realize I have a lot of time but, I want to starting thinking about ideas now for my upcoming appt. I found out that my insurance provider (Kaiser) policy is to induce at 41 weeks. My midwife said  she can push that off a bit but by my appt on the 16th we will have to pick an induction date within a few days of that.

First, a little about where I am at. Baby is still very high, I am 2-3 cm dialated (been that way for 2+ weeks) About 70% effaced (also been that way for 2+ weeks) I was having a ton of prodromal stuff and fairly regular bh contractions and then they just stopped happening. Now I don't really experience any prodromal symptoms at all.

I have an appt. on the 7th and then not another until the 16th. At the appt on the 16th, She will see the next time she is at the hospital and pick that date to induce.

At the appt on the 7th she can stripe the membranes or I can wait and try for it on the 16th. My only concern is if I wait for the 16th and she is only on call at the hospital on the 17th  then that is the date they will induce, that give no time for the labor to start on its own.

Would you have your membranes striped only 2 days after your due date? I really wanted to wait and let things go on there own but, I am also concerned if nothing happens by the induction date its PIT all the way and I won't have the time to try other stuff.

Oh I should add, my membranes were striped at 39 weeks (without my consent) with dd and my membrane ruptured the next day...I think labor would have followed on its own by the next day but, I didn't know better back then and called the hospital where they started PIT. about 6 hrs later. I also was not dialated at all when they were stripped the first time.

Okay, thats for taking the time and all ideas are welcome. Also, other ideas. I am pretty freaked out at the though of castor oil, although it sounds 10times better then being induced. If you would do the castor oil route...when would you try it?

Megan

[jshannyn519]

When I was at my appt on Tuesday I was 37w6d and I had my MW do a stretch and sweep to see if she could kick things up a notch after 12 or so days of prodromal labor. So, in your shoes I would go for the sweep/strip at the next appointment. If it doesn't send you into labor (mine didn't because here I am nearly a week later, still pregnant) then you can have her do it again on the 16th.

If I'm still pregnant on Wednesday when I go in to see my MW next I'm having her do another stretch & sweep.

[erigeron]

I don't really know because I'm not at that point yet, but can I just offer a big old ICK to Kaiser having a POLICY to induce at 41 weeks? Where do they get off practicing medicine/telling providers how to practice it? Ew.

Could you get an appointment between the 7th and 16th if you don't go into labor and decide to get your membranes stripped?

[amaayeh]

Originally Posted by erigeron 

Could you get an appointment between the 7th and 16th if you don't go into labor and decide to get your membranes stripped?

  Just a 'quickie' appointment?  I had my membranes swept at 40w5d and went into labor the next morning (approx. 24 hours later).  If your only chance to have the sweep is the 7th, I would do it rather than chance not doing it until the 16th.  I'm sorry you are having to make that decision!  I totally understand wanting to just wait.

[Klynne]

Originally Posted by erigeron 

I don't really know because I'm not at that point yet, but can I just offer a big old ICK to Kaiser having a POLICY to induce at 41 weeks? Where do they get off practicing medicine/telling providers how to practice it? Ew.

Could you get an appointment between the 7th and 16th if you don't go into labor and decide to get your membranes stripped?

So, what happens if you tell them you won't to set an induction date? Or you agree to set one at 42 weeks?

And Where's the "your body, your choice" in Kaiser's policy?

[mad4mady]

Thanks for the ideas!!

I think I will give the sweep a try on the 7th and find out about setting another appt for a few days after that. As far as the 42 week thing, my midwife is being pretty flexible about it even though the policy is 41 weeks. Technically  I will be 42 weeks on 19th so at least she is saying she can make it after the appt on the 16th. But, yes. I do think that the 41 week rule is bad! I was shocked to hear it because they have actually been really awesome about everything else so far and they are pretty progressive for being a big hospital plan and all.

Does it sound like my cervix is favorable for the sweep?? Being that its fairly soft and 2+?

[Cutie Patootie]

Originally Posted by Klynne 

So, what happens if you tell them you won't to set an induction date? Or you agree to set one at 42 weeks?

And Where's the "your body, your choice" in Kaiser's policy?

ITA.  They *cannot* force you to have an induction.  They can even set a date...but you don't have to show up.  :)  Tell them what you will do.

My plan has been to tell them from the beginning that I will not consent to induction for any reason...except if baby or I are showing symptoms of distress.  I'm 38 weeks today and with hbp and they haven't mentioned induction to me as of yet. 

[jshannyn519]

Yep, I think you're good for a sweep.

[mad4mady]

Originally Posted by Klynne 

So, what happens if you tell them you won't to set an induction date? Or you agree to set one at 42 weeks?

And Where's the "your body, your choice" in Kaiser's policy?

I could probably set a date for 42 weeks being that that date is only a few days after my appt on the 16th however, it would depend on having my midwife on call on that date. My bigger concern is waiting until 41 weeks to start any intervention (sweep, etc) and only having a few days to see if it works before the induction is set.

[mad4mady]

Originally Posted by Cutie Patootie 

ITA.  They *cannot* force you to have an induction.  They can even set a date...but you don't have to show up.  :)  Tell them what you will do.

Thanks for the reminder That is totally true!!

[Klynne]

And on the flip side, your chances of going into labor before the 17th with out intervention are pretty good. :)  It sounds like you have a good midwife on your side.

[Jaspersmommy]

I would also elect to go for the sweep.  As far as I know, it's a low intervention intervention if that makes any sense .  That is, it won't put you into labor unless your body (and thus baby) are ready.  I know some women get more than one a week or so apart so getting it on the 7th would still give you an opportunity to have another shot at it prior to the dreadful induction date.  Sounds like your cervix is favorable and you won't need that date anyways! 

It sucks being on the clock but try to trust that your body is gearing up! C'mon baby

[mumofmak]

DDCC... Just thought I'd add my two cents... I agree you seem like a good candidate for a membrane sweep but I wanted to also recommend that you address baby's position. Could be that baby is not in a great position and that's holding things up (not that you're actually *late* yet!) - I have no idea if this is the case because you have not mentioned anything about it. I had a few adjustments from a chiropractor at the end of my last pregnancy (one who is experienced in working with pregnant woman) and that helped get the baby lined up right and the last session actually got labour going, along with a little breast pump assistance. I can also recommend accupuncture.

Best of luck to you!  I really do know how frustrating it can be to face down those last weeks day by day - it's stressful and I'm REALLY hoping this babe of mine comes sooner than my others (which were born at 42 4/7, 42 2/7, and 41 2/7).

Hope you go into labour on your own soon!  :-)

[SuburbanHippie]

DDCC

I think you're definitely favorable.  I would go ahead and do it on the 7th.  Good luck!

[mad4mady]

Originally Posted by mumofmak 

DDCC... Just thought I'd add my two cents... I agree you seem like a good candidate for a membrane sweep but I wanted to also recommend that you address baby's position. Could be that baby is not in a great position and that's holding things up (not that you're actually *late* yet!) - I have no idea if this is the case because you have not mentioned anything about it. I had a few adjustments from a chiropractor at the end of my last pregnancy (one who is experienced in working with pregnant woman) and that helped get the baby lined up right and the last session actually got labour going, along with a little breast pump assistance. I can also recommend accupuncture.

Baby is head down, but not engaged and so I was wondering the same thing. I plan to ask my MW this tomorrow. Thanks for bringing it up

[citymagnolia]

A friend of mine recently had success with a foley catheter induction--the first one ever done at the hospital she delivered in. Labor was no where near beginning on its own--not dilated or effaced at all and baby was not engaged--but they convinced her to be induced on her due date. She dilated to 6 with the catheter, baby finally engaged, and she was having intense, manageable contractions before they pressured her into pit (first they wanted to try Cytotec!!) She feels certain that her labor would have continued drug-free if they had left her alone. If you do end up being induced, maybe you can get them to try the catheter first.

My advice is always: sex as often as possible! Both of my labors started within an hour of dtd and if it doesn't work, the side effects are still positive! The only few people I know who have tried castor oil ended up with diarrhea and bad cramping but no contractions.

I hope it all works out just right for you. :)

[sharita]

I let them schedule my induction for the next week when I was 41 weeks with baby #3.  Then, the day before it, I called and told them I had to reschedule for 3 days later (which would put me at 42 weeks and some odd days).  I bought myself some time and so thankful I did because would you know the day after my original induction date they set, I woke up in labor on my own at 42 weeks exactly and had a nice 4 hour labor (minus whatever I labored in my sleep, lol)

They definitely can't force ya and if you start feeling the pressure or they start using the scare tactics, let them schedule it but tell them only at exactly 42 weeks not before, or if for some reason they insist before then, let them set it, then call and cancel and reschedule for whenever you feel you would actually go in if you hadn't labored yet. 

My current midwife (who is attending my 3rd home birth) goes to 43 weeks which is almost unheard of but she does heavy monitoring past 41 and goes back and talks to mom to double check dates and stuff.  She also does breech (all positions) births, vbacs, twins, all at home so this doesn't surprise me.  She has worked in lots of other countries where she got plenty of experience dealing with these things where most midwives and especially Drs dont here in the states.

[mad4mady]

I like the idea of scheduling the induction date and then canceling and rescheduling...that would buy me some time. I will also have to ask my midwife about the catheter induction...that sounds interesting

I tried using my breast pump last night to get things going...it didn't but, hey I had a lot of colostrum so that was cool. With dd my colostrum didn't come in for 2 days!!!! So, I am excited that my boobs are ready for baby as much as I am!

Well, today I am going to have the membrane sweep so, send the labor vibes my way

[wennerk]

Just a voice in support of castor oil...I did take it to initiate labor.  I was at exactly 42 weeks from my due date and my midwife said her back-up doc was going to pressure her to get things going.  I mixed the oil with coffee ice cream and chocolate syrup.  It made a nice milkshake and you'd never know it was in there.  For me, it worked like a charm.  I drank it at 2:30pm, slow contractions began at 4:30ish, things progressed.  By seven I was on the toilet thanks to the castor oil and telling my hubby to call the midwife and doula.  Gave birth at 12:28am.  Before that I had been going to the chiropractor, DD had dropped, and I'm pretty sure my membranes had been swept a few days before.  I just hadn't been ready...Good luck!

[astar326]

Originally Posted by citymagnolia 

A friend of mine recently had success with a foley catheter induction--the first one ever done at the hospital she delivered in. Labor was no where near beginning on its own--not dilated or effaced at all and baby was not engaged--but they convinced her to be induced on her due date. She dilated to 6 with the catheter, baby finally engaged, and she was having intense, manageable contractions before they pressured her into pit (first they wanted to try Cytotec!!) She feels certain that her labor would have continued drug-free if they had left her alone. If you do end up being induced, maybe you can get them to try the catheter first.

My advice is always: sex as often as possible! Both of my labors started within an hour of dtd and if it doesn't work, the side effects are still positive! The only few people I know who have tried castor oil ended up with diarrhea and bad cramping but no contractions.

I hope it all works out just right for you. :)

just a word of cation regarding the foley bulb catheter. i had this with ds at 41w5d. it helped induce labor, but bc ds wasn't in a good position (he was face presenting and never descended past -1) he was c/s'd after 37 hours of labor. i really wished i would have tried a chiro (i have been seeing one regularly throughout this pg) to help assist ds to get into a better position. i also found some stats associating the use of the foley bulb catheter to c/s. in one study the rate was almost 99.9% of the time. i would never use it again.

i 2nd lots of sex!