Midwife suggesting C.O. and B/B Cohosh...WWYD?

[mimiharshe]

I'll be 42 weeks on Wednesday/Thursday. I am sure of LMP and must just cook my babies longer. I went to 42 weeks w/ds (had more irregular cycles then though). I was very tired yesterday b/c I had been up w/ds for 2 nights and felt "weak". I had my m/w come over and she suggested I take blue and black cohosh (is the spelling right?) but she used the homeopathic names (starts w/c's). Also, she suggested I start castor oil today. I haven't done either. What I did instead is relaxed, got sleep and read great things on the internet to put me back into a focused reality that 42 weeks is okay and to continue trusting my body and this baby! So, today I just went about being happily pregnant.

Added info: I have had stronger BH contractions since Friday, but active labor hasn't kicked in. I've done the walking, sex, EPO, etc. Also, I'm a HBA2C, so I really don't want to force anything and regret it. I have worked so hard for this, I don't want to mess it up now!

WWYD. How long would you go w/o "helping" things along?

[pamamidwife]

42 weeks is ok. If you're not ok with this, don't do anything just based on dates unless you wanted to. We really do not see any rise in issues with babies until the end of 43 completed weeks...and even then, it's very small (like 10% of babies have issues because of the dating).

If you feel uncomfortable with doing anything, then don't.

Here is my postdates informed choice agreement - it might help. http://midwifemama.com/PostdatesICA.pdf I wonderr why your midwife is so afraid of the dating issue?

Perhaps you could talk with her. Homeopathic blue and black cohosh won't hurt anything (it's certainly not as risky as the herbs), but I would question the castor oil. What is the reasoning for getting labor going?

Stick to your guns, mama. After two cesareans, you deserve to have a birth where YOU are in control.

[mimiharshe]

Thanks Pam. I specifically posted this hoping you would respond! One of the things I read to get my head on straight again last night was your blog. I was tired and probably implied wanting to move things along. However, when she mentioned stripping membranes I told her I wasn't comfortable with that and I did not want to force things. I took her advice, but that doesn't mean I have to do it! She suggested the black and blue tinctures. She seemed to think castor oil was ok even though I've told her my whole pregnancy I didn't want to go through that again (took it w/ds, but that's another story). She mentioned the whole "legally at 42 weeks transfer care thing", but my response was "there is nothing legal about us!": (She can't legally be my midwife anyways b/c I'm an HBAC!) She didn't sound too nervous, but wasn't shy about having me do stuff to move things along. I am calling her tonight to talk to her about it.

Funny, I was telling my doula that I'm comfortable going to 43 weeks...always have been ok w/that in my head. She agrees that I should stick w/my gut! I just feel that if my intuition says everything's ok and the babe is still moving A TON then we're good to go. I think for me it gets hard keeping my faith everyday, every minute... I do a damn good job, but I am human!

So if I feel good about everything, you'd suggest waiting to do anything...that's what I'm thinking too!

[Diva Mama]

Just wanted to send you a hug! Waiting seems to be the hardest part!

[mimiharshe]

Originally Posted by Diva Mama

Just wanted to send you a hug! Waiting seems to be the hardest part!

thanks mama!

[SublimeBirthGirl]

Yep, go with your gut

[bryonyvaughn]

Originally Posted by mimiharshe

...I had my m/w come over and she suggested I take blue and black cohosh (is the spelling right?) but she used the homeopathic names (starts w/c's).

Potentized blue cohosh is called Caulophyllum thalictroides while potentized black cohosh is called Cimicifuga racemosa but most folks call them by their "first" names.

Originally Posted by pamamidwife

...Homeopathic blue and black cohosh won't hurt anything (it's certainly not as risky as the herbs), but I would question the castor oil.

I agree with everything else you said, Pam, but take issue with the myth that homeopathics won't hurt anything. Individuals vary in sensitivities to specific remedies as well as remedies generally.

The way they get lists of symptoms for the materia medicas is to give a particular remedy to relatively healthy individuals and see what symptoms they produce. Some healthy individuals develop symptoms after one dose, some after a few days, and others after two weeks on the remedy.

Now if you give these or any other remedies to a pregnant women when they aren't indicated or when they are indicated but keep giving past the time they are no longer indicated, you risk initiating the very symptoms you wanted to avoid (ineffectual labor, spasmodic pains shooting in all directions, rigid os, etc.)

That being said I wouldn't hesitate to give either remedy when a woman's symptoms matched as it would do great good. If I thought it matched but wasn't absolutely sure I'd give one or possibly two doses, evaluate any response, and continue, stop, or switch remedies based on the change (or lack thereof.)

Originally Posted by mimiharshe

...WWYD. How long would you go w/o "helping" things along?

As someone whose spontaneous labors on average began at 43 weeks, so long as I am healthy and the baby is healthy I see no reason to prematurely end the pregnancy. That being said I realize it is much easier to go long UP/UC than with attendants. My 10 month pregnancy with a MW who *knew* she was merely backup for my UC was unnecessarily burdensome when I had to deal with her fear-filled sobs freaking out my DH. Two children later I had another 10 monther with no back up and my DH followed my lead in taking it in stride that babies come when babies are ready to come.

I second Pam's suggestion of speaking frankly to your MW about the medical indications for inducing. While you're at it ask for your Bishop's score. They seem to be tool I've seen for estimating outcomes of induction.

~BV

[pixiepunk]

i'm wondering, too - do you know when you ovulated or just when your LMP was? because if you're not sure when you o'd, and you say you used to have quite sporadic cycles, it's entirely possible that while you had your period on whatever date that you did not conceive on day 14 of that cycle (very few people do, in fact). i, for instance, always have shorter luteal phases of approximately 9-11 days, with a solid 28 day cycled, which means i usually tend to ovulate between days 17-19.

basically what that means is that you could easily be nearly a week behind what you think you are. perhaps if you're not sure when ovulation occurred, you could mention that possibility to your m/w and it would help her relax a little bit sounds like you are in control and know it doesn't feel right to induce right now. go with your gut, and hang in there, that baby will come out eventually, they all do

[mimiharshe]

Thanks for your insightful responses!

Pixie...I just told that to dh last night...exactly what you said...i know my LMP and my cycles had been regular for a while, but I do NOT know exactly when I ovulate. I told dh I could just be getting at 41 wks instead of 42. I am going to mention this to my midwife. I was having such a relaxing day yesterday I didn't feel like talking to her.

BV...I love reading your responses. I agree that even taking homeopathic forms is too much right now. I don't know how I'll respond and she wasn't suggesting taking a dose or 2 and see how I'm doing, but rather just take them as I please....b/c they won't hurt anything.

What is a Bishop's score...gosh something I really don't know. Sorry if that sounds ignorant. I know with her other clients she'd be doing a Bio Physical Ultrasound now. I don't want that unless I really feel I need to.

Also...like you BV I was thinking that I don't want to deal w/someone elses fears and assumptions...I don't need that energy around my pregnancy and birth. As someone who has had a UC...you never felt at any point you needed to have an u/s or anything else in weeks 42-43? I'm just going to look to dh and my doula for the support I desire!

[bryonyvaughn]

Originally Posted by mimiharshe

...I don't know how I'll respond and she wasn't suggesting taking a dose or 2 and see how I'm doing, but rather just take them as I please....b/c they won't hurt anything.

Ewwww. Most people not taught how to take homeopathic remedies will keep taking them until the bottle's gone *or* until the symptoms are gone. As your only apparent symptom is pregnancy, that could mean a few weeks (not to discourage you!) That's definitely a time frame that would induce a homeopathic proving. I'm glad you know better for your sake as well as the sake of others you may encounter.

What is a Bishop's score...gosh something I really don't know. Sorry if that sounds ignorant. I know with her other clients she'd be doing a Bio Physical Ultrasound now. I don't want that unless I really feel I need to.

I learned the term from other mothers here at MDC. Here's a good description of a Bishop's score calculation and use. I learned of Bishops scores from other MDC moms, then went back and calculated mine from when my MW induced me and then augmented my labor without informing me let alone gaining my consent. My score was a 2 modified to a big fat ZERO! If I'd been informed of my MW's urge to induce and augment and of Bishop's scores generally and mine specifically, I *never* would have consented. I'm glad to get the information on to moms before inductions.

...As someone who has had a UC...you never felt at any point you needed to have an u/s or anything else in weeks 42-43?

I had the psychological advantage going into my 10 month pregnancies that I believed long pregnancies were normal and healthy for me and my family. My mother always went several weeks late, I was a 44 week baby, and my MIL also always went several weeks late with my BIL being a 10-month baby.

HCPs might have scoffed at my low tech mindset *but* I figured if I felt fine and the baby continued moving and growing as he always had, we were both healthy and well nourished. I if I weren't well or the baby's movement decreased (baring a shift to straight OA) *then* I'd consider some indirect measurement of placental function indicated. As it never happened I just never worried about it.

~BV

[mimiharshe]

Originally Posted by bryonyvaughn

IHCPs might have scoffed at my low tech mindset *but* I figured if I felt fine and the baby continued moving and growing as he always had, we were both healthy and well nourished. I if I weren't well or the baby's movement decreased (baring a shift to straight OA) *then* I'd consider some indirect measurement of placental function indicated. As it never happened I just never worried about it.

~BV

Thanks for the info. I'm going to look up the Bishops Score now. The thing is baby started moving a lot less yesterday and this morning....listening to my insitincts (which I have this whole time) I think its' time to maybe help things along (if baby is ready). I did not feel that way Monday, but do today. I'm trying to decide if I should just do the homeopathics, just the Castor Oil or both.

[mimiharshe]

Just wanted to add that since that last post I focused on having faith. I have been feeling the baby...just not as active, which is ok. I just keep telling myself, "I choose to have faith!". It is so hard right now...it feels like it's a by the minute test (of faith).

I looked up the Bishop's score and I don't think mine is very high. I called my m/w and asked her about it. She's coming by tonight. The thing is...my dh and doula are super supportive and faithful in me, my body and the baby, but I'm just not sure how much my midwife is. Maybe b/c she feels responsible? But she's not...I am! I asked her point blank in the past if she had complete faith in my HBA2C and she said yes. She is obviously laid back to an extent b/c she shouldn't even be my midwife legally! We'll see how the appt. goes tonight!

[Kristimomof4]

Go with your gut. At almost 42 weeks along, I had a midwife that pressured me into doing both of those things that yours is suggesting and now I regret giving in. I know I would have done fine without it and you will too. Babies always come out when they are ready. Have you ever heard of anyone staying pregnant because they didn't go into labor at 40 weeks? No. Hold steady in the faith that your body is not a lemon and it will do what it was designed to do and it will do it at the perfect time for YOU! I actually had two midwives working together and the other midwife wasn't concerned at all about it and I liked her advice best. She said, and I quote, "Why don't you and Brandon just really get it on and let's see what happens." The next nigh I was holding my baby boy. Let me tell you that was a whole lot better than the castor oil!!!

[mimiharshe]

Originally Posted by Kristimomof4

Go with your gut. At almost 42 weeks along, I had a midwife that pressured me into doing both of those things that yours is suggesting and now I regret giving in. I know I would have done fine without it and you will too. Babies always come out when they are ready. Have you ever heard of anyone staying pregnant because they didn't go into labor at 40 weeks? No. Hold steady in the faith that your body is not a lemon and it will do what it was designed to do and it will do it at the perfect time for YOU! I actually had two midwives working together and the other midwife wasn't concerned at all about it and I liked her advice best. She said, and I quote, "Why don't you and Brandon just really get it on and let's see what happens." The next nigh I was holding my baby boy. Let me tell you that was a whole lot better than the castor oil!!!

Thanks! That is awesome. I guess I know the baby will come out at the right time...I have to let go of my fears (and my midwives and whoever else) that the baby isn't going to be ok b/c of placenta problems, etc.

What's funny is my husband's name is Brandon too! So I guess we just need to get it on again today!

I know I would regret it too. I've been patient for so long, that now isnt' the time to stop!