Is There a Happy Medium Between All-Out Induction and intervention Free?

[waiting2bemommy]

So I (sort of) worked out my maternity leave and that has helped with the chronic pain I've been having. But now I'm coming up on my due date and the doctor is quite eager to induce me. I'm due on Sunday and she said when I came in Monday she would schedule my induction then. I don't particularly want to go 42 weeks, either, and want to avoid pitocin at pretty much all costs. I've heard some good things and some really scary things about cytotec, and I've also heard that sweeping the membranes can be a way to jumpstart labor naturally. From those of you who have done this before, am I setting myself up for the whole barrage of interventions if I let her strip my membranes on Monday? Are there other alternatives I don't know about that I could bring up with her? What have been your experiences with these? These are the only 2 I'm aware of (other than the natural stuff). I *don't* want the pitocin & I want to labor naturally but I'm willing to try less invasive things to get it started, depending on their risks, of course. And of course I can always *wait* some mroe, but it's doubtful on how long she'll let me go.

[alegna]

You're not even DUE yet- relax

I would not do ANYTHING to induce (including stripping membranes) without medical reason.

First pregnancies AVERAGE 41 weeks 2-3 days.

Average.

Don't let anyone pressure you. You can say no to everything.

-Angela

[JessicaS]

Originally Posted by waiting2bemommy

So I (sort of) worked out my maternity leave and that has helped with the chronic pain I've been having. But now I'm coming up on my due date and the doctor is quite eager to induce me. I'm due on Sunday and she said when I came in Monday she would schedule my induction then. I don't particularly want to go 42 weeks, either, and want to avoid pitocin at pretty much all costs. I've heard some good things and some really scary things about cytotec, and I've also heard that sweeping the membranes can be a way to jumpstart labor naturally. From those of you who have done this before, am I setting myself up for the whole barrage of interventions if I let her strip my membranes on Monday? Are there other alternatives I don't know about that I could bring up with her? What have been your experiences with these? These are the only 2 I'm aware of (other than the natural stuff). I *don't* want the pitocin & I want to labor naturally but I'm willing to try less invasive things to get it started, depending on their risks, of course. And of course I can always *wait* some mroe, but it's doubtful on how long she'll let me go.

What kind of chronic pain issues do you have?

In normal circumstances I would advise you tell your Dr to bite you and you don't need to be induced but I am curious about the pain you are having.

Is is causing you to have sleeping problems? Are you having trouble resting?

Can you give us more information?

[waiting2bemommy]

yeah, I know I *can* say no, but they took me on at nearly 7 months pregnant and they are a big practice...they can give me the boot if I don't follow their "standards of care". She didn't even want to see my birth plan when I brought it in last week, now would she put it in my chart. She told me to just give it to someone at the hospital when I went into labor. Maybe I'm not assertive enough...sigh. It doesn't help that I'm "big as a minute" as my mom says and look about 13 yrs old. Maybe I should drag along my doula AND my mom for every appt....I bet they'd love that lol.

[JessicaS]

Is there a birth center in your area?

Would you be willing to say what city you are in so we can recommend something?

[waiting2bemommy]

The pain....I pulled my round ligament on the job back when I was about 20-ish wks. The ER doc (quite correctly) told me that the ligament wouldn't be able to recover right until postpartum, so the pain would just increase until then, which it has. The last month or so I also developed what I think is sciatica pain.

There have been a couple of days where I literally couldn't move from my seat and almost didn't get to the bathroom in time because I couldn't bear to move and exacerbate the pain. I work with special needs children and did a lot of heavy lifting and pulling, restraining, etc up until 38 wks when I finally had to stop working. I'm sure that didn't help any but I tend to be a person that grits my teeth and works through the pain until it is absolutely unbearable, and that is what I did. I've been to a massage therapist a couple of times and she *says* I have a high pain tolerance, but I'm in a good bit of pain, so....

[waiting2bemommy]

I'm in Virginia Beach. There is a sort-of birth center in Norfolk, which is close to me, but this group of doctors is the only one that would take me so late in the game, and they only practice at two hospitals (I picked the better one of the two, at least). The health insurance through my job didn't kick in til I was 6-7 months pregnant, thus the ensuing complications.

[JessicaS]

Originally Posted by waiting2bemommy

I'm in Virginia Beach. There is a sort-of birth center in Norfolk, which is close to me, but this group of doctors is the only one that would take me so late in the game, and they only practice at two hospitals (I picked the better one of the two, at least). The health insurance through my job didn't kick in til I was 6-7 months pregnant, thus the ensuing complications.

Call the birth center tomorrow, or go and visit, explain what is happening and what your Drs are saying and see what they say.

The Midwifery Center at DePaul
100 Kingsley Lane, 4th Floor
Norfolk, VA 23505
Tel: [phone]
Fax: [phone]
Contact: Neldara Dowell, CNM
Email: [e-mail]
Website: www.bonsecourshamptonroads.com


I am sorry you are being pressured like this.

[njbeachgirl]

Honestly? I would run, not walk away from that doctor. Do anything you can to see if you can find a more understanding care provider. The fact that she won't "let" you go longer, (it's actually YOUR decision)! And the fact that she is not even interested in seeing a birth plan raise HUGE red flags for me.

As far as inducing, walk around (if you can), have sex if you can, eat some spicy food. But there is no reason for medical or even herbal induction methods at this point. (I understand it can be hard in late pg and you just want the baby to be born, and you mentioned that you have pain issues.... but seriously.... letting things take their course will be sooo much easier on you in the end, trust me!)

Hope it all works out and you have a great birth... hang in there.... the baby will come soon!

[alegna]

Originally Posted by waiting2bemommy

yeah, I know I *can* say no, but they took me on at nearly 7 months pregnant and they are a big practice...they can give me the boot if I don't follow their "standards of care". She didn't even want to see my birth plan when I brought it in last week, now would she put it in my chart. She told me to just give it to someone at the hospital when I went into labor. Maybe I'm not assertive enough...sigh. It doesn't help that I'm "big as a minute" as my mom says and look about 13 yrs old. Maybe I should drag along my doula AND my mom for every appt....I bet they'd love that lol.

NO- they can NOT dump you at this point.

I agree- run to a different practice.

-Angela

[SublimeBirthGirl]

I don't do non-medical induction. Late pregnancy sucks, but so do all the things that flow from interventions. I would avoid them unless they became medically necessary (not just "you're past your due date, might as well have a baby" necessary).

[green_momma2007]

I would not let them induce me for nonmedical reasons. I did with my first pregnancy, even though my body was not ready, it wasn't even my due date. Guess what????? My uterus started hypercontracting due to the Cervidil and my baby's heartrate went crazy. I ended up with a cesarean. If you are ok with possibly getting a Cesarean that could have well been prevented and you wont spend a bunch of time blaming yourself for not being more assertive, then induction is an option for you. But just be aware that it can all spiral out of control VERY quickly.

[kltroy]

I'm maybe *slightly* more mainstream here than some folks - I would probably consent to sweeping your membranes at some point past your EDD if you're truly in miserable pain. But I would NOT consent to cervidil/pitocin/AROM anything other than sweeping membranes.

And you should ONLY consent to sweeping your membranes if YOU want to do this. Do not let your doctor pressure you into this! If it will help you stand your ground then yes, take your mom and/or doula into your appointment with you

If you get past 41 weeks and your doc gets antsy, offer to take a non-stress test every couple days to reassure both her (and you) that things are fine. If you go past 42 weeks (according to one of my OB friends "41 weeks is the new 42 weeks" - which is why they get so antsy at 41 weeks now) then you can start thinking about jumpstarting the process a bit more if you're not comfortable with letting things move on their own.

Chances are things will start on their own. Your doc cannot legally drop you this late in the game, so don't worry about that.

[Violet2]

I found that a lot of medical care during pg was me balancing what I felt to be true and my OB's needs. It wasn't just managing care, but the relationship.

Let them schedule the induction as late as you can push it and don't worry about it. You may not need it. If you get to that date, renegotiate it. Do the stress test whatever to prove the babe is okay and keep pushing against their paradigm.

Your doc is not wanting to talk about induction just to induce, but to coordinate the logistics of care per the standards of care their practice subscribes to. So go along to get along, knowing that your agenda is different and what your next step is.

Go ahead and discuss induction. What meds do they use, what do you want to use etc..? Get your preferences communicated and hash out your differences just in case.

Until you're in the hospital with an IV in your arm, it's all just talk. Talk can't hurt you and talk doesn't mean you'll agree to an induction. But it does calm the doctor down and keep people from freaking out.

Your labor will go as it will, not as you or anyone else would have it.

Lastly, no I don't believe sweeping your membranes sets you up for more intervention. Except if it were to break your water--then you'd be kind of screwed.

Have had pitocin (for augmentation of a crappy labor) I would go for membrane sweeping and try everything I could before I consented to pitocin. Pitocin is what will set you up for more intervention.

Good luck!

V

[Kitten]

What is the hurry? You aren't even at your due date yet.

As for your OB's "needs," and what he or she will "let" you do, bah on that. He/she will have completely forgotten you the day after your birth and will not be dealing with any possible long-term consequences of an induction gone badly. I wouldn't even discuss the induction at all at this point, OBs tend to be very good at sweet-talking and manipulating women when it suits their needs. There is NO NEED to negotiate or worry about what their "standards of care" are, this is your body and your life.

It would be illegal and against FEDERAL LAW for them to drop you at this point, for any reason.

P.S. Keep your clothes on until you know for sure what you want to do or you might end up with having your membranes swept whether you decide you want it to happen or not. I've even heard of doctors "accidentally" breaking your water during a sweep if they think you are going to be difficult about consenting to induction.

[SublimeBirthGirl]

Originally Posted by Kitten

What is the hurry? You aren't even at your due date yet.

As for your OB's "needs," and what he or she will "let" you do, bah on that. He/she will have completely forgotten you the day after your birth and will not be dealing with any possible long-term consequences of an induction gone badly. I wouldn't even discuss the induction at all at this point, OBs tend to be very good at sweet-talking and manipulating women when it suits their needs. There is NO NEED to negotiate or worry about what their "standards of care" are, this is your body and your life.

It would be illegal and against FEDERAL LAW for them to drop you at this point, for any reason.

P.S. Keep your clothes on until you know for sure what you want to do or you might end up with having your membranes swept whether you decide you want it to happen or not. I've even heard of doctors "accidentally" breaking your water during a sweep if they think you are going to be difficult about consenting to induction.

:

[artgoddess]

I think bringing your doula and or mom with you to your next appointment is a great idea. They can't make medical decisions for you, but knowing they back you up may help you say no. The fact that she didn't even look at your birth plan realy is horrible. She has no respect for you or the kind of birth you want.

I think it's really early to sweep membranes. If your body isn't ready for labor, it's not going to jump start anything, it's just going to hurt. Call the birth center and tell them your story.


Best of luck

[XanaduMama]

Just to add... have you seen a chiropractor for the round ligament pain? I was (already) in bad pelvic pain a couple months ago (it plagued me throughout my 3rd tri with ds), and the chiro has helped me SO MUCH. Even if you only go a couple times before baby arrives, at least it might make you more comfortable.

Hang in there!! Baby will come when s/he's ready--don't rush it. There are also "natural" things you can try to get some action happening: EPO to ripen the cervix, sex, lots of walking/squatting, etc etc.

Stripping membranes makes you more vulnerable to PROM (water breaking before contractions start), which puts you on the clock and therefore more likely to end up with a cascade of interventions. I wouldn't do it either.

[waiting2bemommy]

Originally Posted by kltroy

Chances are things will start on their own. Your doc cannot legally drop you this late in the game, so don't worry about that.

Thanks for letting me know of that...that eases my concerns a little bit. I heard a horror story of the doctor IN THE HOSPITAL threatening to walk out during labor because the mom (my mom, in labor with me!) wasn't "agreeing" with his protocol. And I was doing fine....he just had a power issue. Years later this same doctor got sued and banned here for malpractice and moved to Texas...but I digress

[Kitten]

The law that covers this is EMTALA and wasn't passed until...1994, maybe? I don't remember.

Doctors still threaten to drop patients at the last minute, even during labor, if they won't consent to something. Either they just don't know that this is illegal, or they just don't care. They can't actually do it, or they are breaking federal law.