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11 days overdue. What do midwives prefer in this sitch?

post #1 of 26
Thread Starter 
I have an induction scheduled for this Saturday...obviously a midwife would prefer I avoid this scenario. I am curious, assuming baby is holding up well in there, would they be more inclined to (a) rather let me go into labor naturally (b) strip my membranes at my appt on Wed and see what happens or (c) break my waters on Saturday and see if that does the trick instead of resorting to pitocin? last week I was 3cm dialated, 50 percent effaced, and baby was wayyyyy up high, if that matters.
post #2 of 26
I think it really depends on your MW practice, I've read about some that do push inductions and such, and others that don't want to do it.
Mine doesn't mind if you go over, at 43 weeks she legally has to offer a non-stress test or an OB consult, but I can refuse either and she just notes it down. My date is the 5th of December, I have a strong feeling about the 16th, my family and my fiance's family all go late, so she has me on her calendar for the 20th...So she fully expects me to go 15 days late.

It's really something to discuss with your MWs, but from what I've heard, if they are concerned and want to induce, they will often strip membranes and give you herbs to take to induce more naturally than pitocin or whatever.
post #3 of 26
My MW doesn't like her ladies to go over 41...she thinks it can get unsafe. As do I. Heart rate can go down, amniotic fluid can lesson, etc. She told me that she tells her ladies to first start with nipple stim, sex, and walking a lot. My SIL just had her membranes stripped fri and is less than 3 cm dialated. I talked to her today and she said nothing has really changed. She was going in on the 18th anyways to be induced...I guess she'll have to wait.

So I wonder what happens if you are seeing a MW and you go way over... would you have to go to the hospital??? Can you go back to the MW after you get pitocin....???
post #4 of 26
first baby? home birth?
post #5 of 26
so you are almost 45 weeks?! wow amazing.
since average human gestation is 37-42weeks6days i wouldnt be concerned at all if you fall within that realm of normal. i also wouldnt be concerned if it were myself if i went to 44 weeks, because that happens sometimes too.
your body and your baby know when your time will be. put your trust and faith in your body and your baby, and dont let anyone bully or pressure you into an unwanted unneeded induction.
post #6 of 26
Some things you should try:

Accupuncture
Chiropractor (specialized in pregnancies)
Membrane stripping (I started having mine done at 37 weeks hoping to avoid an induction)

As a last resort, two days before my scheduled induction at 42 weeks during my last pregnancy, I took castor oil. Although I knew it was supposedly aweful, it seemed preferable than an induction. It didn't have the normal effect because I threw it up shortly. I don't know if it was a coincidence, but I had the baby that night.
post #7 of 26
My midwife would want you to just wait. She would be seeing you often at that point and would be monitoring you and the baby for any signs of trouble. But she wouldn't do anything to mess with you unless she thought there was a problem.

But midwives vary a great deal, as you can see. And since my midwife is alegal, she doesn't have any restrictions put on her by the state (alegality is both suck and sort of nice- mostly suck, of course).
post #8 of 26
Especially if this is your first pregnancy, it doesn't sound that odd to me.

If you are wanting to speed things up, have you tried having sex? Semen contains prostaglandins which help ripen the cervix further. I also had luck with lots of RRL tea last pregnancy for starting some contractions. I also had a really easy labor/delivery that time, which I have heard is why most women drink it! I would also try exercise as in walking or yoga focussing on openning yourself up, and some positive visualization about progressing. When you get closer to where you think you need to speed things along, I would try stripping the membranes then getting in some walking, stretching etc right away to see if it helps move things along. Once you break your waters artificially you are pretty committed to going through with things at that point!

Good luck!

Christy
post #9 of 26
i second chinese medicine, accupuncture. my chinese doctor is an ob specialist.
post #10 of 26
I'm not sure what you mean by overdue - do you mean 11 days past the EDD or 11 days past 42 weeks? And is that today or is that what you'll be on Sat? Personally, I didn't feel comfortably with going over 42 weeks due to the risks I read about and also DS's placenta started to calcify at only 37 weeks. (I had NST every three days from 40 weeks on due to this). I do not like blanket rules that women need to be induced once they hit XX weeks. There are so many situations that are different.

If you do decide that you want an induction on Sat, I'd make sure your body is ready. I did let my dr strip my membranes with DS, but it did nothing. But at least with membrane stripping it's only going to work if your body is ready.(With DD it wasn't possible since I wasn't dilated at all until I went into labor - the night before I was scheduled to go to the hospital!) Once your water is broken, there's no going back. So, I wouldn't suggest that unless you're certain that you don't want to come back to the midwife later if it's a failed induction. (If an induction doesn't work and the bag of waters isn't broken, then you can try again in a few days).

I am not a fan of trying castor oil from what I read. It's not just how it makes you feel but the risk of meconium. Both my babies had meconium at birth despite me not doing castor oil. Luckily, they were okay, but at least I knew I hadn't done anything to make the situation worse.
post #11 of 26
Definitely do not go with PROM, without knowing precisely what your midwife's approach is regarding how long she considers it safe to have ruptured membranes. Some are okay with 12 hours, some 24, some longer, but this is a big gamble, I think, in terms of if contractions do not start, then you're on your way to lots more interventions.

I second the suggestions of sex, and acupuncture/pressure. Walking has been shown to not be an actual inducer of labor, but I think the mind is a powerful thing, so if you believe it, then it might help. Ditto with spicy foods.

I would not go with castor oil, personally, because it can cause severe cramping and great discomfort, from a digestive perspective. Not something that's fun to deal with, plus -- can't it affect the baby's bowels as well? I wouldn't risk it.

I would look into herbal aids for sure though, if your m/w is comfortable using those, and would consider having my membranes stripped. But the baby will not come until s/he's ready, even with membranes being stripped.

If you're 11 days past your EDD, I'd wait to do anything for a few more days, if you can stand it. If you're uncomfortable with unnatural methods of induction (pitocin, etc.,) then you can simply not show up on Saturday. It's your body. Your baby.

Good luck, mama.
post #12 of 26
I'm 39 weeks, 3 days. My midwife stripped my membranes today. At 7 days past my due date she'll do an ultrasound and non-stress test. Then we'll talk induction. She said as long as baby is doing fine, we can wait another week.

They will do something (forget name) to ripen cervix as first step. Then break water as second step. That was all they needed to do with my first daughter. I went immediately into labor - no pitocin needed - delivered less than 8 hours later.

My midwife also discussed everything people have mentioned here as natural ways to get things going. None of that worked with my Daugther and none of it is working now either. My babies are just stubborn!
post #13 of 26
Quote:
Originally Posted by LegalScrapper View Post
They will do something (forget name) to ripen cervix as first step.
Be especially careful with this that it is NOT cytotec they are using!

Quote:
Originally Posted by LegalScrapper View Post
Then break water as second step.
This can lead to a badly positioned baby and a long painful non-progressing labor which ends in a c-section, or even more dangerous a cord prolapse. I would NOT consent to any such thing.
post #14 of 26
Quote:
Originally Posted by jenniferadurham View Post
My MW doesn't like her ladies to go over 41...she thinks it can get unsafe. As do I. Heart rate can go down, amniotic fluid can lesson, etc.
It can; things can get unsafe any time. It's not really any more likely to happen at 41 w than at 39. Evidence-based recommendation would be to start doing non-stress tests after 42 w. to ensure that things aren't getting unsafe. There's no reason to jump straight to induction without even knowing what the situation with a particular patient is just because in rare circumstances things get unsafe for some people.

I think there used to be a "42+ week support group" type thread on Birth & Beyond. If you search for that, that might be inspirational to read.
post #15 of 26
Quote:
Originally Posted by paquerette View Post
Be especially careful with this that it is NOT cytotec they are using!



This can lead to a badly positioned baby and a long painful non-progressing labor which ends in a c-section, or even more dangerous a cord prolapse. I would NOT consent to any such thing.
I had both done with my daughter with no problems. They didn't break my water until I was pretty far along and it went quickly after that. At that point for me it was that or pitocin and I wanted to avoid pitocin at all costs.
post #16 of 26
I had cervidil to ripen my cervix as part of my induction with DS. I agree to avoid cytotec. It can be fine for many women but the risks aren't worth it. The cervidil did actually nothing for me, though I was told it alone can put some women into labor. However, the evil pitocin didn't make me dilate very much either. (At least cervidil was completely pain-free!) I'd do pitocin over cytotec any day. At least they can turn down pitocin. It's hard to reverse the effects of cytotec if you have a reaction.
post #17 of 26
Quote:
Originally Posted by kohlby View Post
I had cervidil to ripen my cervix as part of my induction with DS. I agree to avoid cytotec. It can be fine for many women but the risks aren't worth it. The cervidil did actually nothing for me, though I was told it alone can put some women into labor. However, the evil pitocin didn't make me dilate very much either. (At least cervidil was completely pain-free!) I'd do pitocin over cytotec any day. At least they can turn down pitocin. It's hard to reverse the effects of cytotec if you have a reaction.
tell me about cytotec. What is the problem with it?
post #18 of 26
Part of the problem is that it's a tablet and cannot be stopped once it's administered.

There's a high rupture rate with it. Moreso with VBACs, but even unscarred uteruses have been ruptured with it. There's a reason the FDA has not approved it's use as a labor inducing drug, or even in pregnant women at all.

http://www.midwiferytoday.com/articles/misoprostol.asp
http://www.mothering.com/articles/pr.../cytotech.html
http://www.drugdanger.com/Cytotec.htm
post #19 of 26
Quote:
Originally Posted by paquerette View Post
It can; things can get unsafe any time. It's not really any more likely to happen at 41 w than at 39. Evidence-based recommendation would be to start doing non-stress tests after 42 w. to ensure that things aren't getting unsafe. There's no reason to jump straight to induction without even knowing what the situation with a particular patient is just because in rare circumstances things get unsafe for some people.

I think there used to be a "42+ week support group" type thread on Birth & Beyond. If you search for that, that might be inspirational to read.
i am confused as to how "overdue" you are OP. are you 11 days past 40 weeks....so 41 weeks 4 days? or are you 11 days past 42 weeks?

as far as what MW's do, it completely depends on the MW. My MW understands that I do not believe interventions are necessary absent a compelling medical reason and I'm pretty certain she feels the same (don't want to talk for her though). I would NOT consent to an induction at less than 43 weeks..and even then, I'm not sure..would depend on teh circ's.

Quote:
Originally Posted by LegalScrapper View Post
I had both done with my daughter with no problems. They didn't break my water until I was pretty far along and it went quickly after that. At that point for me it was that or pitocin and I wanted to avoid pitocin at all costs.
im glad you didnt have issues but many many many women have and cord prolapse is a huge risk w/ breaking a woman's water. As for cytotec, i have heard a lot of horror stories with it. Nasty ruptures, etc. etc.
post #20 of 26
Why rush? Your body and baby know what they're doing. Babies come when they're ready to be born. 11 days post date isn't a huge deal.

I was 15 days "post date" with my first and that was normal. I was about a week "early" with my second and that was normal too

If you're worried about it, have your midwife listen in on baby with a fetoscope to check heart rate and movement just to ease any worries
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