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#1 of 16 Old 07-09-2008, 09:13 PM - Thread Starter
 
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My very low intervention midwives suggested that I make an appt. for a biophysical profile for next tuesday (that would put me at 41+4, if i'm still pregnant by then).

These are the same midwives that are very laid back about me opting out of all other testing, don't use dopplers, etc. So I'm thinking if they want me to go, it's for a good reason-they are certainly not test happy. They said they recommend it for all clients who go past 41 weeks.

Thoughts? anyone had one done? do homebirth midwives recommend them often?

I'm getting nervous because the midwives can't deliver my baby at home past 42 weeks, and I have no real signs of labor yet. I guess my chances of going into labor before then are good but ugh! I wish it would just happen already so I could quit worrying and snuggle a baby

x-posted in july ddc
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#2 of 16 Old 07-09-2008, 10:06 PM
 
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I'm sorry to hear that they won't consider a *home* birth after 42 weeks. My mw got a lot of crap from her colleagues when I went 42w5d, but she never once expressed concern. At 42w3d, I freaked out - I had a dream, spurred on I'm sure by all the "concerned" people around me. I was in tears, on the phone, and she recommended that I go for an u/s to ease my mind. I have to assume that that it was a "biophysical profile" - the point of it was to assess baby, placenta & fluid condition.

I know lots of folks are anti-intervention, but are you considering home remedies at this point? (parsley tea, cohosh, castor oil, primrose, sex, walking, etc?)

I guess I'd be anxious, too, if I was told that after some arbitrary day, they wouldn't let me have the birth I'd been planning! Is there any way to re-check your dates to change the "edd" ?

good luck
--janis

Mama to 3 girls 12,8,3
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#3 of 16 Old 07-09-2008, 11:11 PM
 
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I also recommend a BPP at 41 weeks and I'm not test-happy either. That's the standard for home birth midwives here. Despite the hype there are real, known risks in a postdates pregnancy but the important thing is not what the calendar says, but whether or not the baby is doing well. A BPP gives you reassurance, and because it measures 4 different aspects of wellbeing (heart rate, movement, breathing movement, amniotic fluid) is not likely to give a false cause for alarm.
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#4 of 16 Old 07-10-2008, 07:10 AM - Thread Starter
 
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Thanks everyone

Jrabbit- I have done the more gentle "home remedies"- sex, spicy food, I walk 3 miles a day but I think my body is so used to that already! Maybe I need some hills! Also have been doing EPO (orally and internally since week 36) and RRL (since I found out I was pg). I can't really change my edd because it was determined by early u/s.

Next week I might do castor oil under my MW supervision if nothing is happening still. They can't take me due to state regulations after 42 weeks.

Nashvillemidwife- Thanks

What is up with parsley tea? I think I read around here it can hurt milk supply... anyone know anything about that?
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#5 of 16 Old 07-10-2008, 07:17 AM
 
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My MW starts with bi-weekly NSTs between 41.5 and 42 weeks and only recommends a BPP if needed. However, she doesn't transfer after 42 weeks, so that might be the reason she is not in a hurry?

GL I hope you go into labor soon!!

April, wife to Scott, mother to Lily (07/23/08) and furbaby Bella (6/21/04), and expecting baby #2 in February 2012. 

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#6 of 16 Old 07-10-2008, 09:03 AM
 
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I would only suggest a BPP at any point IF I was seeing signs that troubled me. If baby is still active, mom is doing well, and there is enough amniotic fluid on palpation, then I don't worry. Now if a client *wanted* a BPP, that would be fine by me. But 'cooking times may vary', for one thing--and if family history is of long but healthy pregnancies on EITHER/both mom's or dad's side of family, I just don't worry.

I suppose it may vary by region, nashville--but as far as 'standard of homebirth care' I don't know any mws around here that expect a BPP at 41wks.
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#7 of 16 Old 07-10-2008, 09:05 AM
 
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What I know about parsley is that it is a mild diuretic--maybe that is how it effects milk supply. And not that I know everything, but I never heard of it as a 'gentle labor initiator'.
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#8 of 16 Old 07-10-2008, 10:49 AM
 
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i think it really varies by area. here, i can only go to 42 weeks as well. my mw would have had me do a biophysical at 41 1/2 weeks, and i would have, but i'm not very anti-intervention like that.
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#9 of 16 Old 07-10-2008, 10:52 AM
 
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Quote:
Originally Posted by MsBlack View Post
I suppose it may vary by region, nashville--but as far as 'standard of homebirth care' I don't know any mws around here that expect a BPP at 41wks.
That's why I said it was standard for home birth midwives here.
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#10 of 16 Old 07-10-2008, 02:02 PM
 
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oh! Right, you did say 'here' --oops, missed that
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#11 of 16 Old 07-10-2008, 02:09 PM - Thread Starter
 
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Thanks, all.

So, I gather that the BPP is usually a pretty reliable test, and not something OBs would use to scare you into an unnecessary induction?
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#12 of 16 Old 07-10-2008, 03:11 PM
 
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No, I think it's more often used to prove that the baby is healthy and not in need of induction.
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#13 of 16 Old 07-10-2008, 05:51 PM - Thread Starter
 
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Thank all. I scheduled it for next wednesday. here's hoping i'm not still pregnant by then though! :
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#14 of 16 Old 07-11-2008, 08:24 AM
 
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My midwife had me go fr a BPP @ 34 weeks since I was very concerned that I couldn't feel baby move and we were worried that my blood pressure was to high. It was very reassuring. Baby is great! It was the first time I she suggested any tests.

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#15 of 16 Old 07-11-2008, 01:17 PM
 
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Quote:
Originally Posted by njbeachgirl View Post
My very low intervention midwives suggested that I make an appt. for a biophysical profile for next tuesday (that would put me at 41+4, if i'm still pregnant by then).

...

I'm getting nervous because the midwives can't deliver my baby at home past 42 weeks, and I have no real signs of labor yet. I guess my chances of going into labor before then are good but ugh! I wish it would just happen already so I could quit worrying and snuggle a baby

x-posted in july ddc
Well goodness...you were just 40 weeks 5 days when you posted. The average first pregnancy for a caucasian is 41 weeks 1 day, and after that it is 40 weeks 3 days...so depending on which pregnancy this is for you, you might not even be late yet! I'd encourage you to try to relax about the "no signs of labor" thing. Most women don't have any "signs of labor" until the first contraction.

There are emotional stage in labor--excitement in early first stage, getting serious and more quiet in later first stage, miserable in transition.... I find as a childbirth educator and doula that many of my clients seem to go through a "transition" stage in pregnancy. That is, a period of a few days where they are just miserable with how big they are, they think they "can't do it" anymore, they can't get comfortable...and then they go into labor. This could be where you are. (They do the "excitement" of early pregnancy" and "getting more serious and down to business of being pregnant" in the second trimester too!)

I personally would be willing to do a non-stress test (monitoring baby's movements and heartbeat for a period of time). One of my arguments against using the whole 42 week cut off thing is that it is based on data from the 1950's and 1960's when we *didn't* have monitoring to separate out the "high risk" from the "lower risk" cases. I believe that if we use monitoring appropriately, it can allow you to decide when intervention is worth while, and when you can wait on labor to start on it's own. A non-stress test is less invasive than a biophysical profile...but has a higher "false positive" rate--that is, it says a problem might exist with the baby, but really the baby is fine--if it says that the baby is doing good, it is usually right. So if the non-stress test came back concerning, THEN I would move to a biophysical profile, which tends to be more accurate.

Here is a blog post I wrote about natural induction that you might find interesting: http://knittedinthewomb.blogspot.com...inner-and.html

Good luck!

Jenn
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#16 of 16 Old 07-11-2008, 01:25 PM
 
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Originally Posted by njbeachgirl View Post
Thanks, all.

So, I gather that the BPP is usually a pretty reliable test, and not something OBs would use to scare you into an unnecessary induction?
Well...ahem...one of the more common reasons for induction in my area lately seems to be "low amniotic fluid"--which can be anything below 10 cm, seems to depend on the OB and the mood of the OB. Holiday coming up? "Low fluid" is anything below 10. OB wants a break from being in the hospital? Well 7 is okay then... Fluid level is something that can be measured during any ultrasound, and is specifically measured as part of a BPP.

But research from Johns Hopkins several years ago established that in the absense of other concering factors, low fluid alone (which they defined as less than 5 cm!) was not justification for induction of labor. The pregnancy could be safely managed "expectantly."
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