39 weeks and midwife "not confident": ( - Mothering Forums
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VBAC > 39 weeks and midwife "not confident": (
Rands's Avatar Rands 05:58 PM 06-09-2009
I had my 39 week appointment today. The midwife checked me and said the baby was still high, not engaged, and my cervix had done nothing. She sadly announced that she was "not confident" that I'd get my VBAC. She thinks it's got to do with the size of the babies I grow (DS was 9'14). She says there is still hope that the baby will go down and engage but that at this point she would hope to see a lot more going on.

Does anyone have a similar story or encouraging words? I'm so depressed. I came to this forum recently and have been reading successful vbac stories as inspiration every night. I was so confident this would happen for me since the entrie pregnancy has been so much easier and the baby has seemingly been in a better position...

*UPDATE* Had an appointment with my other midwife yesterday...3 days shy of my "due date". From the outside she said his head felt low but she did an internal and said it's still quite high and she can move it, I'm only a fingertip and still thick. So not much change. She'll let me go to 42 weeks and is setting up an OB consult for foley induction if I haven't gone into labour by then....

Has anyone had a similar situation and ended up with a successful VBAC?

ShwarmaQueen's Avatar ShwarmaQueen 06:09 PM 06-09-2009
I think it's premature to make that assumption (that you won't get your VBAC). Eat healthy and stay active, make some love. : Labor will come!
saimeiyu's Avatar saimeiyu 06:10 PM 06-09-2009
Lots of babies don't engage before labor. Not having any cervix changes mean exactly diddly squat. I'm not impressed with your midwife. You have to remember that the process of going into labor is very complicated. And you know that whole first stage of labor? Yeah. That's all about the contractions and how they make the changes in your cervix. It's all about the cervix dilating, effacing, etc.

39 weeks means diddly squat. You should be expecting to go into labor like a first-time mom. That means that there's a pretty good chance you won't go into labor until 41 weeks. If your midwife has a "40-weeks-and-time's-up" rule she sucks and I'm sorry.

Don't worry about it. Unless, of course, you can manage to find a different, more supportive care provider, in which case, I would jump ship with that midwife and go with someone who actually does things based on evidence. Checking your cervix prior to labor is NOT an evidence-based practice, unless they're checking to see if your cervix is favorable for an induction. Which, generally, is not a good idea in a VBAC.

ETA: If I remember correctly, a lot of times larger babies just don't engage before labor starts. I think it's because they're bigger so they want more room until they want out.
liberal_chick's Avatar liberal_chick 06:12 PM 06-09-2009
I really don't see what would make her "not confident" about your situation. Most 2nd (or higher) babies don't engage before labor and there are many, many women who are closed up tight and go into labor that way.

The way I see it is that you've still got 3 weeks before you are overdue. That's a lot of time.
kitkat5505's Avatar kitkat5505 06:16 PM 06-09-2009
None of my babies engaged prior to labor, and I've heard that for 2nd+ time moms that it is common not to engage until labor. I also don't think a cervix check means anything. My MW for my last birth didn't do any cervix checks until I was almost 40wks and asked her to strip my membranes, and then not again until I was pushing during labor. I've had friends be 5+cm for days or weeks before going into labor and others who've been 1cm or less and gone into labor in a day. All cervix checks do is cause stress and worry.
fruitfulmomma's Avatar fruitfulmomma 06:18 PM 06-09-2009
I've never had a c-section but my last baby (#5) did not engage until we were well into labor. And my body wasn't doing much until just a few days before she was born.
Therese's Mommy's Avatar Therese's Mommy 06:21 PM 06-09-2009
Quote:
Originally Posted by saimeiyu View Post
ETA: If I remember correctly, a lot of times larger babies just don't engage before labor starts. I think it's because they're bigger so they want more room until they want out.
I don't mean to hijack, but I found this interesting. I have a friend who had a prolapsed cord with a 10lb baby. He was head down and the cord didn't come out with the first gush of water but a few minutes later. One would think with that much baby there there would be no room for the cord to slip by, but if he wasn't engaged then that is possible.

To the OP, like the PPs said what your cervix is doing now tells you nothing about when you will go into labor and how you will labor. I hope that your mw will support you in your quest for a VBAC. Your body was made to do this
weliveintheforest's Avatar weliveintheforest 06:30 PM 06-09-2009
Quote:
Originally Posted by liberal_chick View Post
I really don't see what would make her "not confident" about your situation. Most 2nd (or higher) babies don't engage before labor and there are many, many women who are closed up tight and go into labor that way.
I agree. I wish your midwife didn't say all that to you.
Rands's Avatar Rands 07:43 PM 06-09-2009
Yeah I don't know what to make of any of it. She's totally supportive of the vbac and was so sad to tell me that news...

I laboured for 38 hours with my DS and got to almost complete with lots of interventions instead of my planned home birth. His head never got into good position and he never came down...so I'm sure that's why she's feeling like this one is on the same track.
mamatolevi's Avatar mamatolevi 09:48 PM 06-09-2009
spinningbabies.com
chiropractic
acupuncture

the usual litany.

39w means NOTHING in the sheme of things. Your baby could drop and engage in a matter of hours, so checking now is useless. I would refuse all other VEs till your labor starts.

so what if your son was big? It doesn't mean this one is and any guesses as to weight are about as meaningless as what your cervix is doing now.

Go get a massage - you deserve it after that appt. - and talk to your doula. If you don't have one, get one. It's not too late.

You CAN do this!!!
Pau's Avatar Pau 09:54 PM 06-09-2009
If she is totally supportive of VBAC she should not have said what she said.
I second the 40-weeks-and-time's-up" makes her a danger assistant for a VBAC.
Avoid ALL types of interventions. As long as everything is ok, there is nothing to worry about.
jess152's Avatar jess152 10:00 PM 06-09-2009
Awww, don't be discouraged! It's hard not to be, but you could still be 3 weeks away from your labour, so it could be no wonder nothing's started happening down there!

Give it another week or two and then see what kind of progress your cervix has made! Jeez, it's too bad the m/w has put that kind of pressure on you at 39 weeks.
MamaMem's Avatar MamaMem 10:06 PM 06-09-2009
Yesterday my baby was "pretty high". Enough so that my midwife was concerned. This morning? It is well engaged.

Hang in there.
kltroy's Avatar kltroy 11:29 PM 06-09-2009
Aww cheer up... so nothing's happening a week ahead of average? So what? When I was 39 weeks w/ my VBAC my doc tried to do a membrane sweep (at my request) but she couldn't even get a fingertip into my cervix to make it happen. It was the same story at 40 weeks. At 40+2 my baby engaged with a "thunk". Seriously, she thunked. It was the weirdest thing. But still, no baby... At my 41 week appointment I was getting discouraged since there was still no sign that I was any closer to meeting my baby (though of course I had to be). Then the next morning I woke up with contractions, and I had my baby the following day (41+2) completely naturally. My birth story is in my sig if you want some inspiration.

Anyway, remember there is no reason your baby needs to be considering "moving out" at this point. Remember that 40 weeks is average. For every baby born at 38 there is another born at 42. You'll do great! Just hang in there and think peaceful thoughts. Your baby will be here before you know it.
Mamatoabunch's Avatar Mamatoabunch 12:12 AM 06-10-2009
Gosh this sure does irritate me. First subsequent baby's often never engage and nothing going on w/ cervix means nothing. You will birth the baby of your own power in just the right time. My last 7 were VBACs and none egaged prior to labor.
Rands's Avatar Rands 11:09 PM 06-10-2009
Thanks for all the input. Hopefully I go into labour on my own sooner than later and that he moves into position nicely and my cervix becomes more favourable. I'm really nervous about my appointment on Monday which will be approaching my due date. I have an OB consult ready to go for 41 weeks.....ugh.
1littlebit's Avatar 1littlebit 11:22 PM 06-10-2009
tell her thanks for her opinion but you were hoping for a slightly more fact based one.

maybe you shouldn't say that unless you can get a new midwife just ignore her and relax, move around, etc. it will happen when it happens
hikingmommy's Avatar hikingmommy 12:10 AM 06-11-2009
I never had a cervical check before labor, but DS never got very low before labor. He took 42 hours of labor and well over 4 hours of pushing to get his 9lb, 10oz body out, but I had my HBAC at 41 weeks, 6 days!
vocalise's Avatar vocalise 12:37 AM 06-11-2009
My midwife did this to me, too. Argh! Don't listen!

I had my VBAC. Dd was 10 lbs, 3 oz. So there!

Do you have a chiropractor? I found a fabulous one who specializes in pregnancy, and she really helped to get dd positioned as well as possible (although she was still slightly posterior) before labour set in.
tuffykenwell's Avatar tuffykenwell 03:33 AM 06-11-2009
I don't think that is fair to make that assumption at this point in time. My first babe was a c due to failed induction and was 9 pounds 11 ounces. My first VBAC happened at 41 weeks exactly and wasn't engaged in the pelvis at late as 40 weeks and 3 days (my last mw appt before the birth). She was 8 pounds 3 ounces. My second vbac was born at 40 weeks +6 days and she wasn't engaged in the pelvis until I went into labour...and after only 5 hours of labour she was born at 7 pounds 14 ounces.


My point being that whether the baby is engaged or not isn't always an indicator of whether you will be successful with your vbac and 2---that if you have one big baby that doesn't necessarily mean that all of your babies will be equally big.


<<<<big hugs>>>> to you and your babe. Take heart and try to be positive!

Steph
MNHall's Avatar MNHall 05:01 PM 06-11-2009
My VBAC baby was not engaged on the Monday that I had my appointment. I had her on Saturday!!

I agree with the others that said it's too early to determine that things won't happen!
Rands's Avatar Rands 02:25 PM 06-16-2009
I updated the thread but I didn't know how to say that I updated in the title...the update is at the bottom of the original post.
ShwarmaQueen's Avatar ShwarmaQueen 02:32 PM 06-16-2009
So basically you have 2 more weeks till you're 42 wks? I think you still have plenty of time. You could looking into Evening Primrose Oil (orally and vaginally) but honestly you're still ok, as far as going into labor on your own. Hang in there!
mamatolevi's Avatar mamatolevi 03:41 PM 06-16-2009
i was induced with pit at 41w5d and had a 10#8oz baby vba2c. It was a fabulous birth. You CAN do this.

You don't have to be sectioned or induced just b/c of dates. Wait it out; you'll go into labor on your own.
Rands's Avatar Rands 03:47 PM 06-16-2009
At my hospital they will not induce with pit...there is a slight option for them to augment with it if you are further into labour though. I think my options for induction, if need be, are foley cathedar or ROM.
Serenyd's Avatar Serenyd 03:49 PM 06-16-2009
Quote:
Originally Posted by kitkat5505 View Post
None of my babies engaged prior to labor, and I've heard that for 2nd+ time moms that it is common not to engage until labor. I also don't think a cervix check means anything. My MW for my last birth didn't do any cervix checks until I was almost 40wks and asked her to strip my membranes, and then not again until I was pushing during labor. I've had friends be 5+cm for days or weeks before going into labor and others who've been 1cm or less and gone into labor in a day. All cervix checks do is cause stress and worry.
: nak
mamatolevi's Avatar mamatolevi 04:46 PM 06-16-2009
Quote:
Originally Posted by Rands View Post
At my hospital they will not induce with pit...there is a slight option for them to augment with it if you are further into labour though. I think my options for induction, if need be, are foley cathedar or ROM.
Personally, b/c of how differently pit is usedin vbacs v. unscarred mothers, I don't see the difference between pit induction v. pit augmentation at that point. The dose for my pit inductin was 2mu/min w/increases only if labor didn't start or progress. They never got over 6mu.

Even knowing the risks of pit induction for a VBAC, I would insist on pit before AROM. At least if it doesn't work, you can still go home and try again later. AROM puts you on the clock and once you're on that clock, they'll either use pit to get you going or send you to the OR.

Say they do a foley cath, you get to 3cm and it falls out. but ctx haven't started yet or aren't progressing how they want them to. they will either do AROM or augment with pit. If they do AROM, and nothing gets started, or starts too slowly for their comfort, (b/c you're on the artificial labor clock) they'll probably do pit anyway.

From what you've been posting here your best bet is to not let them do any more cervix checks till you're at least 41 and a half weeks. that way you can stop worrying about it and just gestate. If they're worried about the baby they can do NSTs and US.
Rands's Avatar Rands 05:13 PM 06-16-2009
How's this for bad...apparently I have an OB consult TOMORROW (my due date) with the doctor who did my first c-section. The midwife says it's just to discuss my options should I get to 42 weeks and not go into labour on my own....
kltroy's Avatar kltroy 05:31 PM 06-16-2009
Ugh. Just hang in there and stand your ground if this doctor is hostile to the idea of a VBAC. If you get to 42 weeks you do, legitimately, have to decide if you want to keep waiting or try to evict the baby. And honestly if a NST came back looking bad and there is a true concern about how the baby is doing for whatever reason you could be faced with a decision too induce too.

So I would try to make this as productive a visit as possible. Ask what your options would be in either situation, what the risks are associated with each option, what the benefits of each are, what alternative choices there are. Bring your husband if you can. Remember, you don't need to make a decision about what you will do during the visit - the best scenario would be that you have a discussion w/ the doctor and at the end leave with some numbers and references, telling the doctor that you will let your MW know once you have taken some time to think things over. Then do follow up w/ your MW so that she can document your plan, should it become necessary. Then hope and pray you don't need it!!
saimeiyu's Avatar saimeiyu 05:36 PM 06-16-2009
I'm just going to tell you. If I had your midwife, I would be *so* gone if at all possible.

I don't understand why you are still getting cervical checks if all it's going to do is stress you out. It doesn't mean anything at all. Nothing. It will not give you any clues. All it is is a risk. How much bacteria do you *really* want to shove up there before you go into labor? It doesn't particularly matter until your water breaks, but if they're this free with it before labor, when it can tell you *absolutely nothing* of value, I'd worry about whether or not they can keep their hands out of there in the event that your membranes rupture and you don't give birth two seconds later. No matter what they tell you, you *can* tell them "thanks but no thanks, no cervical check today." You might have to be quite firm.


I think your body isn't what will prevent you from having a VBAC when it comes down to it, though. I think your body works just fine and it's silly to worry about your dilation and effacement before your body even begins the work of it. (which is what the first stage of *labor* is all about.)

As for the OB consult... Well, take it or leave it. I wouldn't personally step anywhere near the OB that gave me my section, but if that's your backup OB, you might as well meet them. It's probably standard procedure for your midwife. I think a supportive midwife would *at least* wait until 41 and a half weeks before sending you over to him, though. I don't see a reason to burden you unnecessarily by telling you on your *due date* that you're broken. How many people go by their due date? Nuts! Then again, a supportive care provider wouldn't be checking your cervix at 39 weeks and telling you she's "not confident", and telling you that you're gonna get sectioned at 42 weeks. Baloney.
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