strip membranes at 38 weeks? - Mothering Forums

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Old 09-21-2008, 01:23 AM - Thread Starter
 
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I've been lurking alot in this forum. I'm trying for VBA2C. 1st was due to a cascade of interventions at 40 weeks. 2nd was to be an attempted VBAC but I gave up & scheduled the section at almost 42 weeks because I was in great physical pain due to a hip issue. I didn't experience any natural labor with either one. Now I have an OB who is generally supportive of my VBAC, but not in love with it. I have my 38 wk appt on Tues & she said if cervix is open enough, she wants to strip my membranes. Despite all the reading I've done, I haven't seen anything that I recall on this procedure and I'm not sure if I should let her or not. Frankly I doubt I'll be dilated at all, but I want to get opinions just in case.

I think mostly she feels the dreaded, awful, run-for-the-hills, speak in hushed tones, large baby. While I feel AMAZING this pregnancy & there's no indication this one will be even as big as #2 (9lb 13oz) let alone bigger, she seems to be fixated on how much more difficult it WILL (her emphasis) be for me if the baby is "big". I'd rather take my chances with a marginally larger baby at a later date than try to rush my body before it's ready. Anyway, I welcome your feedback. (And thank you for the tons of inspiration I've gotten here!)
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Old 09-21-2008, 02:03 AM
 
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While I feel AMAZING this pregnancy & there's no indication this one will be even as big as #2 (9lb 13oz) let alone bigger, she seems to be fixated on how much more difficult it WILL (her emphasis) be for me if the baby is "big". I'd rather take my chances with a marginally larger baby at a later date than try to rush my body before it's ready. Anyway, I welcome your feedback. (And thank you for the tons of inspiration I've gotten here!)
I was induced and it ultimately led to my c/s- I think that's the common theme around this forum. Sounds like you need to voice your opinion to the OB. If you're feeling good and not ready, why don't you wait another week or two- or even go up to 42 weeks?

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Old 09-21-2008, 02:26 AM
 
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My story is very similar to yours. I was induced w/ my 1st that ended in c/s on my due date because of pre-eclampsia. With my 2nd c/s, he was born 16 days past his EDD but he was also induced due to a poor score on his biophysical profile. Neither of my boys descended into my pelvis and I stayed at 7cm for about 12 hours with both of them.

I don't really subscribe to the "my pelvis was too small" theory but I have wondered if maybe mine were smaller (almost 9lbs and almost 10lbs) they would have had more room to manuever and would have been born vaginally. When I try for my VBA2C (long way off) I have wondered if I will try and get things started earlier. Ultimately I have decided that allowing things to take their natural course is the route that I feel I would have least guilt about (if it ended in c/s). Around 40 weeks I might try natural methods of inductions just because I hate the "clock" I feel like I'm put on and even a day or two would help.

I know a small woman who birthed an 11lb baby vaginally so I think when I have my VBA2C I will focus more on position of baby then his size. DS#2 was posterior and I have a feeling that is one of the reasons I carried him for so long. Position makes all the difference, in my mind, and it is something OBs don't really focus on much.
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Old 09-21-2008, 04:43 AM
 
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i have not met an OB yet that thinks big babies are a good thing where as my midwives love to see them chunky! LOL

If you are comfortable with waiting, then I would wait.

Good Luck!
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Old 09-21-2008, 04:48 AM
 
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my c/s baby was due to a cascade of interventions after a MW stripped my membranes WITHOUT my consent. DON'T DO IT!!! and at 38weeks? hell NO! Tell your OB you are confident your body won't grow a baby too "big" for you to birth.

I would also take it a step further and tell her you aren't feeling up for being "checked". just in case.


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Old 09-21-2008, 03:54 PM
 
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38 weeks seems too early for me as well, though I gotta say when I was in labor with my last, I was having contractions about 5-6 minutes apart all night and they were not getting any stronger or closer together and I was really getting antsy (and probably so was everyone else but they didn't let on) but anyhow, my midwife stripped my membranes and stretched my cervix and it certainly did get things moving and baby was born a couple hours later. Maybe if you start having contractions closer to 40 weeks they can do it. Good luck!
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Old 09-21-2008, 11:38 PM
 
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Ok I'll be the odd one out here... I'd probably go ahead and strip membranes. Maybe at 39 weeks instead of 38, but especially if you know your babies like to hang around for a while, this is a good way to give them a little nudge in the right direction IMHO. I *tried* to get my doc to strip mine at 39 and again at 40 but both times I was high and closed and she couldn't. (I said no at 38 weeks because I still had a lot of work to finish up and I wasn't ready to think about having a baby yet )

Soooo... maybe put it off a week? But then I'd say go for it.

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Old 09-22-2008, 12:18 AM
 
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Have you done any reading about the possible side effects (besides, of course, a baby who wasn't ready to be born yet...) of having your membranes stripped?

They can include accidentally ruptured membranes, and introduction of infection into your uterus.

Of course, women who have their membranes stripped DO tend to have babies who are, on average, born earlier...

But is that worth the possibility of breathing issues, ruptured membranes (and so a possible cesarean because you don't go into labor after 12-24 hours), and/or infections?

Only you can decide that, but before you do go and consent to a vaginal exam (and subsequent stripping of membranes), I would read up, and make sure that you are very sure that it is a choice you want to make.

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Old 09-22-2008, 12:23 AM
 
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i just had my vbac and faced a similar situation. i was induced at 41w1d with dd1 and my cervix was totally closed and high. this time i went into labor naturally at 40w5d but had debated over whether to have the membrane sweep from 38 weeks when my midwife offered it (though she never pressured my at all to have it).

I decided not to do it or an internal exam until 40 weeks (partly because i was not mentally "ready", partly because i didn't want an early labor), at which point i was surprised to find out i was 3cm dilated! so i declined the sweep again. my main reason to decline it was that i was nervous my water would be unintentionally broken (which can happen), and then maybe labor would not start properly or baby would then be "stuck" in posterior position (which happened with my first baby when they broke my water).

i would suggest waiting til 40 weeks (or at least 39+ weeks) when it's more likely to work as your body may be more ready. Maybe consider an internal exam to see if you are dilating at all (but remember that OB may "accidentally" sweep you if you do this!).

Are you taking evening primrose oil at all? I took this from 38 weeks, 2000mg a day orally and i'm convinced it helped me dilate.

By the way, my first baby was 9lb4oz and I had failure to progress with posterior deflexed baby (whole intervention cascade with OB). My VBAC baby was 9lb6oz and she literally flew out of me in 1 push (and I'm sure she was posterior too based on how she "landed" on the floor, although no one actually saw her come out as they thought the pushing phase would take much longer, so baby caught them by surprise and literally fell out of me , so I'll never really know! But my midwife was never concerned about "big baby" or the posterior position (even though I was), always reassuring me that all births are different and that the second time around can be so much easier even if baby bigger. My family were concerned about the big baby thing though, so i tried to avoid those comments, as they did make me nervous as I went over my due date. I just reminded myself that I would rather aim for VBAC with a big baby and see how it went then to schedule the C section and never know. and it all worked out well in the end)

good luck in your decision.
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Old 09-22-2008, 12:45 AM
 
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Listen, all I can do is speak from my experience. I don't want to give you advice, but I'd tell you what I wish I would have done. My VBAC went almost to 42 weeks. I became extremely stressed that I would be pressured into induction or c-section. I remember hitting 41 weeks wishing my doctor had begun stripping my membranes each week starting at 38 weeks. I just kept thinking that might have helped. Who knows if it would have.
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Old 09-22-2008, 02:15 PM
 
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With my VBAC I had my membranes stripped at 39wks (fingertip dialated, completely effaced) and nothing happened. I had them stripped again at 40wks in early labor (2cm dialated) and went right into active labor within a few hours. My water didn't break until I was fully dialated. So I'm personally in favor of it, especially if the conditions are favorable. Two things that helped me efface were EPO and of course the baby was head down frome 22wks on
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Old 09-22-2008, 02:28 PM
 
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I'd rather take my chances with a marginally larger baby at a later date than try to rush my body before it's ready. Anyway, I welcome your feedback. (And thank you for the tons of inspiration I've gotten here!)
You are correct, I think. She is more at risk of having her license pulled for letting you go "too far"....Your absolute best bet of having a natural normal birth, is to birth at home. No one watching over your shoulder, and a watch, there. I have helped at births where the baby was over 12 lbs...born vaginally at home...so being too big isn't that much an issue, and stripping your membranes when your body isn't ready, can lead to a looooong semiproductive labor, and exhaustion for you...I wouldn't do it...even if you go over 42 weeks, if you keep an eye on your fluid levels, you should be able to go into natural labor on your own, and probably have a fairly short one, when your body is ready....makes a huge difference.
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Old 09-22-2008, 02:45 PM - Thread Starter
 
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Thanks so much for your honest opinions. I'll read them through again & talk to DH before going in tomorrow. I'm actually headed to the store now to buy EPO. Yesterday I started having lots of Braxton Hicks, which I know doesn't "mean" anything, but I really didn't have them with the 1st two & if nothing else, it just reassures me that my body is not broken.
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Old 09-22-2008, 07:54 PM
 
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I am in the same boat.
I am 39 weeks and my midwife wants to "stimilate" on Wed. As this is a VBAC I am so nervous about any kind of intervention but at the same time I am more afraid of going over and having to be induced.
I am 1-2cm and 60% so I am thinking I am going to go ahead with it. Or maybe I will just go into labour tomorrow and I wont have to think about it anymore.
Well I hope everything works out for you, I am curious to hear how it goes. Our due dates must be very close.
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Old 09-23-2008, 03:17 PM
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When I was trying for my vbac, I had such negative vibes about stripping membranes or any interventions, but ended up doing a whole bunch of sweeps by 39+w because I was petrified of going so late... I don't think they really helped, as the only thing that got me into labor was castor oil, and DS wasn't in position anyways (little did I know) - so after a long intense labor, I ended with a c at 42w.

With my vba2c, I was petrified of growing another enormous baby again and going late and ending with another c or an induction, so at my 38w appt, I asked to check my cervix since I was having more intense contrax - different from the regular bh contrax I had been feeling... little did I know, my cervix was soft and favorable, and 3cm dilated, so I had her do a sweep. In fact, I wasn't even planning on any cervix checks, but I knew something different was going on and I though it could be the real thing, which it was! If things were not favorable, I would have opted to do nothing or it could create more consequences (or interventions...) I delivered my vba2c that night!

I think it all depends on literally everything - so much has to be in line that if we try to force it when it's not ready, it may not work as well... at the very least, make sure your babe is not posterior before attempting to get things started or it could present a bunch of other issues, as was my first vbac experience...

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Old 09-24-2008, 07:51 PM - Thread Starter
 
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OB ended up being fine with no sweeping at appt yesterday. She said she "strongly recommends" it next week. We'll see. I may not be dilated anyway. I wouldn't let her check yesterday; why bother? I have to admit part of me thinks that if there's a chance the sweeping would work, I'd like to try to go early because my brother is getting married 4 days after my due date (out of town). I could just see THIS birth being the one that starts naturally - oh, about 3 days after my due date. That goes against my whole "let me body do it's thing" stance, but I've got that on my mind, too. One day at a time I guess.

Best of luck to you, mamawithstars.
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Old 09-26-2008, 01:29 PM
 
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Thanks for posting this!

I'm in a similar situation, I'm only 36 weeks, however my doctor has suggested stripping starting at 37 weeks, mostly because she is leaving 6 days after my EDD, and the other doctors in the area are not a pro-VBAC bunch ( one has a 40% c-section rate!), and I've expressed how terrified I am of delivering with one of these doctors.

I'm currently 3cm dilated, and my cervix is 'nice and squishy', so I think I'm going to hold off until at least 39 weeks. At that point I'm going to weigh the risks of S&S against delivering with a intervention happy doctor.

I hope it all turns out well for you!
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Old 09-27-2008, 01:25 AM - Thread Starter
 
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Thanks for posting this!

the other doctors in the area are not a pro-VBAC bunch ( one has a 40% c-section rate!), and I've expressed how terrified I am of delivering with one of these doctors.


I hope it all turns out well for you!
Good grief! Who could blame you for wanting to avoid those doctors! I hope it all works out well for you also.
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Old 10-12-2008, 04:20 PM
 
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It sounds like you have already figured out from what this OB says, that this OB is unlikely to support you in a VBAC and is looking for reasons to start in with the whole cascade of interventions. Stripping of membranes is just another harmful intervention. You have seen the "big baby card" flashed before your eyes already, so you pretty much know what to expect with this OB. I personally would run screaming into the arms of an experienced homebirth midwife, and that's what I did, in fact, and my baby was born without incident weighing a whopping 10 lbs 2 oz, at home, in a home VBAC. The labor pool was a wonderful, wonderful thing to have, as was the experienced and respectful midwife. I am 35, and had other "risk factors" that were not a problem in my midwife's eyes, and my natural labor started at 40 weeks, 2 days, but I was prepared to go to the full 42 weeks that is the actual range for still normal gestation... so don't let anyone kid you that 40 weeks is some sort of deadline. A relative had 3 homebirths and gestated over 42 weeks with each.

Best wishes for your upcoming birth, but imho your OB couldn't have said "I have no intention of assisting a VBAC" any louder if she'd painted it on her forehead. Big baby card, late gestation card, stripping membranes, you name it, any excuse will do, know what I mean?

If you haven't already, www.ican-online.com is a good resource for VBAC support.

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Old 10-12-2008, 04:41 PM
 
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Any news on Livi's Mama? Maybe she has a new LO at this point!

Happy wife and also mommy to my two boys, 12-12-07 (c-sec) and 04-05-09 (vbac!) and another due in December.
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Old 10-12-2008, 08:41 PM - Thread Starter
 
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I'm still here! Thanks for asking. Freshly back from my brother's wedding out of town. *So glad* I didn't have the baby yet. Hard enough doing a busy wedding weekend out of town with the kids we have, let alone a brand new baby!

At 39 weeks, I gave OB some pushback on the stripping & she was completely on board. At 40 weeks (10/7) she was all set to do it & that's when I said I planned on going out of town for the weekend, so, sorry, no thanks. She did do an exam & said that while things are heading in the right direction (cervix softening etc), she expected me to make it through the weekend. (Which was interesting to hear, but whatever.)

what was interesting was that when I first questioned why she wanted to strip, she actually backed down pretty quickly and said that as long as baby & I are healthy, there's no reason I can't go to 41 weeks, 42 weeks, or even past 42 weeks (with lots of monitoring). I about fell off my chair to hear an OB say that, especially with VBAC.

I must say that I'm considering the stripping tomorrow. The baby has seriously dropped. I trust my body to do its thing, but I also am not convinced that stripping at this point would be the worst thing to do. If I don't try it & I run into issues going past 42 weeks, I might always think, "What if?" We'll see how I feel tomorrow, but that's where I stand right now.

Can't thank all of you enough for your words of wisdom.
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Old 10-12-2008, 09:58 PM
 
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I'm still here! Thanks for asking. Freshly back from my brother's wedding out of town. *So glad* I didn't have the baby yet. Hard enough doing a busy wedding weekend out of town with the kids we have, let alone a brand new baby!

At 39 weeks, I gave OB some pushback on the stripping & she was completely on board. At 40 weeks (10/7) she was all set to do it & that's when I said I planned on going out of town for the weekend, so, sorry, no thanks. She did do an exam & said that while things are heading in the right direction (cervix softening etc), she expected me to make it through the weekend. (Which was interesting to hear, but whatever.)

what was interesting was that when I first questioned why she wanted to strip, she actually backed down pretty quickly and said that as long as baby & I are healthy, there's no reason I can't go to 41 weeks, 42 weeks, or even past 42 weeks (with lots of monitoring). I about fell off my chair to hear an OB say that, especially with VBAC.

I must say that I'm considering the stripping tomorrow. The baby has seriously dropped. I trust my body to do its thing, but I also am not convinced that stripping at this point would be the worst thing to do. If I don't try it & I run into issues going past 42 weeks, I might always think, "What if?" We'll see how I feel tomorrow, but that's where I stand right now.

Can't thank all of you enough for your words of wisdom.
Good to hear! Waiting for more updates...

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Old 10-12-2008, 10:33 PM
 
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good luck being patient. i do think its worth it, due to some of the links posted below. im 42 weeks tomorrow and a hba2cs also. its soo hard to get the fear out of our heads.
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Old 10-17-2008, 04:24 PM
 
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I want to add that the normal range for gestation is 38-42 weeks for healthy women. So you really aren't overdue until 42 weeks. It may be your natural history to go to 42 weeks. They just use 40 weeks as a middle number for estimates!

Also, your rupture/complication risks do not go up if you go to 42 weeks. ACOG admits to this in their VBAC Statement. They do go up with medical inductions. So if you are comfortable with it, it is nearly always better to give your body time to prepare for labor, instead of rushing it.

At the very least, make sure you know the risks of a membrane sweep, because there are real risks involving infection and rupturing your water. Then go with your gut!
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Old 10-20-2008, 12:30 AM - Thread Starter
 
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Long saga. Two full days of labor, 3 trips to the hospital. Not really the labor I'd hoped for. More intervention than I'd hoped for. (although no sweep; labor started all on its own). At 10 cm & after a few pushes, baby's heart rate plummeted & OB put c/s team on standby. The thought that I'd end up with c/s after all I'd been through - scary! Thankfully baby recovered. My OB really stepped up to the plate in the end & was a positive influence as I pushed DS into the world. I had a big tear & I'm having some after-effects of epidural, but still so much better than c/s.

In the end I know I did the best I could with the situations presented to me. I had a fantastic doula & wonderful nurses. I must say I'm pleasantly surprised by how excited my co-workers and various acquaintances are that I succeeded at my VBAC. I think I raised alot of people's awareness about VBAC. And of course, most importantly, we have a healthy new baby! :

Thanks again to the moms here & best of luck to expectant mamas! Guess I need to update my sig!
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Old 10-20-2008, 01:53 AM
 
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Thanks again to the moms here & best of luck to expectant mamas! Guess I need to update my sig!
For sure! Fantastic job and thanks for the update!!

Enjoy your sweet baby! :::

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Old 10-20-2008, 09:09 AM
 
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:Congratulations!!

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Old 10-20-2008, 09:20 AM
 
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HURRAY!!!!! Congratulations!!!! : : :
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Old 10-20-2008, 04:34 PM
 
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::

Well done! Enjoy your babymoon!

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