HELP...my OB just stripped my membranes without my consent - Mothering Forums

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#1 of 27 Old 01-23-2010, 01:22 AM - Thread Starter
 
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I'm in shock....I just had my 38 week appointment at Kaiser and had a discussion with my OB about how I don't want to schedule a C-section if I go "post dates" which to her is 40 weeks. I told her I want to wait until at least 42 weeks for my body to go into labor naturally and figure out where to go from there if it hasn't happened yet.

She knew I didn't want to have a vaginal exam this time around but convinced me that we could tell if I'm dialated at all and make sure the baby's head is still down so I reluctantly consented. After she was done with the exam she said..."well...we'll see if that does anything to get things moving."

I was like "wait, what do you mean to get things moving?" and she replied "oh, I just did a little membrane sweep, it'll hopefully get things to progress faster for you."

I was completely in shock. I mean, literally didn't know what to say, my jaw probably hit the floor. I had my two year old DD with me and just had the urge to get out of there ASAP. I feel COMPLETELY violated.

And now...I don't know what to do. I'm scared that I'm going to go into labor tonight, before this baby is ready. I'm already feeling more crampy. I feel the need to do something to advocate for my rights, but I don't know what.

And I'm just, I don't know...really shocked that the Dr. didn't have the decency to at least have a conversation with me before doing such an invasive intervention. It would have been one thing if I was already in labor and not progressing and gave my consent to try stripping the membranes before considering a c-section. But at 38 weeks and only a fingertip dialated, with no complications. I just....don't get it. What should I do? Should I be worried? Is there an increased risk of complications?

Mama to DD 4/07 and DS 1/11.  Missing my Zejah Grace (Born sleeping at 39 weeks 6 days) 2/3/10
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#2 of 27 Old 01-23-2010, 01:32 AM
 
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I would be pissed too. First, I would change Dr. That's just me. I know you're 38 weeks, but I would. It sounds as she isn't that into a VBAC (if that is what you are wanting) or letting you go into labor on your own, or letting you go past 40 weeks.

I'd call the BBB, her office manager, her superior and anyone else I could think of. I'd definitely tell her how I felt too. Maybe write her a well thought out letter of just how crappy it was that she did what she did.


As far as going into labor, if you are ready to go into labor, you will. Your baby too. I doubt sweeping membranes will put you into labor without you being or baby being ready. I think if it was to have broken your water, it would be a HUGE problem, and I'd report her to ACOG or whoever could do any kind of serious reprimand.

I did have my membranes swept at 41+weeks because I was going through a birthing center and was trying to avoid a forced 42 week hospital induction. I do feel that when the MW swept my membranes it turned baby's head to an acynclitic position. That's my belief, and I very well could be wrong. I would though make sure (if a vbac is what you are wanting) that you use a lot of rotating baby positions, like hip circles, sways, lunges and such.
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#3 of 27 Old 01-23-2010, 01:46 AM
 
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God, I would be so mad I'd be seeing red. I can't believe she would do something like that without informing you, let alone without consent.

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#4 of 27 Old 01-23-2010, 01:54 AM
 
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if you're only a fingertip dilated how did she strip your membranes without you flying off the table in pain? in my experience that REALLY hurts.. but maybe that was just my OB being .. rough.. or something? my OB did the same thing though, she told me what she was doing AS she was doing it.. at 38 weeks.. my water broke about 6 days later.. i'm not sure if it was related or not... .. but either way, i'm sorry. that sucks..

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#5 of 27 Old 01-23-2010, 02:21 AM
 
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If it's any consolation, with all three of my previous pregnancies, my OB's stripped my membranes (sometimes more than once), and it had zero effect on when my labors started. It's one of those things that generally won't do much unless you are ready, and just need a nudge in the direction of labor. I've also been crampy following a vaginal exam that was a simple cervix check, with no stripping or rough handling...so the cramping doesn't necessarily mean anything is happening down there.

I'm so sorry your doc did that without your consent, that really is crappy. At the very least, I would refuse any more vaginal exams.

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#6 of 27 Old 01-23-2010, 02:46 AM
 
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My OB did one when I was post dates with my dd (with consent) and it hurt like crazy. I was 3cm dilated when she did it. Did you notice it at all?
For what it's worth, besides being uncomfortable and crampy for a day, it did nothing. I didn't go into labor for at least another week if I remember correctly. But the risk of infection is there.

I would also be furious if that was done without my consent. I would file formal letters of complaint to whoever I could, and I would also switch care - yep, at 38 weeks, I would drop her like a hot potato.

I'm sorry

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#7 of 27 Old 01-23-2010, 03:13 AM
 
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My doc did this to me when I was 41 weeks preg and it hurt like HE**.

If the baby isn't ready, the membrane will reattach from what I have been told.
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#8 of 27 Old 01-23-2010, 03:15 AM
 
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I'm sorry this happened to you. I would definately talk to her or report her if you dont plan to continue on with her. That is a total violation... ugh.

I just had my baby 9 days ago. I was renting a vacation home near midwives so I could have a home birth... Because I was on kind of a time crunch, and I was having lots of prodromal labor for weeks, I was OK with my midwives doing a stretch and sweep. When I was a fingertip dilated, all the midwife can do is kind of stimulate my cervix and stretch it a little. I had mild cramping... prodromal labor continues, on and off. Next week, I was at 2 cm. This time the midwife could do a little sweep, and stretched my cervix to 3cm. I had some regular cotnractions for a couple hours, then it petered out again. Had accupuncture done. More prodromal labor. Couple days later, I was 9 days past my due date, and 4 days away from having to leave the vacation rental. The midwife asked if I wanted a more vigorous sweep, and I said YES! She could easily stretch my cervix to 4, and did a good, long sweep. She was in there for quite a while! I had some cramping, and a within an hour some regular contrax, then a bit of bloody show. I thought it was just from the sweep, but then an hour later, more contrax and LOTS of show. My water broke 6 hours later and I had the baby 6 hours after that.

So I think that your body has to be ready, or its probably not going to do anything. Sweeping is the kind of thing that can tip the scales when you are kind of on the verge of going anyways. As long as they are careful and not breaking your water. During my third exam, she could see my water bulging through my cervix anyways, which meant it was probably going to happen pretty soon anyways.

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#9 of 27 Old 01-23-2010, 05:18 AM - Thread Starter
 
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I was very uncomfortable, but I wouldn't say "flying off the table in pain." Do you think that since i'm only a fingertip dialated, that it wasn't a true stripping of membranes? I'm worried about risk of infection or complications to this baby if it was in fact a true membrane sweep. I haven't had any spotting or loss of mucous plug yet (it' sbeen about 5 hours)... is that a good sign? I just want her to stay in there as long as she needs to to be born healthy. I don't know how I could forgive myself if she came out too early and with complications because of something that I could have prevented by simply not agreeing to the vaginal exam at all. I haven't decided what action I'm going to take yet against the OB, but something needs to be done. I do know that I DEFINITELY won't be seeing her again though.

Mama to DD 4/07 and DS 1/11.  Missing my Zejah Grace (Born sleeping at 39 weeks 6 days) 2/3/10
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#10 of 27 Old 01-23-2010, 05:32 AM
 
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if you DEFINITELY wont be seeing her again i would take action immediately under the premise of her not only performing a procedure without informed consent but it can also be classified as sexual assault in some states.
i personally would persue it to the greatest extent of the law if i could because what she did is NOT ok.
i am so sorry you are going through this. know that there are also steps you can take later after the baby is born if you dont want to jeopardize care with the group you are seeing, but it wont be as drastic as if you file complaints and reports now while the incident is still fresh.
ugh, yuck. it most likely wont change when you go into actual labor though. i am crossing my fingers for you that it wont.
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#11 of 27 Old 01-23-2010, 02:08 PM
 
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First, I would be *pissed*!! Second, try not to stress to much. Stripping membranes rarely works anyway.
Definitely make a complaint. I'm not sure who, but even *if* it was a well intended action, she should have asked first!!

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#12 of 27 Old 01-23-2010, 03:26 PM
 
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OP, if you're at Kaiser you can complain at least to the chief OB in her department - her direct boss. You can also then call the customer service people directly and ask to speak to someone about quality of care. Kaiser, IME, is extremely concerned about customer satisfaction (much more so than any other HCP I've ever been with) and will act quickly to let her know that her behavior is NOT ok. I wouldn't have any direct contact with her anymore; just go to her supervisors and explain what happened and why it was completely unacceptable. If they take you seriously (and IME, they probably will), somebody will probably warn her to at least tell her patients before doing that again.

ETA: and if I was you, I probably would have screamed in her face! No way does somebody get to intervene in anything my body does without asking me first!!! I refused all vaginal exams before I was in labor for this VERY reason.

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#13 of 27 Old 01-23-2010, 05:40 PM
 
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That sucks, and you have every right to be angry. I think I'd actually have a conversation with your doc if you can, next time you see her. Tell her that you are very upset that she did a membrane sweep without your consent and that you feel it really violated your trust in her. I don't think this is excusable on her part, but I also suspect she didn't think it was a big deal - simply a very minor thing that she could do to help alleviate your concerns about going post dates. So while it was an inappropriate thing for her to do, I do not think it was malintentioned, if you know what I mean. If you no longer feel you can trust her see if you can switch.

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#14 of 27 Old 01-23-2010, 05:44 PM
 
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You said you are with Kaiser - you can easily file a major complaint and make a stink about it. I so would. they have a grievance office or something like that (it's been a while since I was with Kaiser)... Go ahead and do all those calls and letters.. This person needs to be reported. And seriously, at 38 weeks???? That's a wee bit early to push for delivery!

An: relax. All my friends who had their membranes swept didn't go into labor.
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#15 of 27 Old 01-23-2010, 05:51 PM
 
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a midwife at the birth center did this to me with my oldest my water broke within hours, babe was in a bad position and I ended up with a c/s2 days later. (and life threatening complications post birth) I wish I had filed a complaint (same MW violated HIPAA laws as well)

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#16 of 27 Old 01-23-2010, 07:40 PM
 
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There are some good recommendations from PPs here. The only problem is a phenomenon that Marsden Wagner calls omerta, which is basically "tribal loyalty." He contends that there is a tendency in the medical profession to guard and protect each other regardless of their actions. That shouldn't stop you from complaining to the head OB and/or your state medical board--by all means you should. But keep in mind that the deck may be stacked against you.

There is another recourse you could take. Please report this OB to www.ratemds.com and, after your baby is born, www.thebirthsurvey.com. It may be too late for you, but you'll be doing a lot of other women a favor if they know to avoid this practitioner.

I'm so sorry, mama. I would be livid.

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#17 of 27 Old 01-23-2010, 08:07 PM
 
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I would be livid also.
As mentioned, you can contact the medical board in your state, which is responsible for licensing.
Here is CA's site as an example http://www.medbd.ca.gov/board/contact_us.html
You then have the right to make a formal complaint. It is my understanding that the board must investigate all complaints. To me it seems what occurred could be described as performing a medical procedure without patient consent. It should be irrelevant how common it is and how many health care providers do it, I believe that this practice should not be performed without 'informed consent' or at least 'patient consent'.
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#18 of 27 Old 01-23-2010, 08:07 PM
 
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I really feel for you. That is a terrible and violating treatment. I would probably try to figure out what is best for my emotional state after an incident like that. If it helps to address a complaint and vent I would do it - or maybe have your husband take care of the official steps. If it would keep me in the spiral and keep me upset about it I would try to take really good care of myself and baby and put energy in finding a different OB for delivery. Maybe try to relax. As far as the sweeping of the membrane goes it does sound like it is not the ultimate "inducement" (and she might have just done it slightly since you didn't feel it that much) if baby isn't ready. Of course it can be different in your case and it definitely was not right of her to just do any intervention without your consent! I hope everything will go well and wish you luck with what ever you decide!!!!

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#19 of 27 Old 01-24-2010, 02:37 AM
 
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Wow, I am angry on your behalf! Do document - write down everything and file a complaint!

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#20 of 27 Old 01-24-2010, 03:02 AM
 
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Quote:
Originally Posted by Jackies Ladybug View Post
her not only performing a procedure without informed consent but it can also be classified as sexual assault in some states....
mmm, not really.

Just to let you know, if you want to file a complaint with the hospital or medical association, this is considered the "standard of care"; the doctor acted with in the standard of care for obstetrics at this point in time and this is not considered malpractice.

Get another doctor. This is a warning to you as to how you will be treated during labor. No consent was asked from you; just wait until you get to the hospital and are hit with the cascade of interventions.
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#21 of 27 Old 01-24-2010, 07:15 AM
 
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From my experience, a lot of folks can't strip the membranes very well anyway. Your Ob would have had to get two fingers through your cervix and done a pretty good swipe around really and that is really uncomfortable although I wouldn't necessarily say painful. I have had a few sweeps and the effective ones have been pretty full on stripping, the other MWs 'think' they are stripping the membranes but really, in comparison, they are just tickling the cervix.

So, fingers crossed, she did the crap version and nowt will happen.

That said, what she did was wrong, wrong, wrong. Just after my first babe was born, the Ob shoved a suppository up my backside really roughly, without consent and without telling me he was going to do it and I had really bad piles too and it has REALLY affected me.

For some reason, some docs think that once you go through the door to the hospital that they can do what the hell they like with you and you are supposed to put up and shut up because its just a part of birth and you are supposed to be prepared for all the undignified aspects of childbirth.

Well thats not the way it is AT ALL and they should learn a little respect.

What happened to you was totally wrong, it is something you need to consent to and you didn't and there are potential risks associated to it.

I am really mad for you!
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#22 of 27 Old 01-24-2010, 11:54 AM
 
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Quote:
Originally Posted by tireesix View Post
For some reason, some docs think that once you go through the door to the hospital that they can do what the hell they like with you and you are supposed to put up and shut up because its just a part of birth and you are supposed to be prepared for all the undignified aspects of childbirth.
Unfortunately, that's sort of the case IF you don't take charge before hand.

I cannot emphasize this enough: Beware of the "Consent to Treat" form that hospitals give you. Most laboring mamas sign anything put in front of them, so it is critical to get all of the paperwork read and signed before the Big Day.

"Consent to Treat" forms pretty much say that doctors and nurses can do whatever the heck they want to you; they get carte blanche over your body and your baby.

CROSS THAT PART OUT AND INITIAL IT. Then add something in the margins about how you require informed consent for all (including the most routine) tests, medications, and other interventions.

Most women don't realize that there is no legal obligation
to sign this form.

It didn't occur to me until now, but the OP probably had to sign one to see her OB... When you find a new OB (and like other posters, I'm urging you to do that!) make sure to alter the "Consent to Treat" form in your "New Patient" paperwork.

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#23 of 27 Old 01-24-2010, 01:58 PM
 
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Originally Posted by PiscesMama24 View Post
What should I do? Should I be worried? Is there an increased risk of complications?
OMG I would be LIVID! What a violation to the supreme degree! And hello informed consent anyone??? I know a previous poster recommended reporting the OB to ACOG, but I would seriously make a report to your state's medical board -- that's the organization that grants and renews your OB's medical license and proabably the best route to having this investigated and proper action taken. It's definately not a quick fix, but it's worth it if this doc can be made to understand that these "procedures" MUST NOT be done without consent.

As far as the effects for you and your baby. I agree with other posters, stripping membranes (and most other non-medicated induction techniques sort of AROM) won't put you into labor unless you are ready. I had it done several times in my last pregnancy, along with pretty much every other "natural" and home induction techniques to prevent a forced 42 week transfer to an OB after weeks of prodromal labor, and none of it worked. If membrane stripping was going to jump start your labor, it would have likely done so within the first 12-24 hours.

If you do decide to stay with this OB (and I can't blame you if you're reluctant to switch providers at this late hour), I would personally would not allow any more vaginal exams no matter what. Checking your dilation, or lack of dilation, is not going to tell you how close or far you are from labor.

Sending you lots of restful thoughts for your end of pregnancy, and calm and peaceful labor vibes (when you are READY for them ).

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#24 of 27 Old 01-24-2010, 03:07 PM
 
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In addition to being an issue of informed consent, I would think it would be considered somewhat unethical to try to force a woman into premature labor with no compelling medical complications a reason. You should definately report this OB to anyone you can, and I would certainly be looking for a new OB who will at least treat you like a person. So sorry for all the stress to you Mama. And sending you good vibes for a fabulous birth.

Homeschooling, homebirthing, co-sleeping, breastfeeding, cloth diapering, APing, UC, super crunchy mom to Ezra(9), Adrian(5), and Lily(May 15) : Non-vaxed mom and babes
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#25 of 27 Old 01-24-2010, 03:37 PM
 
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Hope you are doing fine.
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#26 of 27 Old 01-24-2010, 04:09 PM
 
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In addition to the uncosented stripping of membranes. I would seriously be questioning her statement that anything past 40 weeks is post-term.

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#27 of 27 Old 01-25-2010, 02:02 PM
 
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It doesn't sound like she actually stripped your membranes. Sounds like she did a cervical check. Particularly if you aren't having any spotting, cramping, or pain.

I'd be pissed about the push to induce at 40 weeks. I would just decline any cervical checks from here on out.
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