41w5d Baby not engaged, minimal dilation... wait it out at birth center, or induce at hospital... - Mothering Forums
Birth and Beyond > 41w5d Baby not engaged, minimal dilation... wait it out at birth center, or induce at hospital...
RainbowAdvaya's Avatar RainbowAdvaya 01:46 PM 01-21-2014

I'm currently 41w5 days pregnant and have been seeing midwives at a hospital as well as a CPM at a birth center. The reason I'm seeing both is I started out at the birth center, switched at 26 weeks for financial reasons, and then wanted to switch back at about 38 weeks. The CPM didn't take me back then due to being pregnant and not accepting more clients, but we ran into each other when I was about 40 weeks and she invited me back the next day. So I'm hoping to deliver with her at the birth center in the beautiful birth tubs rather than the hospital!

 

The problem is the CNM's at the hospital are SUPER SUPER pushing induction. I have had borderline high blood pressure a few times, but wonderful blood work and protein so low on a 24 hour urine catch that it couldn't be measured. They told me my chances of the baby being still born at this point is nearly 1 in 100. They got that from a paper that said the risk of still birth doubles following 42 weeks with it going from 2 to 3 per 1000 to 4 to 7 per 1000. Not quite 1 in 100 but I get where she got the statistics.

 

They have booked me for a biophysical profile tomorrow morning (she has performed wonderfully on NST) and a cervadil induction on Thursday.

 

The CPM has no problem with me waiting past 42 weeks, as long as I understand the risks. She's willing to do a membrane sweep tomorrow, and give me some homeopathics.

 

I'm trying to weigh my options considering that I haven't dilated much, and that the baby is still pretty high in my pelvis. I am pretty sure of my dates, btw.

 

So, right now its looking this:

 

See CPM tomorrow for cervical sweep, homeopathics and positioning check (to see if there is anything we can do to get her to engage)

BPP on Thursday (42 weeks)

Prostaglandin induction on Friday

 

At that point, I would need to see how favorable my cervix is. I do not want to attempt induction with a low bishops score. I think the chances of ending in c section are too high, and I almost would rather plan a c section and skip the pitocin or sign out and wait it out completely. I am not afraid of pitocin induction as far as the pain goes (says the woman with no children) but I am super afraid of spinal/epidurals. So I prefer pitocin over c-section for myself, but I want whats best for the baby.

 

My other option is to leave the hospital practice totally and go with the birth center. This would have been easier had I not switched at 40 weeks or had been there all along. I would not have been exposed to the fear mongering at the hospital, but if those are actual risks, then I need to decide based on them. My friend, who went to midwifery school with me years ago, said they are misusing data to scare me.

 

I'm hoping I go into labor tonight or tomorrow and all this can be irrelevant! Its my birthday tomorrow, and I've had a feeling she'd come on it but I haven't had many contractions at all. Two in the last two days, both a little painful. Sometimes I'll feel my stomach tense up (only to the touch, I can't tell when its happening otherwise), but beyond that.. no bloody show, nothing. My cervix is thinning, but the baby is still high. The CNM could barely get a finger in my cervix yesterday, so sweeping the membranes might not be an option tomorrow either way.



cileag's Avatar cileag 08:15 PM 01-21-2014

I sympathize with you! My first was 41 and 3 and a planned home birth (I am a labor nurse so I knew all the hospital induction/worries as well).  Watchful waiting is so taxing emotionally.  I think that a BPP is reasonable at this point and in any situation, I would be focusing more at getting baby to engage since for a first time mother, it is typical for that to happen at term and is not my favorite situation as a starting point for induction (nor is it a particularly imminent sign of labor).  Have you visited Spinning Babies?  Search that and there are some positions that you can do to help engage the baby.  42 weeks was my personal limit for expectant management---after that I was comfortable with an induction.  I think it's smart to want to wait for a good bishop score, but the risk of c/s is still lower with an induction than with a planned c/s, so I wouldn't personally choose a c/s solely based on a low bishop score.  Go forth and do some spinning!


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