I'm about 40w 5d and planning a home birth with my NHS provided midwife in the UK. As part of her routine weekly home visits, she has been talking about standard procedures in this country for suggesting natural and medical inductions. I'm currently scheduled for an at-home sweep in a couple days (week 41) and am booked for an induction next Wednesday (beginning of week 42). I don't have to go through with either of them if I don't want to, and can refuse on the day. However, I do need to know why I would/wouldn't refuse. Research seems pretty mixed on it all. I'd really like to avoid the medical induction as it does mean a hospital birth and possible intervention complications (pitocin--> epidural--> c-section, etc). I'm not so fussed about the sweep though, if it can help me to avoid the medical intervention later on.
What do you think?
This is my first, by the way, and it's been a pretty easy, uneventful pregnancy.
I personally would not allow either, especially with your first baby, unless there's a problem. If your baby's fine your fundal height is not getting huge, leave nature alone. Inducing can be very hard on both baby and you. Of course, if your baby's becoming distressed, or too big, then that too can be hard on them in birth. But barring those complications, let your body and baby decide when the birth is, not some dr or midwife in a hurry.
I was really regular (like, 28 days on the dot) and was using a period tracker app when we were trying to get pregnant so I know when my last period was and when we had sex after that ;-) I guess my due date is relatively accurate based on that and on the 12 and 20 week scans. The baby is head down, fairly low, and ready according to the midwife. I guess I'm just a bit confused as to why they have schedules for sweeps and inductions if it's widely know that babies work on their own schedules...
Everything is fine so far and he isn't too big yet. I really want to avoid the induction as I've heard nothing good about them (and I've read widely and asked a lot of women who have gone through it). The sweep I'm not so sure about as it's new to me. Still researching it. The midwife said that if we let the pregnancy go beyond 42 weeks, the placenta starts breaking down- which I have heard elsewhere- but I don't know how dangerous this is or if I can just trust the baby to know when to come out. I don't want to accidentally do any harm through neglect (i.e. letting it go past 42 weeks or so) but I also know too well about what inductions will do and I really don't want to go there. I'm feeling a bit stressed and confused by it all.
I always encourage my clients to try other more natural approaches before getting a sweep done. However, as a rule there is often a natural labor that comes right after a sweep...the next day normally. The most common complication from a sweep is the water breaking in early labor...which can happen any way, but is nicer if it happens later. Sex and relaxation, nipple stim and so on can all have a good effect as well with less stress! The first baby often takes a little longer to get going for some reason, so it does make sense to wait it out as long as you can.
I have had several sweeps - the worst thing about them seems to be that they are uncomfortable and can cause some mild spotting. I've never had my water break but that is a possibility. Really only once did it throw me into labor.
Definitely try some of the stuff Becca recommended. If you are sure of your dates you might try evening primrose oil. Never tried it myself, I usually see recomendations to apply to cervix but someone on a thread I just saw said you can put a few drops in the tub and that can help too.
Going later than 42 weeks - I have long, erratic cycles and didn't get dating ultrasounds before the last one so we were never sure and I went 44 weeks past lmp with two of them with no issues or signs of postdates. We did bpp/nst to check on them. However I would be more leary if I was absolutely sure on my dates but the placenta is not going to automatically stop working right at 42 weeks, you just gotta watch your baby/body.
Pit induction - had one right at 41 weeks with #6 after she failed nst/bpp. The nurses were really great about starting the levels low and slowly turning them up only when needed. The pain got quite intense at the end but I was able to do it with no epi or other pain drugs. They let me get in the tub at one point, didn't really work for me to stay in there long but it was enough to really speed up contractions and then I also got the TENS unit which was a little weird but worked to help me get over that last bump before she was born.
Hope you are holding your little one soon.
That's a great point Fruitfulmomma - you can have a say in the way you are induced if it comes to that. A lot of my clients have had a very slow pit induction where they did not allow nurses to turn it up unless they felt it was needed. It does depend a lot on just how willing your hospital is to work with your plan.
Thanks for the information, all. Today is the sweep, which I think I'm going to go through with- just to see if it works, really. I've read that it really only kicks things off if you were ready to go anyway. We've been trying to focus on relaxation, nice showers, nipple stim, a bit of slightly ungainly sex (I feel like a dugong!), all the stuff on the natural labour starter list (except the evening primrose oil- haven't got that yet). I really want to avoid the induction thing next Wednesday- even though I can say no, I don't want to have to go to the hospital and present my case regarding really not wanting to be induced yet. It sounds like it's a staggered 3 part induction, all done in hospital- with a 24 hour insert of some sort (like a tampon filled with hormones or cervix softeners or something- not totally clear on it), which could then be followed by breaking of waters if labour hasn't started, followed then by the UK version of pitocin (it's a different name here, forget what it's called). Not sure about ability to determine rate of the drip but I'll ask my midwife when she comes by today for the sweep.
Crossing fingers that it will all go relatively well. I know labour and childbirth are far from predictable but I would like to at least be able to steer it somewhat if there's no emergency...
Just a quick update since yesterday's sweep. The midwife came over yesterday afternoon and did the sweep, which hurt a little (and a lot less than I'd expected) and was pretty quick. I'm 1 cm dilated (and 2 cm if stretched) with the baby well positioned and ready to go. She said it was looking good. I talked to her about my reluctance to have an induction and how just having the appointment made was making me feel stressed, as I didn't want to have to argue with doctors about it. I told her that being scheduled for next Weds felt way too soon and that I wasn't ready for it and wanted to proceed at my body's pace as long as the baby was okay. She agreed.
Then an interesting thing happened: She went through my notes and discovered that my first ultrasound at 12 weeks had reported a later due date than my second one at 20 weeks. My official due date should have been the day before yesterday rather than the previous week! She said, no wonder you didn't feel ready- you weren't! So she called the hospital and changed my information and I've now got about 2 more weeks before I have to think about the induction (and at the rate things are going, I should be able to have delivered naturally by then).
I just wanted to thank everyone for their suggestions and help in this thread and to update you all on what ended up happening...
In the end, it went totally differently to how we had planned it. My waters broke on Wednesday afternoon (the day I would have been scheduled for the induction) around 4:30pm and they were slightly discoloured by what might have been meconium so the folks at the community midwife centre said we should go to the hospital just up the road to get it checked out, to see if the baby was okay. They said we would probably be sent home afterward for the early stages of labour. We got a taxi to the hospital and, well, by the time they had the fetal monitor strapped to my belly sometime around 5 o'clock (I can't remember!), I was in full on labour-- the breaking of the waters had taken me from zero (just a day feeling a bit tired, full and heavy) to intense contractions every 45 seconds in barely half an hour. They scrambled to find a bed for me up in the birthing centre, and little Oscar was born at 6:30--- barely 2 hours from start to finish, with no time for pain killers. I nearly had him in the elevator going up... He sure didn't need any induction!
Here are some pictures and a happy little write up if anyone is interested.
Thanks! I also just wanted to add that when my midwife came by yesterday for a post partum check up, she had with her a trainee midwife from the university nearby doing observations. She explained my situation to her, noting that although my 20 week scan had given me a due date of the 13th (meaning a scheduled induction on the day before Oscar decided to be born on the 26th), I had felt quite strongly at a gut level that this was wrong and that an induction at that time would be a bad idea and that I needed more time. And I was right. She then told the trainee to listen to the pregnant woman's intuition as it's generally spot on.