Would you let them do it?? Opinions please! *UPDATE* - Mothering Forums
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#1 of 32 Old 08-09-2010, 04:07 PM - Thread Starter
 
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I need opinions/thoughts.... Would you have your membranes stripped/sweeped at 38+5??

I saw the stupid "we won't induce you if you go 'overdue' because you are a VBAC" midwife today. I asked her if I go past 41 weeks would they consider doing a membrane sweep or foley bulb induction before they'd do a pitocin induction. She said - again - for a VBAC they won't do any type of induction. 40 weeks cutoff. She then said that on Thurs if my cervix is thin enough they'll go ahead and do a membrane sweep/strip then and try to get things going. I'm GBS-, so thats not a worry. I'll be 38+5.

I emailed my midwife and asked her opinion on the situation. Last week, Pam (my midwife) told me if Beverly (the midwife I saw today) started talking about not being able to induce and having to have a section to let it go in one ear and out the other because we'll find a way not to go to an immediate repeat section just because of "dates". But I asked her opinion on the strip as well. She's on call today so it will be awhile before she answers me I'm sure.


Oh - I also should mention. I *WON'T* allow an induction or repeat section just because I'm "overdue". I know how to say no. Pam, my midwife is completely ok with me going to 42 weeks if both me and baby are healthy. However, I have a history of preeclampsia and have been on full bedrest and BP meds since 28 weeks now because I'm having the same issues as last time. I was induced for SEVERE pre-e at 38 weeks with my daughter and it ended in a heartbreaking section. So - the only reason I'm considering the sweep before my EDD is because my body is trying it's best to get sick and I really, really, really don't wanna go down this road again


Just wondered everyone's thoughts. I don't know what I should do. Part of my wants to go ahead and let her do the sweep, but I'm not really sure of all the pros VS cons.




**** UPDATED 8/13 ****


Yesterday's appointment yielded much higher BP and protein unfortunately. I had intentions at that point of letting the midwife go ahead and strip my membranes. She checked my cervix and there was no progress from Monday's appointment. 1cm and 70% effaced still with a high, posterior cervix. I asked a few questions. She relented that she doubted it would help but would do it if I wanted her too. I declined. BP is running 160/100 tonight and I'm not feeling well at all. Hoping and praying baby Levi gets his cues that mom's body is just starting to shut down and he needs to come on out on his own. I am 38+5 now. I see a midwife again Monday - 39wk even - and if BP is still up will have another cervical check and consider the sweep again depending on what that renders. I greatly fear my body will not hold on much longer and I'll need to be medically induced. I fear that induction will also result in a repeat section just as it did with my daughter. Prayers/positive thoughts appreciated!






x posted in my other DDC (aug) and VBAC board

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#2 of 32 Old 08-09-2010, 04:36 PM
 
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I personally would be ok with it, fairly invasive but I feel like the risks are minimal. It's also one of those things that isn't really going to do much if your body isn't ready. My friend had hers done every appointment from 39 weeks and still didn't have baby till 43 weeks. One of the side effects is spotting and contractions but those could be painful and lead to no where.
I'd say though I would not be pressured into it w fear of c-section, do what you feel comfortable with.
XOXO Hope everything goes well for you, whatever you decide.

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#3 of 32 Old 08-09-2010, 04:38 PM
 
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No, I wouldn't. Why risk it when baby is not ready yet and you are introducing bacteria where it shouldn't be?

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#4 of 32 Old 08-09-2010, 04:40 PM
 
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Wow, I can totally understand why you are asking, this is a really tough one! If I were in your shoes and being watched closely for pre-e, I think I would go ahead and try to get things moving in hopes to beat that pre-e panic. Not sure what type of things I would try, I would ask my MW for recommendations, but certainly at 38w5d your baby is ready.

Good luck!

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#5 of 32 Old 08-09-2010, 04:42 PM
 
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I would not, since your main midwife is saying that 40w does NOT mean repeat c-section.

Dont rush it or you could cause problems that would cause you to need that repeat c-section, while if you let your body do it naturally you are more likely to be fine.

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#6 of 32 Old 08-09-2010, 05:11 PM - Thread Starter
 
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Originally Posted by mommamisty View Post
I personally would be ok with it, fairly invasive but I feel like the risks are minimal. It's also one of those things that isn't really going to do much if your body isn't ready. My friend had hers done every appointment from 39 weeks and still didn't have baby till 43 weeks. One of the side effects is spotting and contractions but those could be painful and lead to no where.
I'd say though I would not be pressured into it w fear of c-section, do what you feel comfortable with.
XOXO Hope everything goes well for you, whatever you decide.
Thank you I'm not pressured into at all for a fear of a section. I will refuse a section of both me and baby are fine. I will not be sectioned for dating purposes. The reason I'm considering is because my past issues with pre-e and the fact that my body is getting sicker and sicker and I'm afraid of what happened with my daughter last pregnancy.

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DDCC

No, I wouldn't. Why risk it when baby is not ready yet and you are introducing bacteria where it shouldn't be?
The "risk" is because of the above stated.

"The reason I'm considering is because my past issues with pre-e and the fact that my body is getting sicker and sicker and I'm afraid of what happened with my daughter last pregnancy."

Thank you so much for your opinion!! I appreciate it!

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Wow, I can totally understand why you are asking, this is a really tough one! If I were in your shoes and being watched closely for pre-e, I think I would go ahead and try to get things moving in hopes to beat that pre-e panic. Not sure what type of things I would try, I would ask my MW for recommendations, but certainly at 38w5d your baby is ready.

Good luck!

Thank you for your opinion, I really appreciate it!!

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I would not, since your main midwife is saying that 40w does NOT mean repeat c-section.

Dont rush it or you could cause problems that would cause you to need that repeat c-section, while if you let your body do it naturally you are more likely to be fine.
Right, I totally get what you are saying - but it's not about going past 40wks - it's about pre-e getting to the point that we have to do a medical induction or repeat section which I don't want at all

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#7 of 32 Old 08-09-2010, 05:23 PM
 
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While not having near the same severity of bp issues as you (and also having had pre-e in previous pregnancy AND a failed induction), I am facing a similar situation. Except my OB will NOT let me go past 40weeks.

That being said, how is your intake of RRL and EPO?

If you haven't started RRL yet, I'd start taking the tincture strength brew every day. It won't cause contractions, but it will strengthen your uterus. The tincture is 1oz red raspberry leaf to 1 pint of boiling water, steep 30 min.

With the EPO, I'd go full throttle. From almost everyone I've heard, it really does induce cervical changes. I am planning on starting on 2000mg vaginally and 2000mg orally at 36 weeks. I've heard of women taking higher doses though without issue.

In all my research, I've found that nettle and dandelion also lower bp. Maybe that plus the medication will help stabilize you?

In your situation, I would do a membrane sweep at 40weeks. No sense in doing it too early before the cut off, in case of ROM, for example.



Ami

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#8 of 32 Old 08-09-2010, 05:33 PM - Thread Starter
 
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While not having near the same severity of bp issues as you (and also having had pre-e in previous pregnancy AND a failed induction), I am facing a similar situation. Except my OB will NOT let me go past 40weeks.

That being said, how is your intake of RRL and EPO?

If you haven't started RRL yet, I'd start taking the tincture strength brew every day. It won't cause contractions, but it will strengthen your uterus. The tincture is 1oz red raspberry leaf to 1 pint of boiling water, steep 30 min.

With the EPO, I'd go full throttle. From almost everyone I've heard, it really does induce cervical changes. I am planning on starting on 2000mg vaginally and 2000mg orally at 36 weeks. I've heard of women taking higher doses though without issue.

In all my research, I've found that nettle and dandelion also lower bp. Maybe that plus the medication will help stabilize you?

In your situation, I would do a membrane sweep at 40weeks. No sense in doing it too early before the cut off, in case of ROM, for example.



Ami
Thanks Ami. RRL I'm doing just a regular brewed tea 3x's a day. I wasn't aware of a tincture type strength - I may start doing that.

EPO I'm doing 3,000mg orally and 1,000mg vaginally each day. I started EPO at 36 weeks.


36 weeks - cervix was tightly closed and not effaced at all
37 weeks - 1cm 50% effaced
38 weeks - 1cm 75% effaced

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#9 of 32 Old 08-09-2010, 06:18 PM
 
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I'd probably wait on the sweep on the off chance you get membrane rupture. Cause then you'd be on the clock and then you may be really facing a RCS... It's such another ball of wax so to speak when you are racing the pre-e, yet trying to avoid a RCS. I'm kinda there with you....last time I lost, but I'm still in the lead this time. Fingers crossed for us both!
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#10 of 32 Old 08-09-2010, 06:55 PM
 
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wow, what a tough situation!

Just because of the pre-e history and currently being watched - I think for myself I would do it. It is a bit invasive, and can hurt but I would mostly be avoiding ending up in the hands of the Beverly MW.
I think I would add some EPO as well.
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#11 of 32 Old 08-09-2010, 07:30 PM - Thread Starter
 
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wow, what a tough situation!

Just because of the pre-e history and currently being watched - I think for myself I would do it. It is a bit invasive, and can hurt but I would mostly be avoiding ending up in the hands of the Beverly MW.
I think I would add some EPO as well.

Bev is my only option when Pam is on call or off and I absolutely hate it. However, Pam is coming in to deliver me regardless - if she's not on call - she'll cancel app apts for that day or come in on her day off.

I'm doing 3,000mg EPO orally and 1,000mg EPO vaginally each day right now.


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I'd probably wait on the sweep on the off chance you get membrane rupture. Cause then you'd be on the clock and then you may be really facing a RCS... It's such another ball of wax so to speak when you are racing the pre-e, yet trying to avoid a RCS. I'm kinda there with you....last time I lost, but I'm still in the lead this time. Fingers crossed for us both!

I totally see your point too I'm just lost. Good luck to you though as well!!

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#12 of 32 Old 08-09-2010, 09:17 PM
 
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i would probably go ahead with it if things look like they're moving along already otherwise wait.. I also don't think it'd want that one MW to do it.. Get your regular MW to do it if possible I'd be worried about the Medwife trying to break your water while in there or something but i'm paranoid. THey're already doing checks every week so i don't see how they'd be putting more bateria there than they already are. If you wait too long you always run the risk of being too sick to physically have baby natural and then section would be the only option. just my opinion. good luck deciding.. i know its a tough decision.

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#13 of 32 Old 08-09-2010, 10:04 PM
 
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Personally, in your situation, I would, but I don't actually think they work very often so I wouldn't hold out much hope in it getting labor going. But I'd do pretty much anything and everything that's relatively safe if I were you.

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#14 of 32 Old 08-09-2010, 10:09 PM
 
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After reading your other thread...I would totally do it. I might have already done it. I am a very laid back birther/mama, nearly a uc-er, but in your case...I'd be all about getting that baby out. Whatever it took. s

"If you keep doing the same things you've always done, you'll keep getting the same results you've always gotten."

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#15 of 32 Old 08-09-2010, 10:14 PM - Thread Starter
 
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i would probably go ahead with it if things look like they're moving along already otherwise wait.. I also don't think it'd want that one MW to do it.. Get your regular MW to do it if possible I'd be worried about the Medwife trying to break your water while in there or something but i'm paranoid. THey're already doing checks every week so i don't see how they'd be putting more bateria there than they already are. If you wait too long you always run the risk of being too sick to physically have baby natural and then section would be the only option. just my opinion. good luck deciding.. i know its a tough decision.
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Personally, in your situation, I would, but I don't actually think they work very often so I wouldn't hold out much hope in it getting labor going. But I'd do pretty much anything and everything that's relatively safe if I were you.
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After reading your other thread...I would totally do it. I might have already done it. I am a very laid back birther/mama, nearly a uc-er, but in your case...I'd be all about getting that baby out. Whatever it took. s

Thank you all for your opinions and advice, it really helps alot. I am just so torn. I don't want to rush baby or cause a problem, but then again I'm working on really, really borrowed time.

When I got sick with pre-e with my daughter I went from being 100% FINE to gaining 20lbs worth of water weight, BP 220/140, massive amounts of protein in my urine, and on the verge of liver and kidney failure - all in a days time! I was seen in the office in the AM and was FINE, admitted to L&D at 11pm that night so, so, so sick. So for me, I know I can go from perfect to deathly ill so quickly and I'm just terrified.

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#16 of 32 Old 08-09-2010, 10:22 PM
 
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I know this is so tough. I know how badly you don't want a RCS. I remember your posts when we all started together the beginning of this year. But, a c-section is NOT a failure. It's what saves lives sometimes. It's what the pioneer women needed and didn't have. It's ONE of the reasons we are blessed to have lower mortality in our day and age.

No, it's not ideal. No, nobody wants one. Me especially. It's my fear every. single. time. that I'll have to have one. But, I KNOW that I'd rather have a healthy baby.

The odds of a healthy baby are on your side. He's full term. You can think about you...and in doing so, think about him. An unhealthy mama isn't a good thing for an unborn baby. Actually, it's not a great thing for a newborn either. It's okay to need help. It's okay to choose the uncrunchy when it's what needs done. Sometimes it takes MORE courage to do what needs done.

I'm sorry this has to be so hard. I'm sorry it's not going how you hoped. But, I hope you can let the fear and tension and the past go, and do what you need to do NOW with a clear conscience.

Lots and lots of

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#17 of 32 Old 08-10-2010, 08:18 AM
 
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I would do it because it's not going to work unless your body isn't pretty much ready anyway-- unlike something like pitocin, it's just going to give you a "push" if you're teetering on the edge of labor. So, that's one thing I don't have a problem with, no harm if it doesn't work (as opposed to some more drastic "induction" things like breaking water, where if it doesn't work you'll be likely to end up with a RCS).

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#18 of 32 Old 08-10-2010, 09:25 AM
 
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Amber, I'm a VBAC momma with a pre-e history as well. From everything you have written, you are teetering so close to "sick" again, and with a fully baked babe I personally would be SO anxious to get him out to avoid everything you had to deal with last time. That pre-e ride is physically dangerous and AND emotionally draining because it is so, so scary. It's no less scary the 2nd time--maybe moreso because you know just how wrong things can go. And how quickly!

If I were in your shoes (and I could be in a couple of weeks here, without the BP issues so far), I would absolutely do EVERYTHING I could to get a chance at a VBAC. I know how it is to want a vaginal birth SO badly; you don't want to end up with regrets if ultimately you do end up with an RCS. For me, that includes sweeps, a Foley, and even AROM if necessary (my OB also will use pit judiciously to get labor started). And also for me, if we tried everything we could to get baby out OR I started to get too sick while trying gentle methods to evict baby, I would know that it was out of my hands and could resign myself to an RCS being necessary.

I guess FOR ME the ultimate bottom line is that if baby needs to come out and the option is something "invasive" or with a risk of failing and therefore pushing me toward and RCS, it's still worth that risk. By trying, at least I get a *chance* at a vaginal birth. If I don't try, it's akin to signing on the dotted line for an RCS. If it succeeds, I get my vaginal birth. And if it fails, I have done everything I can without risking my safety and that of my unborn child by waiting for labor when I am too sick.

That's just my personal take on it (and it probably isn't a popular opinion), having sort of BTDT.

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#19 of 32 Old 08-10-2010, 09:27 AM
 
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I agree with the folks who are saying give it a try.. in your situation, it seems like trying the less invasive options now, when you're already at 38.5 weeks seems pretty safe.

And I also agree with Just1More... a c-section is NOT a failure... it certainly is not what you (or I for that matter) are hoping for with your birth, but the main objective is to have a healthy baby and mama. If that is what you end up having to do to achieve your objective, then that's what you have to do. Don't beat yourself up about it!

Sending lots of white light and big hugs your way mama... and know that this too shall pass.

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#20 of 32 Old 08-10-2010, 09:31 AM
 
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NO WAY would I let them do a membrane sweep, ever, let alone at 38 weeks!

That isn't even 40! And you aren't even overdue until 42. Well, maybe to save my VBAC, I might consider it at 42 weeks exactly.

But definitely NOT at 38+5. If you and the baby are healthy, why does she want to do the sweep anyway? If your health gets worse, and then to avoid a c/s, I might consider it.

Good luck mama!
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#21 of 32 Old 08-10-2010, 09:59 AM
 
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My HELLP syndrome progressed very rapidly the first time. The second I didn't get that far. If you have time, you may want to check out preeclampsia.org. Pre-e is usually much less severe in subsequent pregnancies....but still scary because we all remember our first time. Have you done a 24h urine this time? It may give you some more info...it gives a much better picture than a dipstick. If your 24h urine protein is getting up there, go all out to get that baby out....if not maybe give it another day or 2 and reassess.
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#22 of 32 Old 08-10-2010, 10:24 AM
 
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in your situation i would do it. i think its worth a try at almost 39 weeks.

I had mine stripped with my first DD at 38 weeks (OB didn't even ask) i had some bleeding and contractions but my body wasn't ready yet, so no labor and i would never allow it again unless i was 41-42 weeks or had health issues ..

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#23 of 32 Old 08-10-2010, 10:39 AM
 
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DDCC

have you looked into the theories connecting lots of extra protein with a lower pre e risk? My midwife told me to really eat up protein to avoid pre e and I have no idea if that helped me even though I didn't have any bp issues, but it certainly can't hurt to really push the protein in your diet. If you aren't vegan, I found cottage cheese and yogurt and peanut butter to be my favorite protein sources, especially when I couldn't eat much. I tried snacking on those the most.

Otherwise, in your situation, I think I would seriously consider doing a membrane sweep. Normally I'm a do nothing til I absolutely have to do something (which for my last pregnancy would have been 41 weeks because at 42 I would have had to birth in the hospital most likely with a pit induc) but with your history of going from fine to deathly ill in a matter of a day or so, I'd be very worried about that happening again. There is a risk for rupture, but I think if you trust the person doing it (so I'd try to get pam, not bev) it'll be a good choice for you especially if you are doing everything else you can to encourage your body to get ready like the RRL and EPO already mentioned.
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#24 of 32 Old 08-10-2010, 01:35 PM
 
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I'm about as non-interventive as you can get. I've declined all routine testing, I'm not even allowing doppler/ultasound use, etc. I would normally NEVER consider prenatal VEs, much less a membrane strip at 38wks.

That being said, I can completely relate to the stress and pressure you must be feeling right now. My biggest fear is having another c/s. I know within myself that if I ended up with another one, it would truly be necessary and that the safety of my baby would be the most important thing. That knowledge (and willingness to do what is necessary) does not stop me from being mind-numbingly afraid of the possibility. If I was being faced with that very real option and was in your shoes (and if I'm being completely honest) I would probably consent. I don't think anyone who has not been through that really knows what it's like.

That being said, I don't think it's a decision you need to make right now. I would take it one thing at a time. Maybe you can make the decision hinge on something...e.g. "If I have any bloodwork come back with elevated enzymes, it's time to do XYZ" or something like that.

I like to focus on doing "the next best thing". Ideally I would have no interventions whatsoever. At the same time, there are ideals aren't possible to meet and you have to start thinking about what that next best thing is. I personally think that a membrane stripping is probably LESS risky than black/blue cohosh or even castor oil...for me, that would be something to try before I went to the other kinds of non-medical induction methods.

I hope, hope, hope that your BP and bloodwork remain somewhat stable and that none of this will be necessary. I hope also that you can find some peace of mind no matter what happens.


Marilyn, married to my soulmate Jay and mommy to Elijah Blaze 08/04/2003 and Mila Soleil 10/02/2011 . 
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#25 of 32 Old 08-13-2010, 10:53 PM - Thread Starter
 
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I really, really appreciate everyone's thoughts and opinions! I updated in the OP with yesterday's results.

hippie.gif Hi, I'm Amber

Ava {12.20.08}  Levi {8.19.10}  Aspen  {EDD 7.21.13}

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#26 of 32 Old 08-13-2010, 11:49 PM
 
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Praying that you hold out safely till Monday. That BP is starting to get really scary! I will be thinking "open cervix" thoughts for you. Watch out for those "other" pre-e signs, okay??

 hearts.gif(6), energy.gif(4.5),  diaper.gif (2) and  IT'S A babygirl.gif!!!!  ~9/24/12~ vbac.gifwaterbirth.jpg

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#27 of 32 Old 08-14-2010, 07:36 AM
 
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*hugs* Hope that you and baby stay healthy.

Kelly (28), in love with husband Jason (38) and our awesome babies:  Emma 4/09, and Ozzy 8/10

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#28 of 32 Old 08-14-2010, 11:40 AM
 
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Keep well, stay healthy! The blood pressure and sickness would really wear me out.

I'm sort of surprised that they would do an induction for a VBAC -- I've read, somewhere, that pitocin induced contractions are harder on the uterus and increase risk of uterine rupture, which isn't what you want. But I'm sitting in a hospital now, so I guess the medical model is seeping into me. I'm also trying to come to terms with having a c-section in a few weeks' time.

Anyway, take care of yourself and baby as best you can, and get whatever help you need!
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#29 of 32 Old 08-14-2010, 11:50 AM
 
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I think I'd try to get them to do a gentle induction, if possible and if the sweep doesn't get you going. There have been several mamas over on the VBAC board who were successfully induced (but you probably know that since you cross-posted).

Good luck! I'll be thinking VBAC thoughts for you.

Wife to an amazing man love.gif, mommy to 3 wild dudes: ds1 (5/23/05 @ 30 weeks), ds2 (3/5/09) hbac.gif, and ds3 (9/26/10) hbac.gif. Part time librarianread.gif, full time mommysupermod.gif, occasional chef and maid.

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#30 of 32 Old 08-14-2010, 08:27 PM
 
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Thinking of you....I'm now in the same place but no cervical changes, so sweeping isn't even an option at this point. My recheck is Monday. Spontaneous labor vibes for us both.
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