[~PurityLake~]

With my last pregnancy I was seen by midwives. The midwife recommended and did (with my consent) strip my membranes on my daughter's due date. She said it would help things along if they were supposed to. It started contractions right away. Although not close enough to be termed active labor. Just enough to keep me from sleeping well for two days. The same midwife strong-armed me into letting her break my water after those two days.

This pregnancy, due tommorrow, I have once again been urged to have my membranes stripped, but for different reasons. The reason given is since I'm having a VBAC, they cannot induce me for risk of UR, so if I reach 42 weeks I will get a c-section. They say, to avoid this, I may want to consider having my membranes stripped. This was offered at my 38 week checkup, but my cervix wasn't dilated at all, so she couldn't, which saved me from having to make a hasty decision. So I thought about it and I guess they convinced me, because I was all set to let them do it at the next checkup. Last monday, at my 39 week checkup, I was only dilated a half cm, so was once again unable to have it done. I am obviously afraid of a repeat c-section. Since my 40 checkup is at 8 am tommorrow morning, I may have to make that decision. I haven't had any serious contractions at all. But I was just reading a thread about artificial induction, and people there seemed concerned about stripping membranes, and here I thought that wasn't so bad, especially compared to breaking the water.
Could someone maybe tell me their thoughts? I've heard both sides about risk of infection with stripping membranes, some say yes, some say no risk.

 

[~PurityLake~]

I just wanted to add that I'd be very interested if someone had some facts, or a website with facts, covering the pros and cons of having membranes stripped. I'd really appreciate it. Thanks.

 

[hippiemom]

Sorry I don t have website references for you, but stripping the membranes carries the same risk of infection as when anything is put into the birth canal.. a midwife who is trained and conscientious will use a sterile glove, etc. As far as the invasiveness, yes that is a factor, but far less risky for you than say, cytotec and pit. I like that it can only be done when the cervix is really starting to be soft and open, showing that labor is near (before real labor starts) as opposed to medical methods that are applied when the body shows no signs of readiness for labor. I agree it is not the best situation, as would be spontaneous labor, but if it gets you started and avoids c sec then it is the better choice comparitively.

And many women I see as a doula do not have their membranes stripped and still manage not to sleep well during the couple days of cramps, prodromal labor, etc that lead to active labor. That just happens, not necc b/c of stripped membranes.

Good luck and good birth!

 

[~PurityLake~]

Thank you hippiemom. I appreciate your input. It does make me feel like I have an option to avoid c-section. I have also been taking EPO and was 40% effaced the last two visits, which means my cervix is softening some.

Anyone else have any thoughts?

 

[~PurityLake~]

Well, I had my 40 week checkup. My cervix was only dilated to 1 cm and so I didn't have to decide on whether or not to have my membranes stripped. I'm glad, since I still don't know what I want to do.

 

[alegna]

I would not agree to it without medical reason to induce. Being 40 weeks (or 42 weeks) is not a medical reason. Babies come when they're ready. It's really easy to (accidentally or not) break your water when stripping membranes.

FWIW I wouldn't agree to a section because of dates either.

good luck!

-Angela

 

[~PurityLake~]

Quote:

Originally Posted by alegna I would not agree to it without medical reason to induce. Being 40 weeks (or 42 weeks) is not a medical reason. Babies come when they're ready. It's really easy to (accidentally or not) break your water when stripping membranes. FWIW I wouldn't agree to a section because of dates either. good luck! -Angela

Does that mean I don't have to agree to c-section at 42 weeks, even though that is the hospital policy?

 

[alegna]

Of course. You have absolute rights over your body. Hospital policy or no, you have a right to decline any medical procedure.

-Angela

 

[boscopup]

Quote:

Originally Posted by Abi's Mom Does that mean I don't have to agree to c-section at 42 weeks, even though that is the hospital policy?

If you don't show up, they can't cut you open.

And when you do go into labor, I'd wait as long as physically possible before going to the hospital, so if they try to pressure you with C-section, you can remind them that the baby is going to be out in a few minutes anyway.

It's sad that they're trying to do the same interventions that it sounds like caused your first C-section? Stripping your membranes and then breaking your water because you're only a couple days past due date? That's just not good midwifery, IMO. It's an *estimated* due date, not an expiry date. And now you don't even know if you're likely to go 41 weeks or what... you didn't get the chance to find out last time! You may very well go on your own before 42 weeks. Remember that those dilation checks mean NOTHING. I'm not planning to have them done at all, because they really don't say anything about whether you're going into labor today or next month! Also, know that some care providers will strip your membranes without your consent during one of those dilation checks. I think it's highly unethical of them to do that, but it's happened to many women here on MDC. So be very careful!!!

 

[GooeyRN]

I would suggest not having them stripped. My OB stripped mine w/o my consent.

I was only 37 weeks gestation according to my period, 35 by ultrasound.

2 days later I had my bloody show and then 3 days after that my water broke and I had my baby. She was low birthweight, and showed signs of prematurity. Cervical exams are not needed, but if you consent to them, inform them if you do NOT want your membranes stripped. Some just do it w/o even asking. (like mine) BTW, I did not get an infection and it was only a bit uncomfortable, not painful or anything.

 

[~PurityLake~]

Quote:

Originally Posted by boscopup If you don't show up, they can't cut you open. And when you do go into labor, I'd wait as long as physically possible before going to the hospital, so if they try to pressure you with C-section, you can remind them that the baby is going to be out in a few minutes anyway.

I like that suggestion. I do have a doula and a birth plan this time. I have been told to wait until I've been in labor, and think I'm at least 4 cm dilated, and contractions have been 2-3 minutes apart before I even call the hospital.

Quote:

Originally Posted by boscopup It's sad that they're trying to do the same interventions that it sounds like caused your first C-section? Stripping your membranes and then breaking your water because you're only a couple days past due date? That's just not good midwifery, IMO. It's an *estimated* due date, not an expiry date.

Since I'm being seen on the military base, I've been seen by about 10 different people, RN, midwife, Dr, etc. They mostly seem to be supportive of my decision to VBAC, especially Dr. Douglas Leech. She was really irked about how the midwives and doctors treated me with my first delivery. But sometimes, like with Dr. Ellengerger last week, I feel as though my desires don't matter. I posted about this on another thread. She was just so insensitive.

Quote:

Originally Posted by boscopup And now you don't even know if you're likely to go 41 weeks or what... you didn't get the chance to find out last time! You may very well go on your own before 42 weeks.

Yeah, I feel like I don't have any idea what to expect from my body even though I've delivered a baby already. It feels like another 1st. I never dilated past 4 cm with Abigail, so I don't even know what it feels like to be in active labor. (That's a bit scary because whatever labor I was in, for 42+ hours was the most painful and exhausting thing I'd ever experienced... until the c-section recovery).

Quote:

Originally Posted by boscopup Remember that those dilation checks mean NOTHING. I'm not planning to have them done at all, because they really don't say anything about whether you're going into labor today or next month!

I was beginning to wonder if there was even any point to having my cervix checked. It seemed all it did was make me expect something, and then be disappointed there hadn't been more progress.

Quote:

Originally Posted by boscopup Also, know that some care providers will strip your membranes without your consent during one of those dilation checks. I think it's highly unethical of them to do that, but it's happened to many women here on MDC. So be very careful!!!

That is just scary to think of that! Just the possibility that something would be done to my body WITHOUT my consent makes me not want anyone going anywhere near there.

 

[~PurityLake~]

*oops accidentally posted the same message twice.

 

[~PurityLake~]

Quote:

Originally Posted by GooeyRN I would suggest not having them stripped. My OB stripped mine w/o my consent. I was only 37 weeks gestation according to my period, 35 by ultrasound. 2 days later I had my bloody show and then 3 days after that my water broke and I had my baby. She was low birthweight, and showed signs of prematurity. Cervical exams are not needed, but if you consent to them, inform them if you do NOT want your membranes stripped. Some just do it w/o even asking. (like mine) BTW, I did not get an infection and it was only a bit uncomfortable, not painful or anything.

From what you and the pp have said, about the possiblility of unconsented stripping of membranes, I don't think I even want a cervical exam anymore. Besides, I guess I don't see what 'info' the exam provides, if it's even helpful to know any of that. I think it just makes me worry, and is very uncomfortable.
FWIW, everyone there always washes their hands and wears gloves before doing a cervical exam. Only one of them was gentle enough that it didn't hurt. The last person, at the end, said 'did you feel that?, I pushed the baby's head'.

 

[lyttlewon]

Quote:

Originally Posted by Abi's Mom From what you and the pp have said, about the possiblility of unconsented stripping of membranes, I don't think I even want a cervical exam anymore. Besides, I guess I don't see what 'info' the exam provides, if it's even helpful to know any of that. I think it just makes me worry, and is very uncomfortable. FWIW, everyone there always washes their hands and wears gloves before doing a cervical exam. Only one of them was gentle enough that it didn't hurt. The last person, at the end, said 'did you feel that?, I pushed the baby's head'.

At 41 weeks my doc tried to. She was feeling around and goes, "you are carrying so high I can't reach your membranes. I was going to strip them but I can't". As we left my mom says "You realize she was trying to strip them without even telling you".

:

 

[wrzos]

A little off-topic... I refused an induction for being past-due, and while it certainly wasn't a c-section, I was made to feel I was crazy, putting my child at risk, etc. In fact, I was made to sign a statement that said in effect that I was going against my dr's wishes, and realized that I could end up with a stillborn child as a result. They were convinced he was "done" and needed out. I'm glad in retrospect I held firm - but the emotional pressure I was under was EXTREME.

So, I guess in summary, if you feel like you might like to decline a recommended C-section - have your support system in place, be confident in your decision, etc. You certainly don't want to have personal doubts in addition to all the guilt your dr/hospital will most certainly heap upon you.

 

[aniT]

Well not knowing there was anything wrong with it, I asked my midwife if she would strip mine, she pops her head back up and said, I already did!

She still did it without telling or asking me, even though I asked her to after the fact. So I guess that still counts as doing it without concent.

She was going to induce me if I didin't have the baby by Monday because she was huge; well over 9lbs. My water broke on it's own at 12am (6 hours before induction) and my baby was born on the 12th at 8lbs 3oz. She was DUE on the 17th.

 

[Tori Gollihugh]

I wouldn't prefer this method. That's mostly because I HAD it and it caused my waters to rupture early and the pain in my belly and the pain of contractions was indistinguishable... my uterous was VERY tender. Anyway... my midwife swiped when I was 11 days late, which sent me into menstral camp like contrax and then progressed over night into labor. So, I guess, if I were in your situation (in that I was being pressured to 'naturally' induce) and had my experience, I might consider the swipe close the the two weeks overdue mark. Maybe ask the for an appointment on the 12 or 13th day over due at which you'll let them swipe if you haven't already started labor on your own.
JMHO

 

[huggerwocky]

Quote:

Originally Posted by Abi's Mom Does that mean I don't have to agree to c-section at 42 weeks, even though that is the hospital policy?

What are they going to do then? Physically override you?

 

[aniT]

Quote:

Originally Posted by huggerwocky What are they going to do then? Physically override you?

Unfortunatly it is not un heard of for doctors to get a court order to force pregnant mothers to get C-sections.

 

[jgale]

Here's a link to a summary of the existing research on membrane sweeping at term:
http://www.cochrane.org/reviews/en/ab000451.html

I find the cochrane database to be extremely useful in teasing out what the research says from people's (including my own) anecdotal experiences.

I found it interesting that they say that compared with no sweeping, doing sweeps weekly from 38 weeks on, there were fewer women who went past they due dates, and no increase in infections.

I think you should do what you are comfortable with. I never sweep anyone's membranes without asking them first. I had it done at 38 and 39 weeks with my first and will again with the pregnancy.

Good luck with your birth!

Jessi