Mumsnet Talk

That article posted by Starlight is nearly a decade old!!! I wouldn't rely on that personally. I personally see a stillbirth where no cause can be found as a "baby born to late", I would much rather be induced than face that. But I echo the other posters saying that she should feel able to decline the sweep, or perhaps ask for an antenatal clinic referral to talk things over e.g. what are the risks with having a sweep, how likely is it to lead to a sluggish start to labour and if it does, what else can they do to help get things going if you wanted that?

Rather debatable, Starlight. The article you cite has a few, ahem, interesting ideas, maybe not a great surprise from someone who isn't a midwife in the sense that we would use the term in the UK. And while what she wrote about lack of evidence may have been true in 2004 (I don't know) we do have some better stats since then. Some more recent stuff just found quickly, I saw something in the BMA too but can't seem to find it now:

http://www.ed.ac.uk/schools-departments/medicine-vet-medicine/news-events/all-news/births-140512

US stuff:

http://download.journals.elsevierhealth.com/pdfs/journals/0002-9378/PIIS0002937808005589.main-abr.pdf?jid=ymob

This isn't the BMJ thing I was thinking of but is relevant to Sky's post:

http://www.bmj.com/content/346/bmj.f108/rr/630969

The problem is that you tend to trade reduced mortality for increased morbidity, that's what makes this very complex. Stillbirth rate gets much higher after 41 weeks but induction before that carries higher risks of admission to intensive care for baby. Additionally many women find it a pretty awful experience. Probably most of us would accept that in return for a reduced stillbirth risk, but nonetheless mother's physical and mental health matters too.

And yes, there is some suggestion that the risks aren't uniform across the population. Some women also seem to have placentas that can last a bit longer too- some people's are totally calcified and friable after only 41 weeks, others are still fine at 42 weeks.

www.midwiferytoday.com/articles/timely.asp

This is interesting

sorry by the "poster above" I meant StarlightMcKenzie, I couldn't get my computer screen to show me your name as I was typing

Hi! I wonder how old the original poster is? The Royal College of Obstetricians are apparently considering inducing mothers of 40 years and above at 40 weeks, because of the increased risk of still birth in this age group, here is the link:

http://www.rcog.org.uk/news/rcog-release-induction-labour-older-mothers-may-reduce-risk-stillbirth-say-experts

I am not sure the above link directly goes against what the above poster said, but it does add another thing to think about (that certain groups appear at higher risk of still birth as the weeks go by towards 40 weeks)

there is no statistical increase in risk until a pregnancy reaches 42 weeks and no significant risk until past 43 weeks

It's a difficult one because obviously the stillbirth risk is much higher after 41 weeks, but most people really want to avoid induction if possible too. You could attend the MW appt on the day you're due to have one anyway and see what she says. I had an appt on due date and had been offered a sweep but not decided what to do, as I was scared of both sweep and induction. MW said there was no point as the baby was going to arrive very soon, probably in 3 days, and she was exactly right. So it could be a good idea to ask if they can give you an idea how long baby might take if left to her own devices. You can decide then what to do.

I had a sweep without consent. I believe it led to a cascade of interventions that cause my ds' autism.

Why would you want to go into labour before your body is ready anyway? Apart from the risk of infection, risk of waters breaking etc. your baby could not yet be in an optimal position and your body may not have stocked up on the energy and hormones required to make it a smooth process.

With dc2 and 3 I refused a sweep. With dc3 it was a bit of a issue as I went 12 days overdue and the midwife didn't like it much, but she doesn't have the power of arrest, nor restraint so it was a bit tough really. (turned out she attended my birth and she was absolutely fab, I think mws can be really supportive once they get over the shock of someone doing things a bit differently).

Thanks everyone, I finally had ds at 40 + 8 so not massively overdue but was very knackered and scared as was first time.
If they don't do it till 41 weeks in 2nd pregnancy ive more chance of avoiding the issue this time round, i'll certainly refuse until 41 weeks anyway, certainly don't want to be induced as its painful enough!!
Mumsnet is so useful, I would never have questioned any of this before.

scrumpkin I agree would have 100 sweeps - no, 1000 rather than syntocinon drip! If we are lucky enough to have DC3 I would have a sweep again if overdue but would do anything to avoid that induction drip.

onlinelibrary.wiley.com/doi/10.1002/14651858.CD000451.pub2/pdf/abstract this may help.

It is very important to realise that you can refuse all interventions/treatment (I do tend to come down on the side of life saving procedures but have known of a Jehovah's Witness mother and baby who died as she declined a blood transfusion). Consent should be obtained and documented, don't just go along with something if you do not fully understand the risks and benefits - as a responsible adult I believe this is your responsibility as well as your care givers. Membrane sweeps are a really difficult one as NICE recommends them at 40 & 41 weeks for first time mums (primips) and 41 weeks for subsequent pregnancies (multips) however, we have no idea who would have gone into labour anyway without a sweep do we? I personally do not favour them for primips at 40 weeks as anecdotal evidence (as on this thread) seems to point to a long latent phase and subsequent exhaustion when 'true' labour starts. I'd agree to one at term+10 to do all I could to avoid induction but probably not before. Good luck.

This is relevant for me as I'm due to have a sweep next Wednesday if this baby doesn't get her boots on! I'm in two minds - with DS I was in slow labour for ages and going in to get checked sped things up fantastically. This time around I'm getting cramping and BHs a lot but no labour as such and I'm wondering if a sweep will just kick it over the edge. With any luck I'll have a baby in my arms by Wednesday but if not then I might consider it. Hmmm...

You can refuse anything you like, be that a sweep, or being induced. Don't let them do anything you don't want done!

You can and you should. Proper pain avoided now can keep your spirits up for the real deal waste of time, had 2 and then a week of agony, c sec eventually.

I refused a sweep with dd2. Baby comes, when baby comes. Dd2 was 3 days late.

Dd1 was 3 days early, so no sweep offered, and I still would have said no.

Mixed results then, I didn't find the sweep painful itself, gah hope this one just comes on time and can avoid the issue altogether! !

Yes of course you can. I had three, none worked, they didn't especially hurt but the bloody goo coming away confused matters and disguised the fact I had mecomium in the waters when I had to have ARM. That said a lot of people get really great results from them.

A sweep only "works" if you are about to go into labour naturally. So pretty pointless really.

You also able to refuse an induction.

I had about 4 sweeps with my first and ended up being induced.not good.

With my 2nd hadd a sweep ad 10 days overdue and delivered that night.

I would take a sweep (or 10) above syntocin.

Of course you can refuse. But a sweep worked for me in 2nd pregnancy. Didn't have one with first baby. Midwife says more likely to work in 2nd and subsequent pregnancies. Of course maybe I was going to go into labour anyway......

Yes! I wouldn't have a sweep again (although I am very unlikely to ever need one, lol!) Not because it hurt, but because it just didn't work, and gave me mild period pains the next day.

You can refuse any procedure or any test. It's your body and your baby. I wish I know that when I had my DS. My midwife gave me a sweep without my consent.

Mine hurt like buggery and I bled a lot. Refuse, refuse, refuse.
Good luck <flower emoticon can't do on phone>

Yep , I did and actually when I said to my mid wife I wasn't keen she said ' it is very painful and is no guarantee it will work so don't worry if you don't want to!' My gorgeous ds2 was born exactly 24 hours and 1 minute before I was due to be induced!