11 days overdue ... feeling put under pressure by midwife/registrar who don't seem to hear what I am saying - advice please

[LaidbackinEngland]

I am 41 + 3 days today with my third DS. First DS was straightforward hospital delivery 8lb 4, Second DS was home birth 10lb 4, mild shoulder dystocia and 3rd degree tear - well healed, no further problems. Gave birth before EDD on both occassions.

I have been booked for a home birth with this DS and am keen to proceed with minimum intervention. Have declined sweep at this stage. Had to see senior midwife in hospital today for foetal monitoring. Baby fine, BP fine - no concerns. Midwife announced " we will be doing a sweep today " I declined. Put lots of pressure on me to be booked in for an induction.

My argument is that if the baby and I are healthy - why meddle at this point.

Registrar was busy, so midwife phoned me later after they had been discussing my situation and she is suggesting an elective caesarian or planned episiotomy. Which part of 'I don't want any intervention at this point' do they not understand ?

I am booked for more monitoring tomorrow and an appt. with the consultant. Anyone have any evidence based research I can have up my sleeve as I fear I will face further bullying tomorrow.

I am not a "natural birth at all costs" woman but thought I could at least go until after the weekend without interference .

Any advice welcome .

[cece]

Both of mine were 42 weeks. You are about the stage when the induction pressure starts ime. I caved in with first as I didn't know you could disagree with them. With the second DS arrived before the date I had agreed for the induction (3 days later than they wanted.)

I had a sweep with the second. It was Ok a bit uncomfortable but didn't work for me. Why don't you want one of those? Is there evidence they lead to further interventions?

[LaidbackinEngland]

Cece ...I think I would agree to a sweep on Monday... but worried that might trigger a domino effect of other interventions should it be unsuccessful .

[DarrellRivers]

I think they are worried about your previous shoulder dystocia (which happened before your EDD ) and if this baby is bigger and is growing bigger as time goes by, that is I suspect why they want to get on with things.
I don't know if that helps you at all though, but maybe having an idea where they are coming from, might make it seem more understandable.
Good luck with it all

[amynnixmum]

I had a sweep with both of mine and they didn't work for me unfortunately but even if you go for it you don't have to be pushed into anything else.

[cece]

I ate a whole fresh pineapple with my second... Contractions started wihtin the hour...

[ceolas]

I don't think a sweep necessarily means other intervention is inevitable. However, it's entirely your decision.

[rainbowdays]

I think that the reason you will find yourself being pushed to think about intervention is because the placenta can start failing by 42weeks. They would not want to risk the baby at this late stage. A close friend of mine was fine at 41 weeks - baby good etc, but they left it and the baby died in-utero because of being overdue. I don't want to upset you by saying this, but please be aware of the dangers of leaving things too long too. Also you do have to think about the situation of your last baby being big, it could happen again and the longer you leave it the bigger the baby gets and the more likely problems could arise and a c-s become necessary for the safety of the baby. It is getting less likely that for the safety of the baby that they will let you have a homebirth, when I planned a homebirth they told me that once I passed 41weeks that it would have to be a hospital birth.

I just hope that you start naturally tonight and that all this becomes irrelavent, and that you get the birth you desire.

[lulumama]

no evidence based research, but a sweep will work if you would have gone into labour within 24 - 48 hours anyway

also, it can be that your waters get broken ,which then starts the clock ticking, if contractions do not start .....

if you and the baby are fine, then why not go to 42 weeks..this baby might need to cook a little longer !

if the monitoring is fine, then don;t feel pressured

[MrsCurly]

First of all, a big hug. I was overdue with both my children and I found it a very taxing time - fed up, exhausted, and everyone tells you just to go ahead and get induced.

In the end I gave up at 41+5 and was induced. The birth was very quick and straightforward, and i wouldn't say that I regret it, but it wasn't at all what I wanted at the time and I felt very railroaded in to it. Our hospital has a blanket policy over induction at 40+7 and I had a big fight to go as late as I did.

Can you have a scan to check the amiotic fluid? This was very reassuring for me, and the hospital allowed me to go another fews days.

Sorry I don't have much other concrete advice but just wanted to offer sympathy. And luck!

[lulumama]

lots of sex will help ripen the cervix, and nipple stim can help strengthen any contractions you have

natural induction tips here

[Glassofwine]

Just wanted to say that I have had two friends who had the same experience as rainbow's friend. I really don't want to worry you at all, but having known good friends so upset I would go for full on intervention rather then any risk.

[RanToTheHills]

if you're healthy you can say no. Most hospitals will hold off till 42 weeks. I narrowly escaped and gave birth at 41 + 6 3/4 days at home! I was trying everything though - sweeps, acupressure, curries, lots of sex, lots of walking& stomping up & down stairs.
HTH and good luck.

[RanToTheHills]

i agree with LM. Had 2 sweeps, both a home, both given by mw. Don't do much for yr dignity (but little does about birth,I guess) but didn't really hurt and was vquick

[lulumama]

if the OP is having regular monitoring, which she is , then a failing placenta will be picked up on, intervention carries it;s own risks ...a healthy pregnancy can last between 37 - 42 weeks, some times 43 +

daisyMOO has some good stats re post dates babies

[morocco]

would they do a sweep at home? you know I had mine yesterday and ctx started before mw had even left! mw reckoned it usually works after 41 wks. how certain are your dates? but if you don't want any interventions it's your choice - sorry mw and consultants are being unsupportive

[DaisyMOO]

Hellllooo Lulu!

The absolute risk of stillbirth increases from 1 in 3000 at 37 weeks to 1 in 1000 at 42 weeks and 1 in 500 at 43 weeks, so the risk is still very small. Many hospitals don't routinely induce at 41+3 now as it does tend to increase the risk of cesarean and as others have said you will be offered monitoring if you decline induction (BTW NICE guidelines only state that monitoring should be offered from 42 weeks, not 41+3) To be fair though, there is no guarantee that this monitoring will definitely pick up any problems.

How was your pregnancy dated? Was it by your dates or by ultrasound? Do you think it is accurate - does it tie in with when you think you conceived?

As someone else said, the HCPs probably are more concerned because of your previous shoulder dystocia. Do you think the baby seems larger than last time?

WRT to evidence based research, I have come to the conclusion that it is useless trying to use this to persuade doctors - IME they don't change their mind and you just end up stressed. Really it's up to them to give you the evidence and the facts and allow you to make your own choice. If they tell you xyz, then ask them for the evidence to back up what they're saying. If you're not convinced and would rather wait, just say so (easier said than done I know!)

[SquareSausage]

lulumama,

please redo the link - it doesn't work for me.

i am 39 wks and getting fed up as i went nice and early with ds at 38 last time, so i know how you are feeling laidback.

hope it all kicks off for you v.soon. x

[DaisyMOO]

Here's Lulu's link

[SquareSausage]

thank you daisy, that works!
hubby way out for 3rd curry this week
bring it on!

[LaidbackinEngland]

Thanks daisy - wise words. I am pretty sure of my dates and this baby feels smaller than the last (although I'm not convinced you can tell by feeling/looking !)

The shoulder dystocia issue has only reared its head since I have been overdue ... and the midwives I have seen up unitl now have said just because I have had one baby with mild shoulder dystocia , it doesn't mean I will have another.

Think I will go and chat to the consultant tomorrow - tell him that I would like a sweep at home on monday and go from there.

Hopfully some vigorous sex tonight will start things off 'naturally' ... god don't you feel sexy when you are 41 1/2 weeks pregnant

[muppethasakitten]

Hey laidback - I think you are wise to consider the sweep after all you know. I know I was not it's biggest fan when i had mine and moaned a fair deal about it - but it seems to me it will start things off in a positive way by releasing those prostaglandins and those in turn will bring on your labour if you are within a couple of days of it starting anyway.
If you add it into all the other more natural ways of inducing labour I reckon you'd have a fair chance of it all kicking off.

If you did a quick survey of the girls on our antenatal thread who had a sweep - you don't get the impression that the ones who it worked for had more intervention than those who is did nothing for (look at me - i had one - it didn't work - a week later my waters went and i was induced!)

[DaisyMOO]

No, I know what you mean about not being able to tell the size - I was convinced my last baby was a tiddler and he wasn't!

With a bit of luck you'll go into labour soon anyway - let us know how it goes tomorrow though.

[babedia]

This link has a good explanation about the reasons (or lack of) for the policy of induction around 42 weeks:

[lulumama]

yoo hoo daisy !

WRT to size of baby, was told DD was a whopper , measured 37 weeks at 34 weeks, growth scan at 35 weeks showed her to be 6 pounds !! 7 lb 8 at exactly 40 weeks !