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What's the point of offering a stretch and sweep?

(9 Posts)
Miffster Thu 09-Dec-10 17:20:40

I don't really get it; either your cervix is opening up/effacing of its own accord and getting ready (in which case, leave it alone, and stop risking introducing an infection, surely) or it isn't ready - in which case, leave it alone and stop risking introducing an infection, surely?

I have a mw appointment on Tuesday 14th December, which is my due date and I am sure that I am going to be offered a sweep. Even though she knows my views about VEs and not wanting them.

As I will only just be 40 weeks I have no intention of accepting it. But 14 days after DD - when I'm 42 weeks - is 28th December. Am I likely to get badgered to be swept and get labour going before Christmas, on the grounds that if I want to be monitored, the hospital won;t be able to offer me that monitoring over 24th - 26th December, because of Christmas?

me23 Thu 09-Dec-10 17:33:40

Membrane sweeps are offered from 41 weeks in a primip (first baby) or from 40 weeks in a multip it is an attempt to induce labour without having to actually go down a medicalised induction route with prostadglandins or syntocinon, of course it is each woman's choice whther to accept or refuse any intervention.
Hosptials esp maternity units do not close over the xmas period they still operate as normal it is a 24hr service after all so I don't see why if you choose expectant monitoring they won't be able to offer it to you.
Anyway if you are 42 weeks on the 28th it doesn't matter anyway as xmas will be over. you don't need to be monitored before then as up 42 weeks is still term.
from NICE guidelines: From 42 weeks, women who decline induction of labour should be offered increased antenatal
monitoring consisting of at least twice-weekly cardiotocography and ultrasound estimation of
maximum amniotic pool depth.

Miffster Thu 09-Dec-10 17:53:45

Thank you very much, that has cheered me up

CisforCookie Thu 09-Dec-10 18:07:28

Sorry to hijack your thread, but you both seem knowledgeable on this subject!

I'm 41+1 today and have had a sweep this afternoon, which I didn't have a problem with. However I am booked in to be induced next week - there hasn't seemed to be any question of it NOT happening (should it be necessary, hopefully things will happen before then!). Induction seems to be a formality that just happens at 42 wks as a matter of course.

How does expectant monitoring work? Are there higher risks to the baby after 42 wks or is induction just a convenience thing? I don't feel very confident in refusing to be induced, but really am not keen on the idea for many reasons.

Miffster Thu 09-Dec-10 20:17:21

Cookie I'm reading this thread, hopefully someone will be along in a bit to talk about expectant monitoring ( I am expecting DC1 so don't feel qualified to give advice, just want to be as fully briefed as I can be)

Dreemagurl Thu 09-Dec-10 20:29:33

Just wanted to add that it's YOUR choice whether or not to have a sweep, no one can force you. I was 10 days late and had an induction booked and was so grateful for the sweep which kicked things off and enabled me to have a natural unassisted birth. Obviously it's different for everyone but wanted to share a positive MS experience. Good luck!

me23 Thu 09-Dec-10 20:41:46

cisforcookies, you're right a lot of things in childbirth and pregnancy are simply presented as "this is what is going to happen" rather than "this is what we off and why and it is your choice to decide what you want to do"! A lot of women do not actually realise they have a choice in whatever they want to do.

research has shown that after 42 weeks the risk of stillbirth rises from 1 in 1000 to 2 in 1000 (however this is still a very low percetage) this is because the placenta begin to age after 42 weeks and in some women it fails to provide enough oxygen and nutrients to the baby.

However at this time it is impossible to predict exactly which women are at particular risk, a british study has suggested that woman of south asian origin are more at risk of stillbirth due to prolonged pregnancy than white women are.

After 42 weeks any woman declining induction should be offered 2 weekly ctg monitoring and also a weekly scan which will check fetal wellbeing, the depth of amniotic fluid and the functioning of the placenta. This obviously does not prevent stillbirth as it can happen at any time unfortunately but it can pick up on signs of distress or low fluid.
This page although focusing on homebirth has some good info www.homebirth.org.uk/overdue.htm
also there is the full NICE guideline for induction of labour which contains LOTS of info www.nice.org.uk/nicemedia/live/12012/41255/41255.p df

Miffster Fri 10-Dec-10 09:25:27

Cheers ladies. well, I've just had a bloody show and am having period pains round the lower part of my bump and lower back, so hopefully will not need to have sweep. Fingers crossed.

CisforCookie Fri 10-Dec-10 10:23:06

Thanks for the advice, will check out the other thread now - and good luck Miffster!

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