Any MWs around? Had a sweep (ish) but don't understand something!

[spudballoo]

I am 40+5, and saw the registrar today to start discussing induction. I am booked for a homebirth and am anxious to avoid being induced, managed to compromise at 41+13 but am desperately hoping to get going on my own!

The registrar did an internal, but wasn't very communicative about what she found. Possibly because she had zero communication skills, possibly because we'd got off to a bad start because I wouldn't accept induction at 10 days etc.

Can you help? She said my cervix was 'very posterior' which I know anyway from previous pelvic exams, so she wasn't able to do a stretch and sweep. My cervix is very soft, and short (1cm) and she was able to get one finger inside my Os. I think that's all pretty positive and are signs that things are starting to happen? Am I wrong?

I guess I hoped she'd make positive noises, or say 'Perhaps you won't need inducing anyway', but she pretty much handed me a maternity pad and turfed me out.

I feel really upset and down. I've had wonderful antenatal care with community midwives who are so so supportive of my homebirth choice, but this registrar was awful.

Spud x

spudballoo - you don't have to be induced. I had hb with dd at 40+14, and our midwives have delivered at up to 3 weeks late. They can't force you to be induced, you can request daily monitoring, though they may lecture you throughout on how you're endangering your baby(as happened to a friend of mine - if it looks like you're heading for the 13 days, request a consultant appointment, tell him you've got a long cycle, and request monitoring!

Meanwhile, have lots of long walks, and lots of sex! Hope things start happening soon!

I had exactly the same as you are going through with my most recent birth (8 weeks ago)
They tried to sweep at 40 +7 (but cervix was too posterior to even perform it) Had an actual sweep at 40 + 10 and my cervix was in the position yours was for the sweep. The MW basically said it may happen or it may not (and gave me her experiences for both scenarios)
I went into labour at 40 + 13 - the day before i was due to be induced and had the birth i wanted.
I was so annoyed that for the sake of a few days we are forced into making choices - when we have spent 9 months being told to make our birth plan etc etc - hope it happens for you

Tortoiseshell - it depends where you live and the policy of the hospital trust - i requested what you have suggested and they refused. I would have had to be induced at 40 + 14 - that was my only option

BTW - i think lots of walking really helped me to get started in the end

Tessiebear, they can put a lot of pressure on you, but legally they cannot force you to be induced! And I know what you mean about variability, even in one area it can depend which doctor you happen to see and what their particular views are.

they really bully you - and make you think you have no option - but you are right - no-one can FORCE you to be induced - i wonder if there is anyone on MN who has flatly refused??

Thanks ladies.....I know I can refuse to be induced, and if i get to the middle of next week and nothing has happened I will decline and ask for monitoring. That was the plan today but I just caved [hopelessicon]. I guess I feel I'm going to get going on my own and then it won't be an issue, keep having period pains but then nothing happens. I have acupunture booked tomorrow morning again, luckily the acupuncturist is also a senior midwife at the hospital so perhaps she can talk me through the internal notes more helpfully and give a view on whether I'm on my way or not.

I find midwives SO much more helpful! I really trust them, for some reason round here only doctors do sweeps though. Very odd.

Off to bounce on my birthing ball again. And eat pineapple, and drink RLT, and eat chilli, and stomp round the park etc etc etc.

don't fancy any sex after being roughed up this morning! I have a small cervical polyp which is now bleeding of course. Gah....!

xx

Hello Spud,
Just so you know, my sister went to 40+19 with her home birth and everything was A-OK. Since then I have noticed a lot of these stories of women going significantly post-dates and having no complications. (Not that this applies to you really because you are only 40+5, which is nothing for them to be getting hysterical about).

Most people get bullied into being induced so the statistics are probably skewed as to how well babies manage when post-dates.

You sound very clued up and strong about it though. You just don't really need the stress of this sort of thing at this time, do you? Try to focus on you and the baby and relaxing and feeling positive and just wait till you can speak to a nice woman-centred midwife tomorrow who can speak to you like you are an intelligent human being.

I was living with my sis when she was waiting to go into labour, and it was an incredibly tense time because she started to feel that with each day that went by she was more and more on her own with her decision not to induce - but she stuck to her guns in her belief that her body could do it for itself and she was right. It was so difficult for her, but really was an inspiration and an eye opener for me as I feel quite strongly now that people are unnecessarily hysterical about babies being in there for slightly too long. I sometimes wonder how much the stress of being post-dates hindered her labour beginning.

If they put pressure on you, you could try requesting monitoring every OTHER day (leaves you some room for negotiation)
and if you meet the hospital's criteria for a home birth, ie a normal, low risk pregnancy, o dodgy obstetric history) would think you would be fine. In France they calculate pregnancy as 42 weeks anyway so you'd not even be overdue if you were preg in france.

sorry- just realised thats not whast your original post is asking.

There is something called the 'Bishop's Score' which is used for assessing the favouribilty of the cervix for induction.

Various thinga are looked at and scored on a scale of 0-3

• the position of your cervix- (ie very posterior) scores 0
• The length (1cm) scores 2
• the consistency (soft) scores 2
• The dilatation (1-2) scores 1

Aslo looked at is 'station'- how far dexscended into the pelvis the baby's head is. Not sure what you would score on that but basically a score of less than five if this is your first baby indicates that the cervix is 'unfavourable' for induction (ie if they did it it wouldn't work anyway) so if you were to be induced they would give you a pessary of prostaglandin gel before they tried to induce you, to try and ripen the cervix.

If you score six or more it means that the cervix is more favourable and an induction attempt would be more likely to succeed. The maximum you could score would be 15.

Of course, you could also look at it in a different way- the more favourable your cervix is, the more likely it is that your body is actually going to do stuff by itself!

Have you tried any self help methods of getting things started naturally? Raspberry leaf tea may be worth a try, as might sex (if he comes, semen ciontains prostaglandins and if you come it releases oxytocin which is one of the hormones responsible for labour- if both- then double whammy!), nipple stimulation (either by yourself or someone else!)
Fresh pineapple is thought to have an enzyme in it which helps to bring on labour.

spudballoo- bump for you

I had success with clary sage oil mixed with vegetable oil and massaged into my bump. Of course, it could have just been a coincidence but contractions started as I was massaging.

Don't panic yet, you still have well over a week because they can start getting iffy with you, and even then, as said before - no one can force you to be induced.

For what it's worth, if it was me - I would refuse to see anyone other than a midwife before 42 weeks and then I would ask to be monitored. I have heard of people on the UK homebirth mailing list who have laboured at 43 and even 44 weeks, resulting in healthy babies.

My lovely MW has very kindly fiddled my dates - adding an extra 5 days onto my actual due date

i must be weir as i requested induction. they told me what they told you and said i was 1/2cm dialated and if i was induced id either have a very long labour or more likely end with a c/s i didnt care as i had been in "early labour" for 5 1/2 weeks and just wanted HER OUT OF ME. ended up being induced at 40+6 and had a 3 hour labour. they said that it wouldnt have happened on its own as she wasnt able to push down enough to break my waters which is what got it all going

oooh, you're all so helpful! I am already on the RLT capsules and have been for a while. Just nipped out to the chemist for clary sage, but forgot they shut on a thursday afternoon.

I wouldn't do too well on the Bishop's Score I don't think. Very posterior cervix, not dilated (I assume, when she said she could put one finger through I suppose that's not the same thing?) and presenting part -3. How is the station different from how engaged the baby is, does anyone know?

Husband is on high alert for performing his marital duty!

Baby is BOUND to come tomorrow, it's the one day I really don't want him to come as I know there isn't a community midwife on duty tomorrow night - so getting a midwife to come out ot me from the hospital is going to involve me being very very stubborn, an arguement and me refusing to budge. so this babe is bound to come tomorrow, isn't he?!!

xx

RLT is supposed to tone the cervix and uterus and help to make contractions more effective, so maybe it did work for you PC!

the station is the engagement of baby. So if it is -3 you would score 0 again i think, so only five points.

of course it isn't hard and fast, it just gives a fullr picture of how things might go if you were to be induced.

if she could get one finger through it's 1-2 cm dilated, spud.

if she can get 1 finger in then it means the size of her finger is how much u are dialated so about 1cm?

with regards to station & engagement, the less of the head palpable abdominally (eg 1 to 2 fifths palpable) equates to a lower station felt internally. This may not be entirely accurate, (its a long time since I practised as a mw) but an example would be: 4/5ths palpable abdominally would equate to a station of -3, for instance. However, 0/5ths palpable would probably mean a station of 0 or +1. The station is measured by calculating the level of the presenting part in relation to the ischial spines (bony prominances lying on the inner border of your pelvis) felt during a vaginal examination. A station of +3 means the presenting part is visible just inside your vagina & you can wave to your little darling!!