Manual dilation at 39 weeks

[Hootie]

Hello looking for advice here please as quite scared!

My obstetrician is a German Dr and I live in Australia. At my appointment today she said if I want at my 39 week appointment she can 'manually dilate my cervix' to try and start me off. At the time I thought it was the same as a sweep, but since reading some other posts I'm shitting myself! I know I can refuse, and she won't mind, but in my last pregnancy the placenta was basically knackered at 38 weeks and they said I was 'lucky' I'd gone into labour naturally a bit early.

I only had 2 VE with my last preg, and they were after my waters had gone naturally and a couple of hours of contractions so nothing really hurt at all.

Will they use 'instruments' to do this procedure? I've got bad vulva varicosities, which she knows about but has never looked at. Tbh when I did my strep swab I hurt myself a bit, and the stick is only as big as a cotton bud!

Nervous now as hate the thought of interventions like that so any advice or opinions would be great fully recieved, thanks.

Sounds a bit like a stretch and sweep to me. Definitely ask why she thinks it's necessary, and just refuse if you don't want it.

But stop googling!

Personally I would refuse. There are other ways to induce you if completely necessary or you might push for a c section depending on your own preferences. Manual dilation / sweeps before the cervix is "on its way" were extremely painful for me at 37 weeks. I wouldn't go down that road again!

I was offered to book a sweep at 39 weeks due to similar issues (as it was I went in to labour the week before).

My MW advised that as I had given birth before it wouldn't be as painful and I might well be 2cm dilated by then anyway.

If possible I would leave the worrying until the day of the appointment and see how you feel on the day.

There was a thread about manual dilation last week, if you've not read it, you should as it's not the same as a sweep.

It's done with fingers rather than instruments but is done in three 'stages'.

In the UK it's not recommended and can cause damage to the cervix. If they are concerned about placental function surely a scan would be better with a CS if there's a problem so your baby doesn't have to go through labour and birth with a restricted supply of oxygen/nutrition?

Personally, I'd refuse.

Thanks everybody for your replies. I think it's a cultural thing of dr being a bit more pro- intervention than they are in the UK. Regular ultrasounds are more the norm here, I see her fortnightly now and get a good scan everytime and she said the placenta and fluid levels are excellent. I think it was more a suggestion for my benefit of had enough being pregs! Just scared as I'm not pro intervention at all, and had a great birth at 38 weeks last time. Was obviously painful but a really positive experience.

This is a bit of a tmi question, but will she be able to feel if my cervix is in the wrong position and closed before she does any painful and potentially damaging stretching? Thank god she's petite and has small hands.....

Thanks again everyone, I love mumsnet for all those tmi questions!

Yes she will. I have had 2 sweeps and the midwife could tell me where my cervix was, whether it was starting to efface and dilate.

Thanks billybolly!

Yes Hootie she will, the question then is will she refrain from attempting to continue (along the lines of a sweep which is usually fine) or carry on and 'manually dilate' you anyway which from the description elsewhere seems to be a more forceful procedure and far less appropriate or safe.

Just an update incase anyone else is in a similar situation. Saw the consultant on thurs and because baby is happy and fluid levels good, and apart from being a total grump not much wrong with me we're going to wait another week. I'm convinced this baby is just too comfy now and researching inductions! My parents arrive from the UK on Wednesday and I really want to have had her by then! I'm such a bitch at the mo I won't be good company that's for sure :-(