Being refused sweeps at 38 and 39 weeks for VBAC attempt

[basilbrush]

DC2 was VBAC and I had sweeps at 38, 39 and 40 weeks to maximise my chances of going into labour naturally. DC2 born the day after due date, thankfully!

Have since to other end of country and have just been told by my new hospital here(am 36+4) that sweeps should NEVER be given before 40 weeks as recent studies show that all they do is unnecessarily prolong the latent phase of labour.

They said they will only sweep a first-timer at 41 weeks and a multiparous mum at 40 weeks, but only with a consultant's permission.

I was very surprised at this as I had assumed that "early" sweeps were common practice for VBAC mums, given the dangers of induction if you go overdue.

Has anyone else been refused sweeps? It's true that I had a long, drawn-out labour with DC2 (17 hours) which I am not keen to repeat but I am also very nervous about going overdue!

All I've heard is the MWs refusing to give them if the cervix is not open (can't do it anyway). Here they won't do them before 40w, but seeing as I had 3 sweeps past my due date with both my babies, and not one sweep did anything, I find it hard to believe they prolong any part of labour - they didn't even get bloody labour started. Unless you can pay privately (could you??), you may not get one. I think the baby comes when it is ready, and the body holds on till then - sweep or no sweep. I'm sure you wont' be 17 hrs this time, good luck.

they're following the nice guidelines on sweeps OP. (although I'm not sure why they need a consultant's permission). If it's their unit's policy then going against it will jeapordise their jobs and registration, so I can understand them saying no. TBH sweeps usually work within 24 hours if they're going to work at all so why not wait until you're 40 weeks then have one every 48 hours until you go into labour? I think 1 good sweep at the right time is much better than lots of rubbish attempts to 'massage' a closed cervix.

Or make an appt to see a consultant and ask them to do one there and then.

Or have lots of lovely orgasmic sex. Or just lots of lovely orgasms on your own if OH isn't doing it for you at the moment. It does have some effect on getting you into labour and even if it doesn't at least you've got your oats.

good luck. (I am a community mw btw, not a nutcase who knows too much about sweeps)

You could try speaking to the consultant? To be fair, as the previous poster says, the midwives are following the 2008 NICE guidelines BUT i would also point out that those guidelines do not specifically refer to VBAC hopefuls. There's an implication that multiparous women are a homogeneous group, and they are not! You never know, the consultant might listen?

You are more likely to have pre labour ruptured membranes if you have a sweeep which would mean that if you didn't go in to labour spontaneously then you would be recommended to have an induction. I personally would not have a sweep before term as they also can get you contracting without putting you in to labour. I think that this is especially the case if you are hoping to have a vbac.

I would also second the orgasmic sex, also try nipple stimulation. Also although a sweep might make you more likely to go in to labour if you are overdue, it is unlikely to bring labour forward by two weeks or so, so since you went in to labour around your due date last time, there is a good chance you will this time as well. Don't stress about it, good luck

Thank you, ladies, for this advice.

I'm sure you are all right and there is most benefit to having a sweep when you are full term. I suppose I just assumed that this hospital would follow the same procedures as the last one.

This pregnancy was a total and utter surprise, both my EMCS and VBAC were horrendous really (had nightmares for 6months+ after both [SAD])

so I think most of my stressing is tied up with the fact that in around 3 weeks, I have to go through it all again!!

ah, basil, there's the rub. Sorry you had horrible labours.

are you able to talk to your midwife about it? would it help to make a detailed birth 'plan'? Not in a kind of 'I would like to have a pain free labour and no stitches', but more like 'I would like the number of people popping in to my room limited' or 'if I ask for an epidural I would not like to be counselled out of it' or whatever it is. You can't plan a birth, as you have found out, but you can certainly regain some control over some aspects of your care. If there were really serious things then sometimes pre birth counselling (ie with a proper cousellor rather than a mw) can be helpful. Or, of course, there's MN! Is it something specific that is worrying you?

Hope you can find something to help you feel more relaxed going into it.

Interesting about the differences in location! I was offered a sweep at 38+6 by the consultant, as I'm also trying for a VBAC. It didn't work anyway, she couldn't reach. The community midwives here aren't allowed to do them without the consultant's say-so until you're 41 weeks, but the consultant's said I can have another today at 40+1.

whatinthewhatnow

DC1 - was 28h of labour (attempted homebirth) before leisurely drive to hospital for failure to progress as only got to 4cm. Placental abruption as we pulled up at the hospital, followed by crash section 10 minutes later. It took me a VERY long time to get over the guilt of having tired to birth at home and the "What ifs". Luckily, DC1 was fine, in SCBU for a week and only 5lbs at 41 weeks but fine in the long run.

Most people agree that that is pretty stressful! However, my VBAC was "textbook" and so should not have resulted in the emotional trauma that it did. I think that I was so scared by the previous birth and so terrified by the pain of the contractions that I really slowed things down with fear and adrenaline and screaming myself hoarse. I was 100% out of control for the last 3 or four hours, like a wild animal.

DC2 - 17 hours labour (pretty standard for first vaginal deliveries)

• totally drug-free but only as G+A which I been really hoping to use made me sick
• no forceps etc, pushed out baby on own in 45 minutes, 2nd degree tearing.
• Healthy 7lb baby, discharged next day.

So I was " very lucky". And I honestly spent the second half of the birth thinking I was going to die, I was so scared. A whole year later, I was referred to gynae consultant as sex was so painful it was impossible. At first, they thought they had "sewed me up to tightly" but then decided the problem was psychosomatic and sent me home with an array of plastic willies to "practise with". I felt like a total freak and a failure and it was another 6 months or so beforE DH and I finally got back on track in the whole nookie department. (Poor guy!!)

Anyway, sorry to ramble! This has very little to do with my OP

basil, don't think that just because your second labour was a success on paper that you shouldn't feel crappy about it. 'normal' labour can be incredibly frightening. I found my VBAC (3.5 hours, normal delivery 1st degree tear, home in 4 hours) beyond description in terms of pain and fear. Had I had the problems you had with your first birth and then afterwards, or a labour which lasted as long as yours, or not been able to have gas and air then I'm sure I would have been as traumatised as you.

It goes without saying that you are not a freak or a failure.

Has anyone been helpful in terms of talking to you about the next birth?

I was planning to talk to a midwife about it but now Birth Stress has been bumped down my list of worries! A growth scan yesterday at 37 weeks showed some patches on the baby's bowel which could be nothing at all or could be a Downs / CF marker

So now am obviously very worried about birth but for different reasons!

But thank you for your understanding message!

oh gosh, I hope it all gets sorted soon. Good luck with it all basil. x