An ignorant question about sweeps and inductions and all that stuff

[MPuppykin]

Hi, this may be an ignorant question, but I genuinely am curious and very willing to be educated.

I have been reading some of the threads about various forms of inductions and sweeps and the crochet hook and all of that sort of thing, and what I keep hearing is that often it results in labour or contractions that are even MORE painful for the mother, or a birth that is more difficult because the hormones have not kicked in. Why then are they performed- it seems almost routinely - if you go over the due date? Isn't this rather barbaric? Is it for the convenience of the medical personnel? What really is wrong with just letting a mother go over term, if the baby is happy and it is just not ready yet? I have been a little worried about this, because due to work travel at the time we were TTC, I know that I was likely to have conceived some two weeks at a minimum after the doctors have estimated based on the last period. I am a bit worried at being told that I have to get things going if neither I nor my baby are ready. (In my own case, some 40 years ago, I was induced just over three weeks before the due date because my mother's obstetrician was going on a golfing holiday. That is in family folklore now. My mother at 21 was too young and in awe to question it. ) It just seems from what I read on MN that sweeps etc are normal, and I am just confused by it.

I'd be most grateful for any insight offered!

you can refuse a sweep

i am not sure about inductions tho'

I questionned my midwife about this and, in our area, they let you go 2 weeks over your due date before doing sweeps and inductions.

However, I felt very strongly that I didn't want to be induced so I told her I wouldn't consent to this unless there was a medical necessity. She was very supportive and said that if I did this they could simply monitor me every day to check all was OK.

In the end I only went 2 days over so it was all academic. But there does seem to be a tendency to "get things going" for no good reason. And also to speed up slow labours.

Good story from my hypnobirthing book - mother refused a drip to speed up her labour, midwife said "You'll be here all day and night", mother said "That's OK. I haven't got anywhere else to be"!

I think they like to induce, although it depends on area, because after 2 weeks it does get cramped in there and the placenta stops working so well because of the larger baby that you will be carrying.
Better off asking a medical prof though....

Happywheezer - yes I understood that it is about the placenta deteriorating but I wonder what the statistics are for that happening in view of the discussion regarding the accuracy of due dates and that France thinks that pregnancy goes on for a week longer than the UK does? (seen that on another thread, hope I am quoting correctly).

Thanks for replies. Very interesting indeed. Hoping more MNers weigh in as well. I have mentioned to my MW that I am really against the idea of an induction, specifically mentioning the due date issue, not sure if it registered though.

Girlynut... the quote from your book is interesting..... especially as I thought some labours are supposed to go all day and all night on occasion!

Hi MPuppy, i understand that the reason for being inducted after 2 weeks is that the longer you wait after 2 weeks the more increased the risk there is to your baby due to the placenta becoming less and less efficient at being able to supply the correct nutrients etc to your baby. I do not think there is any way for doctors to know whether your placenta is becoming less efficient or not hence the reason they are keen to induce after two weeks. Another reason is that babies can continue to grow and so be much bigger and more difficult to deliver. All my family have been over 2 weeks overdue and have had 9lb plus babies.

I was induced and i have to admit it turned out to be a very long process so i can fully understand your apprehension. I had an epidural after 26 hours as i was only 1 cm dialated and i knew that once they gave me the drip and broke my waters my contractions would get worse and after 2 nights of no sleep i had had enough. Saaying that though i would definately make the decison to be induced again though for the reasons i have stated above even though the risk is quite minimal. They cannot force you to be induced. I would say just make sure you understand all the facts and make a decision you are happy with.

Good luck x

Hi, just weighing in with my experience, DD1 arrived at 40+6 according to dating scan but at exactly 40 weeks according to my LMP and cycle calculations (obv this was not the date the maternity unit were using).

My waters broke and nothing happening after 24 hours I had syntocin drip to get things moving.

Apparently my placenta was very gritty and "at the end of its life" and DD was not overly big, 8lbs 5oz.

But I have heard someone on here say they delivered at 42 weeks and their placenta was in tip top condition.

So on that basis, I will take my induction at 40+10 this time due to previous experience. I would hate to think placenta wasn't doing its job!

Don't know if that sheds any light

MPuppykin,

This is something I have been a bit worried about too. I am having my first baby in Cyprus and it seems to be the norm here to get the baby out on time. From what I have been told, they don't let you go overdue at all. You are brought in on your due date and induced and if that doesn't work...it's a C-Section!
The reasons they give for this are first of all, they don't like to deliver big babies as it's an increased risk for the mother (and apparently, us British ladies have big babies! ), and secondly, the placenta becomes less efficient. You can see it breaking down on a scan apparently but they cannot tell exactly how much it is affected.
Neither an induction or a section seems terribly appealing to me so I am hoping and praying that the baby hasn't inherited my terminal lateness!

The risk of stillbirth at 37-40 wks is 3 in 1000, and 40-42 weeks is 6 in 1000 (I'm not 100% sure of these stats - my postnatal memory is very fuzzy, but the risks are very small) so by inducing you before 42 weeks they are cutting the risk by half. Normally such small numbers wouldn't be thought of as particularly risky but given the catastrophic consequences, it's thought to be worth intervening so most hospitals have this as 'policy'. However, this should be explained to you (IME it isn't) and you can make a choice based on the cold hard facts. Try looking up NICE guidelines on induction and it might say there.

I refused induction for DD2, believing my dates to be later than the scan dates and also trying to avoid another emcs. Basically, no-one can make you do anything you don't want to do. As long as they are happy that you are aware of the risks, they should be fine with it. I had extra scans after 41 weeks to check that there was still enough amniotic fluid and that the blood flow through the placenta was still good. However, I did have 3 sweeps to try and hurry things along because I was over dates with DD1 and I really wanted a vbac. If there was any concern from any of the scans they would have given me an elective cs. I hadn't heard about the sweeps causing stronger contractions thing. In the end, DD2 was born at term+16 after 3 nights of contractions that dissipated during the day. She had the cord around her neck so was in distress, so was an instrumental delivery but a superb outcome for both of us compared with DD1's birth.

I asked the consultant midwife at our meeting what the longest gestation our hospital had had and her answer was 44 weeks , however this was before dating scans so there was some doubt about her dates. Basically, everyone goes into labour eventually but hospitals are in the business of trying to make sure there is a live baby at the end of it.

Thank you everyone so much for your replies, I am very grateful indeed. I shall look up the NICE guidelines and will make sure that I ask, ask ask if anything is suggested to me. That has been really helpful. 

That last symbol was meant to be a smiley emoticon!

I wouldn't want to be medically induced but will be asking for a sweep every 3 days from 40+7 if I go overdue - ie at 40+7, 40+10 and 40+13 - would be induced at 40+14.

Sweeps are slightly uncomfortable but don't last long and if they work you just go into labour naturally... I don't see the downside providing you don't have one until a few days before you are due to be induced.

If you are confident of your dates then discuss that if you are late by their dates (likely if its a 2 week difference) - did you have an early scan? - also they can scan the placenta to see what sort of condition its in. I would not agree to be induced until 2 weeks after my dates.

re: ARM (crochet hook) - if I did need to be induced I'd opt for that after the pessary and before a drip because with ARM & pessary you can still be mobile and move around and have an almost natural labour.

i was slightly horrified when i was asked whether i wanted a sweep at 38 weeks!!! i refused and if things dont get moving i agreed to have one at 40+8
not sure why they are so impatient to get babies out... it is not as if they are carrying them...