Going past your EDD, GBS+ & sweep? Help!!

pithikaki

So I'm due Saturday, have a wonderful MW group employed by the hospital I'm delivering at, so they have full jurisdiction and it's very natural birth friendly.

Assuming I go to my appt this Friday (39w6d), they offer an optional internal and membrane stripping - they don't do any internals regularly throughout the pregnancy. 

Depending on how things go, she said they induce with Pitocin and/or Cervidil later on, but don't typically want anyone going past 42 weeks.  She also had me schedule 2 sonos because they get booked quickly, one around 41w, and one around 41w3?d to check fluid, etc.

I'm scared of a sweep/internal because I'm GBS+ and I really want to avoid the possibility of having my membranes ruptured by accident and/or increasing the risk for infection.  Also, if she does break my water by mistake, I will undoubtedly have to go to the hospital for the meds and be stuck there, and although they are very NB friendly, I am sure there is a limit to how long they will let a GBS+ woman, on/past her EDD be sitting with no or little progress and broken waters!

I don't want to rush this baby out and I've had symptoms of impending labor especially lately, so I feel like she just needs some time.  My worry is if I decline the internal and sweep and don't go into labor, at my 41w appt, will my options be even less NB friendly?

I'm truly terrified of an epidural and pitocin.  They're not pushy where I go, but I don't want to get stuck at an appointment or in the hospital and feel squat out of luck and off guard.  Advice please!

Kathzoo

It sounds like it is important to you to let labor begin on its own.  So, decline the internal.  Regular biophysical profiles and nonstress tests are good ways to ensure baby is doing well in the last weeks of pregnancy.  As long as you and baby are doing well, you can refuse an induction.  Most likely, labor will start before 42 weeks.  Best wishes for a great birth.

InfinityDreamer

If it were me I would wait until at least 41 weeks before attempting any sort of interventions, which I consider membrane stripping to be, unless there is clearly fetal distress or issues with an aging placenta.  If stripping your membranes is going to have any sort of effect it will usually do so within a day or two so at this point I don't think you'd need to rush it since you won't even have met your due date by friday.  

I don't know how exactly your practice operates but even at close to 42 weeks you should be given the option of attempting nipple stimulation, castor oil, prostaglandins gel etc before just jumping in with the pitocin to induce labor.  2 1/2 weeks is a long time, and baby could come any day between now and then.

janswedding

Well, if they do let you go the full two weeks, that is a long time to be able to just let nature take its course and allow things to happen on their own.  And chances are they will.

All the other questions are things you should ask the mw at the appt.  You can get the pros/cons of membrane stripping and find out how great the chances of membranes rupturing.  Also you can find out how long they give you after membranes are ruptured before you have to go to the hospital, and how long after rupture do you have to induce if labor hasn't started.  You can also find out about alternate induction techniques like nipple stimulation (like with the breast pump) and at what point they recommend doing those.  Also, find out their protocols for the gbs antibiotics.  I think it is just that you have to have the iv antibiotics within x number of hours before birth and you are covered.  I don't think being past your due date affects the gbs at all.

 I was gbs + with my first and they still gave me 24 hrs after membrane rupture to get to the hospital and start augmenting with meds.  And I had to get the iv antibiotics, but had a heplock so that when I wasn't actively getting gbs meds, I could disconnect from the iv pole. I also decided to just avoid internals as much as possible.

Good luck and positive labor thoughts! 

pithikaki

Thanks girls, I appreciate the advice and support.  I know they want me to come in right away if my water breaks to give me the first round of antibiotics at least.  They did say I could have the heplock and they aren't strict there at all so I would still be allowed to roam the hospital, eat, drink, etc.

I also consider the membrane stripping an induction, it just seems so common I wanted to know if it was silly of me to try and avoid it/keep it as a last resort.  She did mention cervidil, sex, nipple stimulation, castor oil, etc. and I think they do want to push those other methods before starting to discuss pit, but I also have asthma and I've read prostaglandins(sp?) might be a bad idea.

I will bring my mental list of questions on Friday and follow my gut to wait it out and think about these things/internals until 41w, at least.  Hopefully it doesn't come to that

Thank you!!

lily225

I would decline the internal and sweep this time, then, and maybe get it closer to the time you would be induced anyway. If you are going to end up in the hospital anyway to have a baby, at least it would give your body a chance to start labor on it's own (with the sweep and possible water breaking (i don't think that that's very common)) rather than going right to pitocin.

RockyMtnMama

You can always avoid the sweep/internal now and then if nothing happens in the next 5-7 days, get it then.  You might be more likely to respond the closer you are to labor anyway.