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Natural Birth
mistresscox
member
To strip membranes or not? (long)
mistresscox
member
I will try to keep this brief, but since I'm more of a lurker and not a poster here I will give you some background first.
I had a c/s with my DD because I had such severe hyperemesis that I was severely dehydrated and she was in distress. 
She came 4 days early after me not being able to even keep down water for about a day and a half.
Fast forward to this pregnancy-much different story (thank goodness!). All in all it's been a really healthy pregnancy and I am a GREAT VBAC candidate. I have a very supportive OB (she's had 2 VBAC's herself) and a previous L&D nurse as my doula. This time around I've had more u/s because of last time (DD had IUGR we had no idea about) and every one has been perfect-estimating a 7 lb baby (perfect!) so no problems with size or fit. When I sat down with my doula and did my birth plan we had decided no stripping of membranes, and OB supported that. She said she actually usually doesn't do it because she hasn't seen enough evidence that supports that is consistently works and instead just opens things up for infection. Great. 
Plus we all expected me to go into labor right around my due date since DD came a few days early and usually second time moms go sooner than the first.
However, now I'm a week overdue and I'm starting to rethink this. Because I'm a VBAC I can't/won't have pitocin or cervadil induction-so basically no medical induction. I've been doing natural induction methods since last Friday (2 days before due date) with nothing. As of Thursday I'm still 0 dilated (she didn't mention my effacement and I was too upset to ask). I go for an appointment on Monday, and again on Thursday to check on baby. If no baby by Thursday they will schedule me for a c/s the following week (I'll be 42 weeks by then). I am debating asking for her to strip my membranes at the Thursday appointment even though I've not been on board with it before now. But I sort of feel like it's worth a shot if it keeps me from having surgery!
IDK-I just need some feedback. At this point I'm so hormonal and exhausted that I can't really think things through clearly and I just need some outside opinions to chew over.
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Re: To strip membranes or not? (long)
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I think you have to weigh the risks associated with doing a membrane sweep against the risks of a c/s. I took a quick scan through google scholar and couldn't find any information on how often infection does occur due to a sweep -- lots of studies mention it as a risk, but from the ones I looked at, it was never mentioned that any of the subjects ever got an infection. So... I'm not sure what the actual risk factor is (most likely it's really low if few to no studies mention it). Maybe ask your OB if she knows? However, if you are GBS+ that might change things.
The way I would approach it (and probably will if I start getting into mid-41-week) is that a membrane sweep with a (most likely very) low risk of infection is better than me being induced - or in your case, losing the option for a VBAC. You've tried other methods to ripen your cervix and get baby moving, and so far it's not working. I guess I would look at it in the "what else can I do?" light. Kind of as in the next step up. (Think - EPO/walking/sex/etc. is the lowest level of "intervention", followed by a membrane sweep, followed by [insert other slightly invasive techniques here], followed by a foley bulb, followed by cervadil, followed by pitocin, followed by a c/s.) Yes, it is part of the string of interventions, but I think it may be one you want to take before it's too late and you completely lose your option for a VBAC.
Note: I'm all about not performing unnecessary checks and sweeps (i.e. checking dilation and effacement at 38 weeks), and I do think that there is a risk of infection, but I also believe that there comes a point when the risk:benefit ratio starts to tilt in the other direction, and you may be starting to get to that point. Like I said to begin with, you have to look at the risks of a sweep vs c/s. I would want to do pretty much anything I could to get baby to come if I was closing in on a firm c/s date (esp w/o the option of a medicalized induction).
BFP 8.14.15 ~~ Due 4.22.16
I'd absolutely get my membranes swept (and did!) if past 41 weeks (I think it makes no sense to do it prior to this). It will only kick start things if you are close to ready to go (if done well). I had mine done twice after 41 weeks - the second time I went into labor within hours so it was the nudge I needed.
I don't know much about the risk of infection but I think if you are within days of a repeat C that you want to avoid, it's worth a shot and is lower risk than other possible interventions.
FWIW, I also went the day before my due date with Callum and almost 2 weeks over with Eleanor - so the second baby doesn't always come sooner!
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Yep, my 1st baby came a week early. This LO, well... ::points to siggy::
When you decided to forgo the sweep, your scenario was different. It was an easy choice bc all signs pointed to an early delivery. Now you have a different hand, so you have to reevaluate some choices. I would definitely consider getting the sweep vs facing a RCS. I think it's definitely the less invasive option to get your labor jump started.
I will be getting mine swept at my apt on Tuesday bc it may take a couple tries and I want to give my body the best chance of avoiding an induction.
Thank you so much for the feedback ladies! What you all have posted is what I was thinking, but I wasn't sure if it was just my frustration and hormones making me sway. I guess I will see tomorrow if I am at all dilated and talk to her about sweeping tomorrow if possible. If I'm 0 dilated again though I might scream! LOL!
I have tried literally every OWT induction method I can think of/heard except castor oil. I started taking EPO at 37 weeks along with red raspberry leaf extract. At 38 weeks I started consistently bouncing/rolling on my birthing ball (mostly to get my hips in the right position). My whole pregnancy I have been extremely active with a very physical job (that I just stopped doing at 40w4d) and walking a lot, including doing yoga 2-3 times a week. I've also consistently had chiropractic care the whole pregnancy, and started acupuncture and acupressure at 39w 5 days. I eat pineapple and spicy food consistently (but mostly just because I like it lol!). I have sex as much as I can talk DH into it (not as much as we should, but I only have so much control over that sadly). I seriously have gone through everything I can think of.....so maybe sweeping the membranes is needed.
Just the thought of going 2 weeks over though and still ending up with a c/section is so beyond depressing to me, especially when I know what a great VBAC choice I am. Here's hoping there's a bit of progress tomorrow!