Interventions prior to being late- opinions/ what is your doc's policy

Katm89 · June 2016

Hey Ladies,
FTM here. I just went to my 32 week appointment and I found out at 36 weeks they start me on Primrose oil to soften the cervix. I found out that at my Midwife clinic they induce at 41w5d. I asked more about this and found out they do the primrose as early as 36 weeks and then at 40 weeks they talk about castor oil and membrane sweep. Then, they told me that normally FTMs go an average of 10 days late... so why do all these things if its normal? Also, I heard bad things about drinking castor oil( sorry if my spelling is wrong).... My husband thinks I took it wrong but it felt like wow they expected my body not to do it on its own to start priming things at 36 weeks.... any opinions on primrose oil? I haven't looked into it... Will you ladies get internal checks or decline them? I'm scared I heard they don't mean anything and they hurt.

jamiesc58 · June 2016

My doctor said absolutely DO NOT drink castor oil. Castor oil is a stimulant laxative that causes contractions in the bowels, which in turn stimulates uterine contractions. Like most natural induction methods, this only leads to labor if your body is ready for labor — full term, cervix soft and dilating, etc. So if your body isn't ready, you will be on the toilet no stop for nothing. I have had the membrane sweeps but have never used the primrose oil. I have been induced and for me it was not horrible.

Fremdschamen · June 2016

I'd be inclined to turn down the primrose oil and the castor oil, unless your midwives can offer you strong evidence of their effectiveness. The membrane sweep didn't do anything for me, but if offered, I'd likely try it again, since it is minimally invasive. I don't mind the internal checks-- I like to know where things are at-- but that is totally a personal choice thing.

Keep in mind that it is YOUR body and you are entitled to decline these things if you want.

Ask your midwife for the pros and cons of each-- my midwife is very careful to give me all the information first and then lets me make my own decisions about the procedures I want to undergo.

tisunge602 · June 2016

Agree with what @jamiesc58 said about castor oil. Can be dangerous stuff and really shouldn't be taken before 40 weeks. I believe the membrane sweep is the only proven method to help move things along; most of the other stuff (i.e. Sex, pineapple,
spicy food, long walks, raspberry leaf tea, etc.) are just wives tales. None of it worked for me and I was induced at 41w1d.

As far as the internal checks, I believe you have to get one done around 36 weeks for
the Strep B test. After that, it's up to your doc. Some will give you the option; others will want to do it every week after 36 no matter what. If you're given the option, all
they really tell you is how much you're dilated/effaced at that point, which doesn't necessarily mean anything. Some women walk around at 3-4cm for weeks; some go from 0-10 in just a few hours. It can kind of mess with your mind so it's a matter of personal preference.

ginger819 · June 2016

My doctor doesn't do anything to help labor along (though I didn't ask about a membrane sweep last time). Last time I didn't really want to wait until 42 weeks, which is the latest they would let me go, and just went ahead and got induced at 41 weeks and it wasn't bad. I did all of the internal checks last time, mostly because I was curious. They weren't the most comfortable thing in the world, but they weren't terrible. Then again I was dialated to 3 cm by 38 weeks and still ended up induced and having 16 hours of labor, so it didn't really tell us anything.

My MIL tried to tell me to take castor oil since she did it and went into labor, but the risk of it not working and still being stuck in the bathroom kept me from doing it. I've never looked into the primrose oil.

AliKay20 · June 2016

My OBGYN never mentioned anything about oils. At my 36 wk appt, he said he's going to assess bacteria down there and whether I need to be on antibiotics or something (I may be totally wrong about antibiotics) but he mentioned if I have a lot
of bacteria culture, it will impact something related to labor. He showed me the kit with long q-tip and said he'll measure my cervix. Nothing on oil but now I'm tempted to ask.............

texasmama2014 · June 2016

We didn't do any of the above, but I would have welcomed them towards the end. I did all the home remedy crap except castor oil and nothing worked except pitocin.

danjoly · June 2016

July lurker
I would seriously question the castor oil and even showing article to your doctor or midwife that I can be really dangerous for the baby!! It can induce diarrhea to you, but studies showed it can make the baby have a bowel movement in-utero. Meconium aspiration is a real deal and brings lots Of babies in NICU every year.

Stephanie7693 · June 2016

I have my exam for 36 weeks next week, and he will be doing the strep b test and measuring my cervix. The strep b test is to test for that bacteria. It's not good or bad, and my doc says 25% of women test positive. Without antibiotics during labor for a women that is positive, about 1 out of 100 babies will get sick after birth from the bacteria. So although the risk is small, it's there and it's preventable. As far as everything else, I don't think that is standard for every practice. I know my doc would not encourage any of those things to help prime your body for labor at 36 weeks. Just because you are full term does not mean your baby is ready to be born. I would seriously question your midwife about all of it. They should not try to induce labor in anyway until after 39 weeks.

Bookhousegirl · June 2016

I would definitely skip the castor oil for reasons stated by PP, but I would probably do all the others.

In terms of strep B, mine was positive last pregnancy and it just meant I had to have one bag of antibiotics through my IV before DS was born. This wasn't an issue for me, since I had an epidural and didn't have any problem with needing an IV, although I know some women want to avoid any IV's during labor.

Jaspertheyoungturnip · June 2016

Agreeing with all PPs. There's very little evidence that most of those things work at all. There's vastly more evidence that EPO will help prevent tearing than there is inducing labor. I'm a little skeptical of your midwife, so if I were you, I'd do some research of my own and respectfully decline anything you don't want to do. I will not be doing any internal checks for a reason already mentioned, they don't tell you much and if you're checked too often, it can increase your risk of bacteria.

pelorunningmama · June 2016

My doctor won't induce until 42 weeks unless she has reason to be truly concerned about me or the baby. I started drinking raspberry leaf tea around 32 weeks last pregnancy and also used primrose oil. It was my understanding that those do not cause labor, they just help to prepare the uterus for labor and could possibly mitigate some tearing. I plan to do both again.

ebilbao · June 2016

That's a hard no on the castor oil, a maybe on the primrose oil and a yes to internal checks and Strep B test.

Curls919 · June 2016

DS was born at 36+3 and had a few issues due to being early (in addition to my getting weekly shots, etc to keep this kid in longer) so I am just very confused/leery of the fact that any medical professional would try to 'speed things along' early.

That being said, my ob said they'd induce anywhere from 39 weeks (if there's medical reason) to a week or so later. They don't want you going 2 weeks late since that can cause complications of its own.

I personally wouldn't want to do anything before my due date to make the baby come early.

Sekerambo · June 2016

This go round I am a no for internal checks. They really aren't necessary since they don't actually give you an idea of when a person will go into labor. With dd1 they checked at 39 weeks and I was as closed/tight as could be. A week later baby was in my arms. My cousin on the other hand was at 3-4cm at 38 weeks and didn't have her baby until 41 weeks. There is no point going through the discomfort only to gain no actual information. I also don't want to get my hopes up only for pregnancy to last weeks longer.

Strep b really isn't a big deal. I tested positive with dd1. I had to have an IV but I only had to be attached when they were giving me the medicine, otherwise I was free to walk and labor how I wanted.

AliKay20 · June 2016

@stephanie7693 @bookhousegirlThanks ladies for more detailed and accurate info! My memory is hazy from last wk's appt! All I could think of was, "okay it's almost go time. Fk...."

strep b test was what my doc was referring to!!!

Katm89 · June 2016

@Stephanie7693, @knottie1442786653 The appt I just had was with the "new" midwife... so it could be that she just explained things wrong. I know we don't "induce" until 41w5d... I guess they actually want the baby out at 42 weeks. The primrose oil she explained was just to help ( like raspberry leaf tea) and I could refuse... I asked specifics about what they would start with for induction... if I would have to go to the hospital and start pitocin or if they would do a membrane sweep, nipple stimulation... and such prior to that step... she explained that at the 41 week appointment they would discuss doing castor oil, membrane sweep etc if I was comfortable. ( I normally see the other midwife.... but this "new" midwife is my back up..) She did react to my weird looks about the castor oil and said if I wasn't comfortable I did not have to go with that... and was very nice about it. I know from my doula as well as birth class that castor oil can be applied to the belly as a lotion and work much more effectively than drinking it... I would never drink it. I don't believe I have to do internal checks... not sure when they would ask me though. I know at 36 weeks we are going the strep B... My midwife( the reg one) is having me take vaginal probiotics to help prevent me from having the strep B... it can't hurt... its just good bacteria... and I put it in once a week before bed...( kind of looks like preseed, but needs to be refrigerated). She never mentioned measuring my cervix at that point.

@LWC112 The MW mentioned that it can either be taken orally or vaginally... which one did you do? and did you feel like it helped?

Everyone else thank you for your responses... as a FTM I'm not sure what to expect... my MWs are usually very hands off... but maybe I just got way to much condensed info that may never even apply to me. I meet with the new MW again on July 7th and then the rest of my appts are back with my main MW.

pelorunningmama · June 2016

@katm89 Pretty sure I vaginally inserted the primrose oil using a tampon applicator. I honestly can't remember 100%, but I do remember wearing a pantyliner to keep it from leaking on me. Sounds so weird I know. I didn't start primrose oil until I was 38 weeks though. I honestly have nothing to compare it to on whether or not it helped. My labor was long, but that's because I had a bag of water that they didn't find until about 14 hours in. My tear wasn't too bad and the actual pushing part was quick.

I had read that primrose oil can help avoid an episiotomy which I didn't want and I also did not want to be medically induced, so I was comfortable trying it. DD came at 39 weeks 5 days.

Jaspertheyoungturnip · June 2016

As long as you don't feel pushed to do anything, that's good! Do you feel like she gave you enough information on each of those choices for you to make a decision?

Katm89 · June 2016

@Knottie1442786653 Since she is new to the practice I think she was reluctant to actually say what my MW might recommend. She said we would go into more detail at the appointment to see if its something I was comfortable with and then I could decide. I feel bad I kind of put her on the spot. She has been a MW since 2003 but she just joined their practice and I am not sure if she is fully aware of their policies... she did say that he has alot of the similar beliefs as far as birth... and informing her client and such... She seemed really nice kind of like I could boss her around... Hopefully she is a bit stronger than that the day of the birth if she ends up delivering me... I also have a doula the day of to kind of protect my choices a bit... we are going over the birth plan twice.. since next appt I am Meeting with the new MW and then my reg MW for the 36 week check up.

Stephanie7693 · June 2016

@Katm89.. as long as she is respecting your feelings and wants, I don't think you should worry. But definitely don't do anything you aren't comfortable with if it's not a threatening situation. It sounds like they won't push you into doing anything, and it's good you will have someone else there to advacate for you the day of birth. And when it comes to pregnancy and birth, there is so much to consider that will not end up applying to you anyway. Sounds like you have things under control, and your next appt should help a lot too

kecoff01 · June 2016

As a STM, I remember the last 10 weeks or so being pretty overwhelming as well. My OB never mentioned anything like that, only that once I hit 40 weeks they would want to schedule and induction before 41 weeks. I ended up being induced for preeclampsia with my first at 38+6 anyway and that was with Pitocin. I was 3 cm dilated before they started the Pitocin and my daughter was born about 8 hours after they started it, so I responded very well to the induction.

I tested positive for Group B strep with my first and all it meant was that I would need IV antibiotics throughout my labor. That was fine because I had an epidural. This time around I'm hoping I'll test negative for the Group B strep because I want to do a natural childbirth this time and don't really want to be chained to an IV. The swab is taken from your anus, not your vagina, so you don't have have to have an internal exam.

I opted for the internal exams with my first and will likely do so again, just because I'm curious more than anything. I think with my first I was 1-2 cm starting at about 35 weeks. I didn't find them uncomfortable, but if you are bothered by PAP smears or anything like that you might find it uncomfortable. The only thing was that I would usually have some mild bleeding (normal) afterward.

Good luck!

texasmama2014 · June 2016

My doctor doesn't like to go over 41 weeks, I think she tries to schedule around a day or 2 after 41 just in case you end up getting bumped because of the risk associated with going past 42 weeks.

Katm89 · June 2016

@Stephanie7693 I think you're right. I will take it with a grain of salt.

@texasmama2014 I'm so glad you explained the reasoning for your doctor wanting to induce at 41, I never thought about the induction being rescheduled because of having no room... Maybe that's why my MW practice wants to do an induction on 41w5d so that there are 2 days to kick start the labor. I completely understand the need for induction at that time... I mean I want baby to be ok.. and I know when I conceived so I'm not worried the due date is wrong.

@kekoff01 I think I got ahead of myself by asking those questions haha. I always do that and my regular MW handles me better... at my 18 week appt I busted out my Birth plan... and she was like lol "Oh, so you want to do all your prenatal care in one appointment" and we both laughed and I relaxed a bit.

JLyn821 · June 2016

I find it odd that your OB would recommend the oils especially before your due date. It just seems sketchy to me.

My OB starts internal checks at 36 weeks. I talked to them about declining when I was pregnant with my son. She said they didn't have to tell me the number if I didn't want to know, but they want to know because if I'm already 3cm when my water breaks or I go into labor, they're more likely to tell me to come in quickly as opposed to if I wasn't dilated at all.

My OB also doesn't even start talking about induction until after you pass 40 weeks. I was scheduled for induction on 41+5, but kept getting bumped because of a full moon. My water ended up breaking and I had DS at 41+6.

kristynmac · June 2016

I am really interested in the Primrose oil, but I have a couple of questions.
1. When do you start taking it orally and as a vaginal suppository?
2. How much did your doctor recommend that you take for each dose?

I plan to wait to ask my doctor about this--my next appointment is in 2 weeks and I think that I will have the GBS test done then. Are you even able to do the EPO (vaginally) if you test positive for GBS?

rubredvelvet · June 2016

I'm really shocked that they would even suggest that. 36 weeks to me is way too early to start any intervention. Castor oil works but can have very aggressive side affects, and I wouldn't even attempt it unless it was right before a medical induction- and even then would try all the other suggestions first.

Katm89 · June 2016

@kristynmac I read online that it really isn't effective unless you start taking it weeks before delivery... I googled a bunch and its believed to not really induce labor... its suppose to help with effacement and making it easier once your body is ready to dilate... but doesn't actually cause dilation... My MW said you can take it either vaginally or orally... I plan on taking it orally and then maybe closer to 39 weeks do vaginally... I don't think if you test pos for GBS it would effect whether or not you can take it vaginally... most of the time if you have GBS its totally normal and safe for you to have that bacteria... its not safe for baby... which is why they give you antibiotics at the birth...
My MW said they would discuss it at my 36 week appointment... but I read online that you start with a lower dose like 1000mg a day and then move up to like 4000mg closer to delivery, but idk.. apparently it cures alot of other diseases.... so its like a supplement... and not really strong enough to kind of force you into labor.

@rubredvelvet My MW was answering my questions about induction for after 41 weeks.. she mentioned they might suggest castor oil prior to pitocin... she didn't recommend taking it at 36 weeks... just the primrose oil

ShanRum3 · June 2016

My OB is willing to induce after 39 weeks, especially since I have GD. Basically all I would have to do is ask.

Alygohome · June 2016

Would not do caster oil, like at all. I am being induced at 37+5 by a high risk dr but this is due to medical conditions. They don't induce or do anything until after 39 weeks here usually.

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