Thoughts on sweep at 39 weeks

ncmc

I had my 36 week check up in CUMH and everything is looking fine thankfully. The doctor was talking me through the timelines with regard to induction etc (they induce with gel @ 40+10) and she offered me the option of having a sweep at 39 weeks. She said she is a great believer in them as although fairly unlikely to encourage the waters to break, they can at least soften up the cervix and make it more prepared for labour. She said the scenario they want to avoid is you getting the gel at 40+10 and your cervix being completely unprepared for labour leading to protracted labour or section.

However was talking to my sister and she said that when she was having her kids (in Cavan) the midwives were very slow to do sweeps in case it broke the waters but no labour leading to either protracted labour or section!

So it seems two very different schools of thought with the same goal of avoiding protracted labour and section. So I'm a bit confused now and don't know what to do. So would love any thoughts on getting an early sweep versus hanging fire til overdue?

lazygal

I think medical evidence is unclear as to whether they help. I understand theyll only help if you're favourable cervix wise. There's also the risk of infection with any internal exam.

January

Sweeps don't help make the cervix more favourable, they help to release cells around the cervix and release the hormone oxytocin to get labour started. Docs cannot do a sweep if your cervix is not favourable.

They tried 3 times (at 39+6, 40+2 and 40+8) to give me a sweep but because my cervix was not favourable they could not do it.

ncmc

Oh I see, I misunderstood her so, I thought she meant that if might encourage the cervix to soften. So really I've nothing to lose by seeing if I'm favourable and then they won't do it if I'm not?

Roesy

ncmc wrote: »

Oh I see, I misunderstood her so, I thought she meant that if might encourage the cervix to soften. So really I've nothing to lose by seeing if I'm favourable and then they won't do it if I'm not?

I wasn't favourable at 39 weeks so I couldn't get a sweep. I was induced at 10 days over. I think getting the internal at 39 weeks and being told I was sealed up tight helped me resign myself that I was going all the way to the bitter end

ncmc

Roesy wrote: »

I wasn't favourable at 39 weeks so I couldn't get a sweep. I was induced at 10 days over. I think getting the internal at 39 weeks and being told I was sealed up tight helped me resign myself that I was going all the way to the bitter end

:D:D

So as it stands I would be due for the sweep on May 28th, I have a family wedding on May 31st, at least if I'm told I'm 'sealed up tight' on the 28th might mean I can relax a bit and enjoy the wedding! Gotta find the silver lining I suppose!

Roesy

ncmc wrote: »

:D:D

So as it stands I would be due for the sweep on May 28th, I have a family wedding on May 31st, at least if I'm told I'm 'sealed up tight' on the 28th might mean I can relax a bit and enjoy the wedding! Gotta find the silver lining I suppose!

Consultants words, not mine He did say I could go myself but he'd be surprised.

Dr.Winston O'Boogie

Hello all,

My girlfriend is due next week. She was at the hospital today for a routine checkup and they said the baby is grand and healthy, but a bit on the small side. 6.5 pounds.

Because of this they said they don't want her to go overdue and gave her a sweep to see if they can bring labour on. If this doesn't work she is scheduled for another sweep mid week next week and then after that will discuss the options.

They say its all precautionary but they just don't want a slightly smaller baby going overdue as there is more chance of a still birth. Everything else looks perfectly healthy according to them.

Any other similar experiences out there?

SanFran07

Mums can also choose not to be induced at T+10 and wait until T+14 which is policy in other units.

Dr. Winston - your gf can always ask for a second opinion. If your baby is 'grand and healthy' but on the small side of normal then maybe your baby needs to stay put... Unless there is a clinical indication ie baby has stopped growing....blood flow issues to baby...placental issues...then the healthiest and safest option for most babies is a spontaneous labour. If there were truly concerns for your baby serial scans would be ordered on a regular basis and a very close eye would be kept on your baby...

Your gf is not overdue until 42 weeks - not 40 weeks.

Hope all goes well!

pwurple

6.5 pounds is very close to average birth weight.

Also, the closer to birth, the less accurate the weight measurement is. The person doing our scan at 39 weeks said the margin of error was 600g, or 1.3 lb.

6.5 + 1.3 = 7.8lb, which would be above the average weight for a female baby, and average for a male baby.

How Strange

Both of mine would've been that size at 39 weeks. I had a sizing scan on my son because the consultant thought the baby was looking big but the sonographer said he was a very healthy 6.5lbs. She said they put on an average of 0.5lb a week after 38 weeks so she gave me her estimates of what his birth weight would be. She was right as he was born 7 days later at 7.2lbs. My daughter was 7 days overdue and was 7.9lb.

From my experience, unless there's something else of concern, I'd be very happy with that weight at that stage.

Best of luck

Dr.Winston O'Boogie

Thanks all, yes we both think that 6.5 sounds healthy enough at this stage. The doctor did say he has no concerns over the health of the baby, but after he mentioned the chance of a still birth increases by double if someone is overdue and the baby is on the small side my GF felt like she had to go along with it.

Now we are both thinking that it seems a bit excessive. Neither of us mind the sweep as such, but would rather avoid an induction if the sweep doesn't work as her body should know when the time is right to have the baby. She also wanted as natural a birth as possible so this will interfere with that plan.

We are back at the hospital next week for another check and possibly another sweep so we will raise our concerns then. The baby could well be 7 pounds at that stage, and due on the Sunday. That seems like a decent size to me (its a boy).

kaki

Yeah, that sounds very much like the good old "dead baby" card.

Dr.Winston O'Boogie

kaki wrote: »

Yeah, that sounds very much like the good old "dead baby" card.

Which means?

Betsie_xr3i

That's a perfect size my 1st was 10days over due and she was 6lb 14oz she was perfect my 2nd was 4days early and she was 7lb 11.5oz x best of luck

Dr.Winston O'Boogie

There is also the fact that our baby has single umbilical artery syndrome, its a very low risk situation apparently but I suppose they just don't want to take any chances in case the babies growth post due date stalls. All the growth up to now has been normal though.

http://en.wikipedia.org/wiki/Single_umbilical_artery

May make more sense to get him out around due date though so we can look after him properly out here!

kaki

Dr.Winston O'Boogie wrote: »

Which means?

Apologies, I phrased that poorly.

"Dead baby card" refers to a care provider overstating risks or presenting the information in a skewed/emotionally unbalanced manner, in order to push an intervention that may not be medically necessary (and may not necessarily lead to better outcomes for the mother or baby) but more to the advantage of the care giver.

Maybe you could ask for a second opinion, and discuss the relative benefits and risks of waiting or inducing pre-term? 6.5 pounds sounds perfectly healthy, and as other posters have mentioned the late-pregnancy weight-estimates can be off by a lot.

Dr.Winston O'Boogie

kaki wrote: »

Apologies, I phrased that poorly.

"Dead baby card" refers to a care provider overstating risks or presenting the information in a skewed/emotionally unbalanced manner, in order to push an intervention that may not be medically necessary (and may not necessarily lead to better outcomes for the mother or baby) but more to the advantage of the care giver.

Maybe you could ask for a second opinion, and discuss the relative benefits and risks of waiting or inducing pre-term? 6.5 pounds sounds perfectly healthy, and as other posters have mentioned the late-pregnancy weight-estimates can be off by a lot.

No bother, yeah probably gonna ask for a 2nd opinion when we are back in next week. As I said with the single umbilical artery situation they may just be overly cautious, which may not be a bad thing at the end of the day.

pwurple

Dr.Winston O'Boogie wrote: »

There is also the fact that our baby has single umbilical artery syndrome, its a very low risk situation apparently but I suppose they just don't want to take any chances in case the babies growth post due date stalls. All the growth up to now has been normal though.

http://en.wikipedia.org/wiki/Single_umbilical_artery

May make more sense to get him out around due date though so we can look after him properly out here!

That does make sense then with the weight... If the growth is slowing down, it could be linked to that.

Chattastrophe!

pwurple wrote: »

That does make sense then with the weight... If the growth is slowing down, it could be linked to that.

I agree. I wouldn't agree to an induction based purely on a slightly lower estimated weight, but I would absolutely be looking for one if there was a single umbilical artery and also low weight.

The hospital should have been clearer with you on this. I imagine that the single artery was a big factor in their suggestion, far more than the baby's weight (although both combined could be worrying.)

Dr.Winston O'Boogie

Hi all, well after all the discussion it turns out we were wasting our breath...waters broke on Saturday and healthy baby boy was born on Sunday evening after a natural labour (well including an epidural)....so happy it went like that and there was no induction needed in the end.

He must have sensed our concern and decided to make his own way out!

kaki

Dr.Winston O'Boogie wrote: »

Hi all, well after all the discussion it turns out we were wasting our breath...waters broke on Saturday and healthy baby boy was born on Sunday evening after a natural labour (well including an epidural)....so happy it went like that and there was no induction needed in the end.

He must have sensed our concern and decided to make his own way out!

Oh that's great, congrats!

ncmc

That's super news! Congrats. What weight was he in the end? The doctor had me worried as he kept saying she was on the small side according to the scans and it turned out she was 7lb5oz. I don't think the scans are very accurate in predicting weight.

Dr.Winston O'Boogie

ncmc wrote: »

That's super news! Congrats. What weight was he in the end? The doctor had me worried as he kept saying she was on the small side according to the scans and it turned out she was 7lb5oz. I don't think the scans are very accurate in predicting weight.

He was 6 pounds 13oz when born on Sunday. On the Thursday they told us he was 6 pounds 5oz so they probably underestimated his weight a tad..