Updated: Jun 14, 2018
I was less than 39 weeks gestation.
I was fully informed that a 'normal', healthy pregnancy should last anything between 37 and 42 weeks and I was also aware that not having given birth for 10 years, it was likely my baby would behave like a first-born (in some ways) and make her timely arrival sometime AFTER my allocated ESTIMATED due date.
I was more than happy that my baby, just like Gandalf the Grey, would arrive 'precisely' when she meant to.
What I didn't bank on beforehand, was the sheer volume of pressure I'd be put under ~ mostly well-meaning even if ill-informed ~ to medically induce my baby's birth sometime BEFORE she was ready, simply on the basis of this allotted ESTIMATED date.
I had community midwives offer me a 'gentle sweep' (of course, there's no such thing, a sweep is a sweep. It does sound nicer, calling it a gentle variety though, I guess?)
I had antenatal peers desperate for their own sweep, I had family and some friends too, telling me I wouldn't be 'allowed to go past 40 weeks' and honestly? Of course, I was a tad cumbersome and very, very keen to meet my baby.
But, rather suddenly, at 39 weeks, it felt as though the world had lost its patience with me being pregnant.
"Enough is enough", everyone was telling me, "let the medical staff fiddle with your cervix, possibly go on to inject you with synthetic hormones, membrane rupture!"
Let's force this baby out!
I was actually one of the lucky ones, aside from my bleeding condition (which I blog about separately), I was having a wonderfully healthy pregnancy.
I was healthy, my baby was apparently healthy. There was no MEDICAL reason whatsoever to cut short her gestation. AND I saw this coming (albeit to a lesser degree) as I'd been training myself with Katharine Graves hypnobirthing techniques, daily, for about 5 months by this stage. I was more than prepared to decline this offer of intervention and I had very good reason too ~ as I shall explain...
As an aside: I wouldn't actually recommend teaching yourself hypnobirthing, get a professional to do it. I had my background in CBT and mindfulness on my side, I had a depth of understanding of the literature regarding my own circumstances that many midwives and obstetric professionals I met along the way didn't have and yet, when I completed my hypnobirthing teacher training, I recognised gaps in my practice that had I actually attended a course during my pregnancy probably wouldn't have existed.
Don't get me wrong; 2 fold:
1: I had an awesome (in the true sense of the word) birth experience - I did just happen to get a greater understanding of the materials through my training and then, couldnt help but wonder if it could have been even more powerful?
2: Any effort and time you put into relaxation practice prior to labour WILL be of benefit. Most of us operate (most of our time) at what I called our 'baseline' stress level.
Say that's a 5 on a scale of 1-10.
If we float around at about a 5 for most of the day, whilst doing ordinary tasks, when we encounter a stressful or challenging situation, our blood stream levels of stress hormones like cortisol and adrenalin increase and our experience of stress, psychologically and physically, might resemble a 7 - just for arguments sake.
However, if you practice relaxation or mindfulness based stress reduction (as per my previous profession) then you can bring your resting stress level (your baseline experience of daily living) down a notch or two, maybe even three.
So let's look at that again, your baseline is now a 3, you encounter some challenge and have exactly the same hormone-induced stress-response, your stress level increases by the very same amount and yet your actual level is now still only a 5 - which in this example, is where you might have started out, if you'd never practiced relaxation.
I used to say to those clients and I'd say the same to hypnobirthing couples; that some practice is beneficial and more practice is more beneficial.
The same goes for your reading and learning around the maternity system and birth planning. The more research you could do, independently, the better. All of it will deepen your understanding of the maternity system and aid in your evidence-based decision making. There's simply a depth of learning and practice achievable through a taught course that can't easily be gained in isolation, you have the expertise of your own personal antenatal educator and of their qualifications and years of experience in your corner. Nothing can really replace that.
So anyway.. What is a 'sweep' exactly?
And why was I avoiding one like the plague?
"A sweep is an induction, by another name." Those of you that have read her books will know that's Katharine's voice.
Rather shockingly, it's reported that this procedure is sometimes (often?) conducted without the informed consent of the mother.
Have you had one? Did anyone you know have one?
Ask around. Conduct your own staw-poll. My guess is that most, if not all of your mother-friends on Facebook would have been 'offered' a sweep - without this 'offer' following a frank discussion of the procedures' relative merit.
So, we're all lead to believe that the biggest PRO is that it may kick start your labour - before baby is ready, that is - All the most recent evidence suggests ONE THING and one thing ONLY will actually kick start your labour and that is your baby.
The first link (below) is one of the best immediate resources for a super-quick introduction to the topic that I've seen. It's a brief video in which Rebecca Dekker of Evidence Based Birth describes the procedure itself and then, outlines a consideration of the pros and cons of membrane sweeping, based on actual evidence, not just routine practice.
These are the numerous CONS it's likely your mates weren't told:
"One of the cons is you can’t have your membrane swept if you cervix is closed. Your cervix needs to be at least one centimeter dilated in order for this procedure to occur. Another con is that most women report that the procedure is either somewhat or very painful. In fact, one study found that 70% of women reported that the procedure was significantly painful, with an average pain score rating of seven on a scale of one to 10, with 10 being the worst pain possible.
Membrane sweeping can also cause bleeding after the procedure. It can also cause your uterus to become really irritable and contract irregularly. You may lose some sleep and worry a lot because you’re having lots of weird, irregular contractions that are not labor, but they just really bother you. Or it could be the start of labor, so you may be unsure as to what’s going on because it just leads to that uterus irritability.
When women in studies are randomly assigned to have their membranes swept and their membranes are actually swept, they actually receive the procedure, about 9% of them experience their water breaking as a side effect of the procedure. You have about a one in 10 chance of your water breaking if you have your membrane swept. This can lead to longer labors, and it can also lead to the chance that you might need a formal medical induction if your water broke and you didn’t go into labor on your own.
Finally, one of the cons of membrane sweeping is when it’s done without informed consent. I hear reports of women all over the world who tell me that their membranes were stripped or swept without their consent. Although there has never been a research study done on this phenomenon, it is anecdotally something that does happen to some women. That’s just something to be aware of when you’re going into those appointments." - Rebecca Dekker - Evidence Based Birth (2017)
So, yeah. I declined. But that's me... For me, increasing the risk of medicalised induction and C-section WITHOUT an immediate medical reason for doing so, didn't make much sense.
These were some of MY reasons and I understood and accepted this decision as being evidence-based and person centred.
Only you can decide what's best for you and your baby.
So what do you really need to know in order to make these sorts of decisions?
That link I mentioned to the very accessible introduction video. I think it's only about 6 minutes long:
My advice is also to read this: Dr Sara Wickham (UK Midwife, Author & Researcher) wrote a book on the matter of INDUCTION purely for passing your estimated due date - If that's not accessible to you (for whatever reason) This article is a great starter.
The Association for Improvement of Maternity Services (AIMS) also offer a fantastic range of journals, birth rights campaigns, booklets, books and other resources that cover the whole range of maternity decisions and their evidence-base.
Download this book entitled Am I allowed? By Beverley Beech, Who was AIMS Chair for 40 years. "She is a legendary campaigner for women's rights in pregnancy and birth, skilled international orator, and writer. It's a must for any pregnant woman who wants to exercise informed consent and be more in control of her pregnancy and labour. It gives you the information to make YOUR informed decision."