Home Birthers & Hopefuls!

I know what you mean about calculators being a little different. My scan gave me an EDD of 22.12.11, which is impossible as to have that due date I would needed to have ovulated on 31.03.11 and the opks where very negative that day, and the next and only a just starting to transition the day after that. I won't be consenting to induction or a planned c-section cos I reach 42weeks anyway. This baby is coming out by spontaneous labour unless the placenta's in the way or one of our lives depend on it.
 
I won't be consenting to induction or a planned c-section cos I reach 42weeks anyway. This baby is coming out by spontaneous labour unless the placenta's in the way or one of our lives depend on it.

That's exactly how I feel Celesse :winkwink:
 
Definitely, I'm declining a sweep monday too (40+3), decided I'm going to wait until 42wks before I consider it. But want to exhaust a couple of natural methods first, got my clary sage oil ready, and hubbie (he helped get the baby in, it's only fair he puts in a bit of effort to help get baby out :lol: ). I'm not going to go for a long exhausting walk as friends/strangers keep suggesting, I'm sweating and aching just sitting down, I want to conserve energy not blow it all and then have to labour!

My normal MW when she gets back will wonder why and probably advise I have one on her appointment (41+3) as she's told me all about how great they are because they've reduced the number of women they induce - but how many CS's have the increased I wonder?

I can understand the EDD frustration too, and you're all very right to question it and not just accept what their silly wheels say. My MW's seem to change every week anyway, I see her every monday when I'm +3 days, however I have +4 +2 +5 on many of mine, go figure.. I've always insisted there is a bit of discrepancy with mine as I charted and know when I ovulated, and really my due date should be 9th July. At the start one particular sonographer said it doesn't make any difference its only 8 days, to which I corrected her as it bloody does at the end!

I asked my MW and consultant about it and they said they always go by the scan and theres nothing I could change on there or do about it quite frankly, it would still be set for 1st July. Soooo next time I shall take a private scan at 12wks and decline the nhs one, see how they like those apples! :winkwink:
 
i had a private scan at 9 weeks which put my due date 9th august but the nhs scan put me forward 3 days to the 6th. i concieved 5th novemeber which i no so my EDD is spot on
 
I'm hoping my henna comes tomorrow so I can get a nice design on my very rounded and bulging bump, so glad Smokeyjoe posted about that, I'd never have remembered you could do that. You still around Smokey? Getting positive signs?

Still here! :haha::blush:
Just more of the same sort of pre-labour/period pains that I've been having for the past 2 weeks :wacko:
I had a MW app yesterday, so baby a bit more engaged (2/5th). I was offered a sweep, but declined - MW made me feel like that was the wrong thing to do :growlmad: but last time it was so depressing to be told my cervix wasn't favourable that I swore I wasn't going to do it this time :dohh:

Anyway - strawberry picking sounds lovely :D Where did you order henna from?

Jodie - hope you can get the whole cot/basket thing sorted :D

Cranberry - there's a template birth plan on the NHS site and also I think on the Boots one :flower:

I tried a few local shops with no luck (as I'm a bit desperate to get it like NOW) so I had to get some off ebay. I looked over a lot to make sure I was getting it off as trusted seller as I could. There are some that don't mention chemicals etc... so I stayed away from them. The one I've ordered from seems to have a good knowledge of henna, makes it fresh etc... I didn't want to have to make it up myself as I have no idea, the seller has 100% feedback and has sold loads, so fingers crossed, it's here if anyone wants to have a look: https://cgi.ebay.co.uk/ws/eBayISAPI.dll?ViewItem&item=260499515455&ssPageName=STRK:MEWAX:IT
 
My midwife shifted my EDD forward by 2 days to the 9th but I'm sticking to my original date of the 11th. The only benefit to them changing it to the 9th would have been they would have let me have the home birth 2 days earlier than planned when I hit 37 weeks. But that was two weeks ago now and I'm still looking at my pool and am getting quite eager to put it into use and to meet my bubs as soon as possible. I'm sure bubs is much happier where it is right now but mama is getting impatient! :)
 
Brace Yourself!!!


I have been reading up about EDDs and Prolonged Pregnancy.

Here is the evidence - I've extracted this form a few source and Guidelines.

Women need to be informed of the possible risks associated with interventions to induce labour, as well as the options of continuing with the pregnancy, in order to make an informed choice.

In pregnancies which continue beyond term (37-42 wks of gestation), the chances of perinatal morbidity and mortality increase slightly (Crowley P: Interventions for preventing or improving the outcome of delivery at or beyond term, the cochrane database of systematic reviews 1997)
There are several studies:
One large observational study in Scandinavia (Bakketeig L, Post term pregnancy : magnitude of the problem. 1989) indicates that the number of perinatal deaths is lowest at 40wks (0.2%), rising to 0.3% at 42wks and 0.4% at 43wks. However to contradict this, there are studies that show that there is little difference in meonatal morbidity, but an increase in length of labour and operative delivery (Alexandra et al: Forty weeks and beyond: pregnancy outcomes by wks of gestation 2000, Caughey et al Complications of term pregnancies beyond 37wks 2004). Two large retrospective studies and one small prospective study have suggested that babies born bayond 42 wks gestation are at a moderately increased risj of neonatal morbidity, including fetal compromise, low Apar score (<4 at 5min), and meconium aspiration. It is worth noting that it is well recognised that meconium staining of the liquor is more common in prolonged pregnancy. However, a systematic review indicates that the risk of meconium aspiration syndrome and neonatal seizures is unaffected by routine induction of labour after 41 wks, indicating that the neonatal morbidity associated with prolonged labour many have another underlying cause. - so all this means that it is not clear whether prolonged pregnancy by itself causes increased perinatal mortality and morbidity, or whether factors that put the fetus at risk also prolong the duration of pregnancy. Better identification of clinically dymature fetuses and those that are SGA (small for gestational age) may enable interventions targeted at those fetuses that are truely at risk.
Two Independent Swedish studies (Classon et al Outcomes of post erm birth: the role of fetal growth restriction and malformation 1999, Divon et al, fetal and neonatal mortality in posterm pregnancy: the impact of gestational age and fetal growth restriction 1998) indicate that the increased risk of still birth in prolonged pregnancy is party explained by and increase incidence of SGA infants. This rose from 2.2% among term births to 3.8% among babies born at 42wks or beyond. So indicating that not all babies are equally at risk, and that AGA (Appropriately grown for gestations age) infants may be better able to cope with prolonged pregnancy.


Calculation of due date and definition of prolonged pregnancy:
Of course all this is dependant on what your dates are, and how "accurate" they are, as none of the methods for estimating EDD are accurate and there are variations in calculating EDD.

Estimates about the frequency of prolonged pregnancy vary between 4 and 14%. But the natural incidence of prolonged pregnancy is difficult to define because of interventions in modern obstetric practice.
There are some correlation between factors such as hereditary, racial, seasonal variations, women who work nights, and male fetuses suggesting that prolonged pregnancy is more common in these groups, as well as some rare major congenital abnormalities.

A systematic review of the evidence indicates that routine early pregnancy ultrasound should be used to predict EDD, in order to reduce the number of women who require induction of labour for apparently prolonged pregnancy. This recommendation is supported by evidence that menstrual dates systematically overestimate gestational age when compared with scans.
Using the last menstrual period (LMP) is the most common method of calculating gestational age but many be inaccurate if periods are irreglar, if conception occurs soon after or during use of oral contraceptives, or if menstrual history is uncertain. Estimations based on LMP use Naegele's rule, a calculation of the menstrual cycle and ovulation. Naegele's rule is based on the precept that pregnancy lasts 280days fro the first day of the last period and assumes a 28day cycle with ovulation occurring on day 14. A study of 400,000 birth in sweeden (Bergsjo et al, duration of human singleton pregnancy: a population-based study 1990) indicated that more accurate estimate of due date would be reached by adding 283, rather than the more usual 280days to LMP.

Fetal well-being and prolonged pregnancy
Several tests are commonly used to asses whether the pregnancy is affecting the well-being of the fetus.
The antepartum carditocograph (CTG) is essentially and assessment of the fetal health at the time of the observation and its ability to predict continuing fetal well-being is therefore limited.
A non-stress antepartum CTG, sometimes described as the non-stress test (NST), in usually the first choice as it is non-invasive and easy to perform. However published randomised controlled trials of antepartum CTG provide no support for this technique, and there is no demonstrable improvement in birth outcomes and its use may even be linked with increased perinatal mortality and is linked with an increased C-section rates.
An estimation of amniotic fliud Volume (AFV), including max pool depth and amniotic fluid index (AFI), form a standard part of fetal assessment where the pregnancy is thought to be prolonged as both fluid volume and index diminish progressively through the latter part of the third tri, The mean AFI in prolonged pregnancy is 10.4am, with the third centile at 5.8cm. An AFI of less than 5cm is generally accepted as a definition of Oligohydramnios. Although Oligohydramanios is not necessarily associated with adverse outcomes, it is associated with intrapartum fetal heart rate decelerations and passage of meconium. Recent research suggests that although AFI is superior to a measure of the single deepest pool of liquor, it has a poor sensitivity for adverse outcome and its routine use if likely to increase obstetric intervention without improvement in the perinatal outcome. (Morris Et al, The usefulness of ultrasound assessment of amniotic fluid in predicting adverse outcome in prolonged pregnancy 2003)

Induction of labour versus expectant management for prolonged pregnancy
there is considerable controversy surrounding the management of prolonged pregnancy, based on the uncertainly about the degree of fetal risk and disagreement over the need for medical intervention.

One meta-analysis indicate that routine induction of labour between 41 and 42 weeks reduces the risk of perinatal death in normally formed babies.
Another trial with women with uncomplicated pregnancies at 41 weeks was unable to demonstrate a significant difference in perinatal or maternal outcome and concluded that either management policy was acceptable. (National institute of health and human development network of maternal-fetal medicine units. A clinical trial of induction of labour versus expectant management of post term pregnancy 1994)
A similar study, sought to asses the risks of maternal and perinatal morbidity concluded that the decision to intervene at 41 weeks on the basis of gestational age alone does not appear to be justified, but recommended that beyond 42weeks induction is still the preferred management option (Roach et al, pregnancy outcomes beyond 41 wks gestation 1997)
A large USA review concluded that routine induction of labour at 41wks is likely to increase labour complications and operative delivery without significantly improving neonatal outcomes (Alexandra 2000)

Induced labours are associated with higher rates of further interventions such as instrumental delivery and c-section and with social economic costs resulting from injury and longer stays in hospital. One study has shown that routine induction is less expensive than the alternative of serial monitoring in prolonged pregnancy (perhaps a worrying motivation!) (Hannah et al postterm pregnancy: putting the merits of a policy of induction of labour into perspective 1996).
It has also been demonstrated that, although induced labour is associated with a higher rate of c-section than spontaneous labour following a policy of routine induction at 41 wks. It has been pointed out that while induction itself may be the factor, it is more likely that the indication for induction in the group is the cause of the higher rate of c-section. (Roach 1997). A cohort study concluded that this increased intervention rate can be explained by the clinicians' heightened vigilance, where this resulted in the lower threshold to intervene in a pregnancy perceived to be "high-risk" (Luckas et al Comparison of outcomes in uncomplicated term and post-term pregnancy following spontaneous labor 1998)

Summary = if you have managed to get through all that lot!!!

- A policy of performing a routine early ultrasound to predict EDD appears to reduce the number of women who require induction of labour. However, if current practice were amended in the light of research, and 3 days were added tot he formula, LMP might prove to be just as accurate as ultrasound in calculating EDD.
- While studies consistently demonstrate a rise in morbidity and mortality rates with advancing gestation, perinatal deaths are rare and the actual risk of either remains small.
- Although increased fetal surveillance can provide reassurance to both parents and clinicians in prolonged pregnancy, there is still no clear indication for the most effective method of testing, nor when testing should be initiated.
- A policy of routine induction between 41 and 42 wks gestation reduces the risk of perinatal mortality, but as least 500 inductions need to be done to prevent one perinatal death. It is not clear whether women feel this is an acceptable increase in intervention, particularly when compared to the alternative of increased fetal surveillance.
- Women need to e give accurate, up-to-date unbiased information about the risks of prolonged pregnancy, the options for elective induction of labour or expectant management and increased fetal surveillance and the poential benefits or risks of these.


Gold stars to anyone that reads all this!!
XXx
 
My word that is alot of info and I did get through most of it. So basically waiting and not rushing labour is in the majority of cases the best thing to do, but the longer the pregnancy goes on the higher chance of there being problems with baby or CS? Have I got that right or am I totally confused?? lol
 
Ooooh thanks Bourne :D

I think Indigo, there is a slight increase in risk to baby the longer the pregnancy goes on and then I suppose you're more likely to be induced, therefore more likely to end up with CS - plus the fact that they're going to be more 'cautious' with you because you're already 'overdue' and therefore ever so slightly more likely to have higher risks ..... I think :wacko:

I guess the thing that bothers me is that when they do the CTG monitoring, the baby might be ok for that 1 hour, but they have no way of knowing that baby is ok 2 hours+ later. Similarly, if they hear/see a wee blip on the CTG and you're already 42+ and a VBAC, I have a real feeling that they'll want to just whip you up for a c-section. It sort of puts me off going for the CTG monitoring - I don't really see the point... unless of course there was a major issue (but that would have to be picked up in the hour you were on the machine :dohh: ) Argh!
Anyway - it's not going to come to that for any of us, because all these babies are going to come before 42+ :haha::blush:
 
Yes they are, I'm sure of it. :) I predict Friday-Sunday of next week for me, just got a feeling. You got any ideas?
 
I have no idea really, except that I feel a whole lot more relaxed now DH is on holiday for 6 weeks :happydance: :haha:
 
Wow, Bourne! Your wee fingers must be louping after all that typing! You're and endless font of valuable information, brilliant.

Ooh, Indigo, getting exciting, can't wait to read your birth story.

And you Smokey, hopefully now your hubbie's off your mind and body will let go and Bingo!

Good luck all...
 
I know when I ovulated and it was CD 15. The doctor said "Sometime in the middle of May" and the MW asked "When do you count your due date as?" so I felt really good about choosing my care providers. That was the best part about going independent and I didn't have any scans so no need to change it based on that. My fundal height measured ahead for the last few visits but I remember the doctor telling the student that by this point, it doesn't really mean anything unless there is a big difference.

Oh yay, more BnB homebirths are on the way!
 
I know when I ovulated and it was CD 15. The doctor said "Sometime in the middle of May" and the MW asked "When do you count your due date as?" so I felt really good about choosing my care providers. That was the best part about going independent and I didn't have any scans so no need to change it based on that. My fundal height measured ahead for the last few visits but I remember the doctor telling the student that by this point, it doesn't really mean anything unless there is a big difference.

Oh yay, more BnB homebirths are on the way!

That's a much less pressured way of thinking about it Rmar :thumbup: I think if I ever have another pregnancy I might not have any scans for that very reason :haha:
 
Thanks so much for that research summary, I read it all *pats head*

x
 
Glad that everyone endured my post! lol ;-)

I'm also going to brave it and put it in the 3rd tri - wish me luck the thread doesn't turn nasty! Xx

There are no right answers.. and the doctors and the MWs DON'T have black and white truths for any of us. There are only the ones that you are happy with -Now that is what I call informed choice! Your choices are the choices that are right.


I have been on a whirlwind of being productive of late!.. and thankfully my OH has finally taken his finger out and decided to join in more! (Maybe just to keep me quiet!) He has managed to take the garage appart and find all the things we need; finally found some clothes to put this baby in.. The bathroom is all decorated! (just need to put a cabinate up)
We now have almost everything ready for the birth.. and have started to think about names! (I know, we have left that bit a little late!)
I have still yet to organise a bag for DD incase she needs to go anywhere - so that is on the list of jobs today. along sorting out a playlist for birth.

Oh and it doesn't look like we will be able to film this birth at the moment - can't find the right equipment!? I want to use my camera for pictures... So going to try and ask friends if they will lend me their camera and a tripod!
Xxx
 
I have been on a whirlwind of being productive of late!.. and thankfully my OH has finally taken his finger out and decided to join in more! (Maybe just to keep me quiet!) He has managed to take the garage appart and find all the things we need; finally found some clothes to put this baby in.. The bathroom is all decorated! (just need to put a cabinate up)
We now have almost everything ready for the birth.. and have started to think about names! (I know, we have left that bit a little late!)
I have still yet to organise a bag for DD incase she needs to go anywhere - so that is on the list of jobs today. along sorting out a playlist for birth.

Oh and it doesn't look like we will be able to film this birth at the moment - can't find the right equipment!? I want to use my camera for pictures... So going to try and ask friends if they will lend me their camera and a tripod!
Xxx

Wow! You have been productive! I'm struggling to keep the house in order at the moment. It took me nearly an hour just to tidy the kitchen and do the washing up in between the backache and waves of nausea im feeling today. :sick:

I did manage to get my box of bits ready for the home birth this weekend, and the birth plan is now done. Yesterday I found all the material I've been storing for a patch work project so I might get all that washed today - but I don't think I'll be doing much more than just general pottering about now. I can't do anymore batch cooking as I don't have any more freezer space available - at least we won't starve over the next few weeks! :happydance:
 
well i got my birthpool today and then my kit on wednesday :happydance:

altho its seeming too real now im scared lol
 
Had my 16w appt with the MW and brought up home birthing and she was better than I thought. It was the old witch MW as the one I was supposed to see was off on holiday, even tho I specifically checked that it would be her...

Anyway, she had a student in with her so I think she was showing off, but she was fine tbh. Told me all about the risks of shoulder dystocia, and that scans arent accurate, but then why do them? Also, I know theres room for error, but a 7lb predicted baby isnt suddenly going to turn into an 11lb toddler. She said that they will support me whatever my decision but that she wants to make sure its informed which is fair enough. She said the only real difference for me is that the scbu is upstairs if youre in hospital rather than a 20 min drive in an ambulance.

She said that they would take me in for failure to progress/wait and I didnt tell her that I would be refusing exams, thought that was a conversation for later. Basically the message was well if youre sure dear. Will have to see how things go ofc, I said to her that if Im ill I'll go in, otherwise I see it as a natural process.

They dont deliver birthing packs, they bring them with at the birth and I have to sort my own pool as they dont hire them out. I didnt ask about the arrangements for MW but she said that its shared between MW in the area, hope shes not mine. Id almost rather have someone worse but a clean slate.

So I feel ok about it, was worried Id have a fight on my hands. Also, the bloody woman found the HB in about 20 secs, it takes us 20 mins! Maybe she isnt as rubbish as I make her out :p The noises which I thought were my guts blurping are actually movements oO odd. I reckon I can feel some odd fluttery blblblbl feelings, MW told me its far too early tho, 16w...? Sounds right to me.
 
with zane i got my first massive kick that my oh felt at 15 weeks, and with this one ive been feeling kicks and movements from 13 weeks. so me thinks shes taking out of her ass lol

ive had it so easy when its comes to telling mw im having a hb, ive not had the oh this and that can happen or anyone tell me i cant. its been ok great ile do this ect and dont go into early labour lol
 

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