# Advice on induction methods for baby with SUA and group b strep + mom?



## Helen White (Aug 19, 2004)

Hi. I'm pregnant with my 3rd baby. My first was an induction (due to PIH) the day before my due date. The method of induction was breaking my water (I wasn't very informed about the risks of this at the time). It was 23 hours of labor, vaginal birth. I went into labor on my own with my 2nd at 39 weeks 2 days, and labor was about 12 hours. That birth was unmedicated and vaginal.

I'm now 12 days past my due date with baby #3 and have so far declined induction. I have also declined having my membranes stripped (this was done in my previous pregnancies), because I am group b strep positive and don't want the increased risk of infection. I've been 2 cm dilated, 90% effaced, and "very soft" for weeks now. So far my blood pressure has been good, and baby passed a nonstress test yesterday. My next appointment is for Monday, at which point I will be a couple days into my 43rd week.

If, by Monday, I haven't gone into labor on my own, I will be seriously considering induction. I know many here feel comfortable waiting quite a bit longer, but, for me, after 42 weeks, the increase in risks of stillbirth begins to concern me more than the risks of induction. (Especially in this case, where baby has SUA, as SUA babies are at higher risk for stillbirth.) I am very much hoping to go into labor on my own in the next few days, but if we do end up going with a medical induction, I could really use some advice on what the best method would be. I have concerns about all of them, especially because my baby has SUA (single umbilical artery, or two-vessel cord) and I'm group b strep positive.

This care provider likes to induce by breaking the water, but I will not be going along with that, both because of increased risk of cord compression and increased risk of group b strep infection. I've been declining membrane stripping because of concern for infection. I've read that pitocin should be avoided for babies with SUA because of the increase in risk of fetal distress (and I'm not crazy about pitocin anyway!). I wouldn't take cytotec under any circumstances. I guess I'm leaning toward something like cervadil, hoping that would get labor going by itself? I have found a study that linked it with more strep infections than pitocin inductions, but it still seems like less of a risk.

Input would be appreciated!

ETA: I forgot to mention, but this is a BIG baby. Not the norm for SUA babies, but my previous babies were 10 lbs 10 oz and 9 lbs 4 oz, and this one is expected to be at least as big, likely bigger.


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## Nan'sMom (May 23, 2005)

Have you considered doing a biophysical at 42 weeks and re-evaulating whether induction is warranted? I don't know much about SUA, but this might be worth a thought. Also have you considered trying to get rid of gbs and retesting? There are a bunch of threads on that.

I think if I had to induce for some reason, I'd try herbs, homeopathy, acupuncture, exercise, nipple stimulation, etc. first, then maybe cervidil. I'd not do water breaking since it's an on the clock method and you only have a certain number of hours to birth before care providers try to insist on a c section. Induction worries me quite a bit though.

Good luck and happy birthing vibes to you!


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## coloradoalice (Oct 12, 2005)

What is SUA?


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## Helen White (Aug 19, 2004)

Yes, we'll probably do a biophysical profile at my next appointment (I'll be a couple days past 42 weeks by then), and we'll definitely take those results into consideration. I'm not absoultely determined to induce on a particular day, but the longer I go past 42 weeks, the more likely we will be to go ahead with an induction.

We have been trying a lot of the natural methods of getting labor going (walking, nipple stimulation, etc.), and I'm sure we'll continue to do so over the weekend. I'm just trying to figure out what would be the best method of induction if we end up going that route.


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## Nan'sMom (May 23, 2005)

Best of luck to you! I know it's one thing to say the baby just comes when it's ready and another to actually be in the situation oneself. My first baby as born at 37 weeks, 2 days and my second was born at 41 weeks, 5 days. I didn't do u/s during the pregnancy but was considering whether to do a biophysical after 42 weeks, and was altogether more nervous about the whole thing than I ever would have expected.

I kept teling myself that the baby knew when to be born and other similar affirming things like that. (Plus, from the beginning, I felt that I knew she would be "late".) As it turned out, it was a great labor and she was born easily and happily. She was so alert from the beginning. I think she knew when she needed to be born. I think she was also waiting for our very ill dog to pass on.

Oh, one other method I'd heard of, and you probably have too, is evening primrose oil...sounds like you've got a lot of information on natural induction methods already though.

Happy birthing to you!


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## Helen White (Aug 19, 2004)

Quote:


Originally Posted by *coloradoalice* 
What is SUA?

SUA is Single Umbilical Artery (also called 2-vessel cord), where the umbilical cord is missing an artery (normally there are 2 arteries and 1 vein). Most babies who have it will be okay, but 20-50% end up having anomalies (genetic or of the heart, central nervous system, or gastrointestinal tract). There's also a higher incidence of Intrauterine Growth Retardation and premature birth (obviously I'm not worried about those last two at this point), and there's also a higher incidence of stillbirth. I've also read that SUA babies are more vulnerable to distress during labor.


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## coloradoalice (Oct 12, 2005)

Thanks, now I know what you're talking about!!

I hope things more along soon for you!


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## Helen White (Aug 19, 2004)

Thanks for the responses. I'm 42 weeks today and am finally seeing pieces of mucus plug, so maybe I'll get to have the baby this weekend! I'd still appreciate any thoughts on the various induction methods and their comparative risks, in case baby still hasn't arrived by my next appointment. I want to weigh my options as well as I can beforehand.


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## Spark (Nov 21, 2001)

Have you tuned in and talked to your baby? I sometimes think that's the best way to figure out what your baby needs.

Here's a link that is probably right up your alley.
http://gentlebirth.org/archives/natinduc.html

Also, are you sure the baby in launch position? LOA? Dates not wrong? Etc?


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## Helen White (Aug 19, 2004)

Quote:


Originally Posted by *Spark* 
Have you tuned in and talked to your baby? I sometimes think that's the best way to figure out what your baby needs.

Here's a link that is probably right up your alley.
http://gentlebirth.org/archives/natinduc.html

Also, are you sure the baby in launch position? LOA? Dates not wrong? Etc?

Maybe it's a personal flaw, but aside from feeling kicks and thinking about how much I love her and want her to be safe and healthy, communication with my unborn baby has proved beyond me.

Thank you for the link. I've done some reading on that website (gentlebirth.org) in the past weeks. They actually have an article on SUA babies that recommends a more aggressive and less patient approach than I have taken. For example, they recommend "aggressive use of herbs to help baby come earlier and smaller." They also recommend the use of Cytotec for induction of SUA babies, something I find rather alarming and would never choose for myself or my baby. In any event, considering that I'm now 42 weeks with a 10 lb + baby, gentlebirth.org has actually caused me more stress and worry over this upcoming birth than many of the other websites I've visited during the course of my research. You can read more about what they have to say about SUA babies here:

http://www.gentlebirth.org/archives/SUA.html

I'm no expert on position. Baby is head down, and I've been walking and doing squats.

If my dates are off, it can't be by more than a few days, as I was testing daily with an early response test and got my first positive less than 28 days after my period.


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