"Surprise Sweeps" and other "surprise" procedures

Squiggler

I've read in a few of the pregnant threads lately of women being given "surprise" sweeps by their consultant/midwife.

To me this would be a serious violation of both my body and my right to informed consent.

Is it unreasonable of me to expect that I would be asked before having such a procedure performed?

I've also heard/read of other "surprise" procedures being performed including
administration of gel and episiotomy.

I would be seriously enraged.

Is this type of thing normal? Are we really expected to accept whatever is done to us? Am I the only one who thinks that this type of treatment is seriously out of line?

January

I'd accept a surprise epiosiotomy rather than tearing. But surprise admin of gel or surprise sweeps I would kick up a stink over.

Gee_G

i think they just mean surprise sweeps when it is not an appointment made for this reason but they decide when you are there to do it, i doubt they do it without consent.
And in regards to an episiotomy, this is usually a last minute thing (someone correct me if i am wrong) to minimise tearing,which they prob wouldn't have time discuss as such, which i think i would be ok with.
I'm not sure about the above as this is my first baby but i presume Thats how it is :-)
any surgeries etc i havebeen in for i had to sign consent forms for different things.

cheesebiscuits

This happened to me twice when I was pregnant 2 years ago. It was horrible. She was quite aggressive and hurt me but I wasn't sure if it was normal or not.

Gee_G

they did the sweep without telling you?

cheesebiscuits

Gee_G wrote: »

they did the sweep without telling you?

She said she was checking for something else (cant remember her words exactly). I told her I didn't want anyone going "in there" and she said ok that's fine.
Then she just did it. I pulled away and she had a go telling me to lie still and stop moving. When I reminded her I didn't want one I didn't get a reply and she just got up and walked off.

0ctober

To be honest a surprise sweep wouldn't bother me as I am desperate at this stage to get things going. Although it would be very unprofessional not to ask your consent and I can understand why it would upset someone. Surprise episiotomy- I'd imagine there isn't a huge amount of time to ensure your consent, I'd agree with someone else here who said they would prefer it to tearing.
Like GeeG said maybe it was just that they weren't expecting to be offered one going into the appointment? If it's something you're worried about discuss it with your doctor/midwife, especially before any internals.

Ginny

I went in for my 39 week appointment, was given a scan and told to hop up on the table for an internal, I thought it was a bi sore but was ok. later that day was admitted and I was asked if a sweep was performed, I said I don't think so, as I wasn't told on was one. They checked my notes and a stretch and sweep had been done. To be honest I didn't mind that, I felt the attempts at breaking my waters A lot more upsetting and un dignified and aggressive, and the reg just wasn't giving up until she go it done no matter how sore it was for me. As for the episiotomy I did say do it if I need one but don't tell me when you're doing it. She didn't listen at all and let me tear

Squiggler

January wrote: »

I'd accept a surprise epiosiotomy rather than tearing. But surprise admin of gel or surprise sweeps I would kick up a stink over.

Gee_G wrote: »

And in regards to an episiotomy, this is usually a last minute thing (someone correct me if i am wrong) to minimise tearing,which they prob wouldn't have time discuss as such, which i think i would be ok with.

But this is the thing... there is no evidence that an episiotomy reduces tearing, some studies indicate that it increases the chance of severe tears and there is evidence that they take longer to heal than a natural tear.

http://www.babycenter.com/0_perineal-tears_1451354.bc just one information source, but there is a lot of research out there that indicates that they are to be avoided.

It is usually done to speed up delivery, perhaps because the baby is becoming distressed. It shouldn't be a routine procedure, and certainly not a surprise one.

theg81der

I would say it would be harder to do a sweep if someone is "readied" for it maybe thats why. I`d prefer not to be told I don`t care as long as they do it. Epiosiotomy is a different story - don`t want one suprise or otherwise!

pushkii

Yes i think that's what happened with me if i knew i was going to get the sweep i would have really tensed up.
I think the Dr went in to do an internal and when he felt the cervix was ripe he did the sweep! I still would have liked it to be explained to me and my consent asked as i got quite a shock and was not expecting it. At least there was a midwife with me during it and it didn't hurt that much.
As for an episiotomy if it was an emergency that would be fine but having one done without need and consent would really madden me.

jeeney

I don't blame you pushki - I would like to have been told too if a sweep was going to be performed.

I agree with you OP Squiggler! I too would be most put out if I was not told/consented to what they were going to perform. I have no experience of having sweep, etc done as I didn't need it during the last pregnancy. But regarding the episiotomy, I had it in my birth plan that I really didn't want one unless was medically necessary. They midwives repected my wishes but after 2.5 hours of pushing they suggested it to me. At that stage I agreed as I was so exhausted. But note, I was given the choice and could have refused. And so it seems hospital experiences tend to differ greatly as do women's opinions of having procedures done unexpectedly or not....

pwurple

Squiggler wrote: »

But this is the thing... there is no evidence that an episiotomy reduces tearing, some studies indicate that it increases the chance of severe tears and there is evidence that they take longer to heal than a natural tear.

They are usually done for vaccuum assisted births, where the baby is in difficulty, heart rate is dropping, and they need to get the vaccuum onto the head.

I went in for my 39 week appointment, was given a scan and told to hop up on the table for an internal, I thought it was a bi sore but was ok. later that day was admitted and I was asked if a sweep was performed, I said I don't think so, as I wasn't told on was one. They checked my notes and a stretch and sweep had been done.

This is a complete disgrace, and I'd go absolutely flipping mental if that was done to me. You weren't even at your due date. What hospital was that?

Squiggler

I'm glad to see I'm not the only one who would prefer to be asked and given the choice.

It's just something I've seen crop up in threads here over the past two years with little or no reaction, or even sometimes with a reaction that showed that the Mother wasn't even aware of the purpose/advantages/risks of the procedure.

There is so much going on already in pregnancy that it's difficult to be fully informed about all the possible interventions and procedures and their benefits/risks. But I'd expect at the very least that healthcare providers would explain what they were thinking of or planning on doing and why.

I'm not going to be letting anyone near my nether regions at this rate, just in case they get ideas.

Squiggler

Squiggler wrote: »

It is usually done to speed up delivery, perhaps because the baby is becoming distressed. It shouldn't be a routine procedure, and certainly not a surprise one.

pwurple wrote: »

They are usually done for vaccuum assisted births, where the baby is in difficulty, heart rate is dropping, and they need to get the vaccuum onto the head.

Yes, which I can understand, but it's clear from some posts here that not everyone understands that, or has had it explained to them by their carers. It was cited as a way of preventing or limiting tearing, which it absolutely does not do.

Kaylami

bit different but with my first I was admitted at 38+5 with odema etc.
my partner had just gone home for the night and the consultant came to see me.

I was told i was being given an internal examination "just to check".
while this examination was being done i was told to expect some pressure.

i asked why and was told because were about to break you waters.

just like that!

nothing was explained to me and i didnt have a chance to ask any questions!

needless to say this time i question everything!!!

Ginny

pwurple wrote: »

They are usually done for vaccuum assisted births, where the baby is in difficulty, heart rate is dropping, and they need to get the vaccuum onto the head.



This is a complete disgrace, and I'd go absolutely flipping mental if that was done to me. You weren't even at your due date. What hospital was that?

Ah in fairness I had issues re fluid and lack of movement and was only 1 day from due date, the consultant just wanted baby out ASAP. Funniest thing is the person who gave me the "surprise sweep" was the only person who listened to me, for the rest of the induction and labour I felt very side lined and ignored. So much so I don't think I could do it again. I'm hoping at the 6 week check up I can actually talk through what happened with someone in the hospital.

Hannibal Smith

Surprise sweeps and procedures, I would completely disagree with....but I don't know how that's defined. Is it when they say they're going to examine you and you get a sweep as a by one get one free deal? Or do you mean when you turn up to an appointment and you're told you're getting a sweep?

Unfortunately there are sometimes when you have to be checked and there's only one way of checking On my first I had to be induced 4 weeks early and the doc came along to check my cervix (I was an inpatient). It was obviously no where near ready, but I really wasn't expecting that kind of a check :eek::eek::o but I guess how else would he have done it? I remember telling my OH when he came to see me that night that I felt violated :D but, I guess it had to be done? I think I was being a bit of a baby . I wasn't so precious second time round ...you can tell by all the smileys I'm using I'm still embarrassed by it

Anyhow, other than that one 'off' experience, I've had everything from the fetal scalp monitoring, to blood tests on the fetus (with the large metal rods) and at each stage I was informed all the way along of what was going to happen (this was at the labour stages)....they were an unexpected surprise, but they had to be done.

Hannibal Smith

Kaylami wrote: »

bit different but with my first I was admitted at 38+5 with odema etc.
my partner had just gone home for the night and the consultant came to see me.

I was told i was being given an internal examination "just to check".
while this examination was being done i was told to expect some pressure.

i asked why and was told because were about to break you waters.

just like that!

nothing was explained to me and i didnt have a chance to ask any questions!

needless to say this time i question everything!!!

Nooooooooo! :eek: Now THAT I would be mad with :mad:

January

Oh god I would be furious if they broke my waters without asking me!!

My consultant at number two asked me if I wanted to see if I was favourable for a sweep but when he checked I wasn't so he didn't even bother trying.

wmpdd3

On number 1, after 2 hours pushing the little table with a forceps and a scaple was wheeled in. The midwife got my attention and told me to start pushing 3 strong pushes on each contraction or i was getting an episi. She knew i didnt want one, so i pushed for my life, torn massivly internally. Once i was stiched i was fine. I had given my birth plan to the moswife when i met her. In the queue at the clinic around 36 weeks, nearly everyone got a sweep except me. They were mostly around 39 weeks. I had my baby 10days later!

Squiggler

Hannibal Smith wrote: »

Surprise sweeps and procedures, I would completely disagree with....but I don't know how that's defined. Is it when they say they're going to examine you and you get a sweep as a by one get one free deal? Or do you mean when you turn up to an appointment and you're told you're getting a sweep?

Anyhow, other than that one 'off' experience, I've had everything from the fetal scalp monitoring, to blood tests on the fetus (with the large metal rods) and at each stage I was informed all the way along of what was going to happen (this was at the labour stages)....they were an unexpected surprise, but they had to be done.

I was mostly talking about what happened to ginny and cheesebiscuit. No information and no consent and only being told after the fact.

By Informed Consent I mean when a woman accepts a test, treatment, or procedure based on her own knowledge and after being presented with all the necessary information (benefits and risks, implications and future consequences) by her care providers in an unbiased way. (taken from this Association for Improvements in Maternity Services Ireland Factsheet)

If someone told me they were going to break my waters, without at least explaining why and asking if I agreed I would have a serious problem with that.

I just find it incredible that there seems to be this assumption among maternity care providers, the general public and, it seems, some pregnant women that pregnancy removes all basic rights from a woman. The more I experience (second pregnancy) of maternity services, and society's general attitude, here in Ireland the more it disturbs me.

Squiggler

Squiggler wrote: »

I just find it incredible that there seems to be this assumption among maternity care providers, the general public and, it seems, some pregnant women that pregnancy removes all basic rights from a woman.

Sorry, just realised that this bit might sound harsh. I don't mean it to be. It just seems that some women have been so browbeaten or brainwashed that they don't seem to believe that they have any right to expect pregnancy and birth to be anything other than a hellish nightmare to be endured, where everyone tells you what to do and what's going to happen and you just take the pain and damage... and 'sure you'll forget all about it when you've got your baby in your arms'. :rolleyes:

I've been doing some research lately on Postnatal Depression rates, has made for a few days of interesting reading. Highest incidence among women who had managed vaginal hospital births.

I wonder how much that is due to the lack of information/control/consent/privacy etc?

taxus_baccata

here here squiggler. I have a friend who suffered terribly as a result of a "surprise" episiotomy. It broke my heart to see what she went through, hospital doesn't seem to give a damn even though she has complained.

Squiggler

taxus_baccata wrote: »

here here squiggler. I have a friend who suffered terribly as a result of a "surprise" episiotomy. It broke my heart to see what she went through, hospital doesn't seem to give a damn even though she has complained.

:mad: That's the type of thing I'm talking about. Makes me feel sick!

It's wrong, shouldn't happen and yet it does AND not only are the affected women given no support but nothing is done to prevent it happening again to them or to someone else.

And, it puts people like me in the position where we don't feel that we can trust the midwives and other hospital staff, because they (in general) apparently see nothing wrong with this type of action.

Hannibal Smith

gotcha

wmpdd3

I agree, but I found such a difference the second time round as soon as I gave of questioning vibes I was treated totally differently. It was as if they could see I was writing a complaint as I was contracting!

I totaly agree with the fall out from managed vaginal hospital births and have someone close to me going through this at the moment and aside for the six week check up there is no support.

The PHN is really baby focused, they refer any dip in mental health to the doctor who seems to rely on meds as opposed to support. The best I could suggest is for the person to write down everything that happened so they can possibly accept it and try build on it.

Kash

I had a surprise sweep - I had been admitted for an induction, so was having regular internals to check my cervix (as you do) but in the middle of my fifth or sixth I felt something far more painful and THEN the doctor said "I'm just doing a quick swep here for you darling" as I tried to squirm back through the wall.

Fair enough, perhaps some people will tense up if they know in advance, but personally I prefer to be mentally prepared!

Squiggler

Kash, that's awful. To me that is no less a violation than rape.

Ayla

I too had a surprise sweep with my first. The consultant, in doing her exam (I was only +7 EDD) thought I was showing signs of early labour & figured I'd be going in the next couple of days. So I was confused when she said, "ah sure, I'll just help things along"...wwooop. Done. No explanation, no discussion, no decision needing to be made.

In all honesty, I was more upset that she didn't talk to me about it first, more so than the fact that she did it at all. She knew I wanted intervention free, and she saw all the signs that I wouldn't be lasting more than a few days anyway. Why she did it I don't know...maybe she really thought I wanted the "help," or maybe it was just autopilot for her.

It all happened so fast it wasn't really until I was leaving that I actually understood what had happened at all.

Considering the (well evidenced) fact that sweeps & any internal exams hold their own risks I am surprised that consent isn't required.