Doc breaking your water

Mt2G1012

Is there any reason this would medically have to be done?  I will only be induced if there is a medical necessity.  My doc induces at 41 weeks and 5 days if there is an issue with fluid levels, etc.  In birth stories on here, I read a lot about docs breaking a woman's water.  Is this necessary becuase of the pitocin and no progression in dilation?  Would they break your water if you aren't progressing enough?  Sorry of this is dumb, I'm just trying to figure out if I need to include this in my birth plan.

darkpixie08

There's no medical reason to break someone's water unless you are trying to induce/speed up labor.  I would probably opt for breaking of the water vs. pitocin if possible, because my understanding is that pit contractions are incredibly strong and usually very painful.  Contractions after breaking your water aren't going to be a picnic, but I would think that they would be easier on your body than chemically induced ones.  Basically if I needed to induce/speed up labor for medical reasons, I would probably want to try stripping membranes coupled with walking, red raspberry leaf tea, evening primrose oil etc, if that didn't work, move onto cervadil, if that didn't work move onto breaking water, if all else fails move onto pit.  Pit for me is ideally a last resort.  Granted all of this would depend on how quickly they needed me to go into labor.  Once your water is broken however, if you are in a hospital, you are on a more strict time table, because they start getting really worried about infection, just something to keep in mind.

randalin

There are a few reasons for having your sac artifically broken - to attach a fetal monitor to the baby's head, to test the amniontic fluid for meconium, but I think it is mainly done to speed up or induce labour. There are some risks to having this done though and I would read up on them so you're informed and can make the right decision that is right for you if you need to.

yeshuahamasshiah

AROM (artificial rupture of membranes) is consider a form of induction.

While I would say labor with your bag of waters intact for as long as possible, if you are at the verge of being artificially induced with medication then AROM would be my first choice before Cervadil/Pitocin or any other drugs.

Also keep in mind that once your membranes have been stripped you are at a higher risk of infection.

To answer your question, I do not believe AROM to be necessary, specially if you are not past your due date, but it would be up to you and your care giver to make that decision, if it is considered to be medically necessary then you would have to make that call.

AROM simply increases the production of prostaglandins. Using evening primrose oil in your vagina, along with taking it orally would increase your prostaglandin presence and help to ripen/thin your cervix. Also semen is rich in prostaglandins, so having sex and making sure your partner ejaculates inside would also help.

HTH

LindseyJW

my MW broke my water about 36hrs into labor b/c my ctx had stalled and we hoped that breaking the water would jump start things. didn't work.

bandwife

randalin:

There are a few reasons for having your sac artifically broken - to attach a fetal monitor to the baby's head, to test the amniontic fluid for meconium, but I think it is mainly done to speed up or induce labour. There are some risks to having this done though and I would read up on them so you're informed and can make the right decision that is right for you if you need to.

This.

While I would not include it in my birth plan I WOULD ask my OB/MW what their policy is. Once your water is broken a lot of OBs/hospitals have policies that you must deliver within X number of hours.  This can lead to more interventions.

tastyburger

I'm going to try and labor as long as possible with intact waters.  It reduces pressure from the baby, can "preopen" the vaginal opening to make it stretch better for the baby's head, and . . . is considered "good luck."  : )  But if it comes between trying that or another means of induction, I will let her break my waters.

Mt2G1012

Thanks ladies.  I guess I will need to do some more research.  However, I will talk with my doc about it and tell her this is what I would like if induction were absolutely necessary before any medication. 

~adamwife~

I didn't have my water broken the last time and I am SOOOOOOO glad I didn't.  It didn't break on it's own until the last push and then swoosh my son came out riding a wave.  The water served as a cushion throughout the birth and made the pain much more manageable.  After that experience, I would never have my water broken unless I wasn't progressing and the baby or I were in danger.

With my first I had my water broken at 4 cm and the pain went from a 2 to a 10 in about ten seconds.  It was horrible.

AutumnBride929

My midwife broke my water to induce labor.  I wanted that done before any Pitocin was given to me.  I'm glad I didn't need it right away.  The amniotomy was all I needed to start my labor at 41 weeks, 6 days.

nd01

I'm just lurking here (as I ended up getting an epi but I did try for a natural birth)... but for what it is worth, I was 41 weeks and had very low amniotic fluid levels so was mandated by my ob/gyn to go to the hospital to be induced (my doula agreed given my levels).  As I wanted to avoid an epi, I also wanted to avoid pitocin so they broke my water instead.  I absolutely jump started labor but I wonder if the pain would have not been so bad if I had that cushion of fluid during the contractions (however, I still think it was preferable to pitocin).  

CTL2005

I actually requested that they break my water with #3, because I was in a weird situation where I was dilating without being in labor and at midnight I was just ready to get the show on the road.  The long story is that I had been 6cm and 100% effaced at the midwife appointment (1 day overdue).  Since I lived 45 minutes from the hospital and my other two births had been speedy (7 hours and 3 hours) they told me to come at the first sign of anything.  When the BH's would not go away after getting up and walking around or lying down, my husband insisted we head in to be checked.  We got to the hospital and the hooked me up to the monitors and checked me.  I had ZERO contractions while on the monitor for 30 minute, but was now 7cm.  They told me to get dressed and walk around for an hour.  My husband and I window shopped at the gift shop and I kept having very manageable BH's.  After an hour I went back to be checked and I was 9 cm.  At that point (12:15 am) they said there was no way they were sending me home at 9cm and so I requested that they break my water.  He was born less then 45 minutes later...so I dilated to 9cm without being in active labor...crazy!  I am sure he would have come out on his own, without water breaking, but I was looking forward to active labor and ready to get the show on the road and start having some real contractions.

So that was my reason for requesting that the midwife break my water.  And, Oh Good Lord did the contractions start coming on fast and furious after the water was broken.  I went from 0-60 in like 3 seconds. 

duncanpowers

Henci Goer had some good studies in her book about this. Basically, there is no scientific benefit to AROM in early labor, period. It did not speed up or shorten labor or dilation. However, after reaching more active labor and 4-5 cm dilation, it can assist if labor is stalled. So, as pp mentioned, later in labor, if it's stalling out, it's something that can naturally help move things back on track. But unless it breaks on its own to start, there's no point in having it done in the early stages or if stalled at 2 or 3 cm.

blackfire5th

I only lurk on here occasionally, but the Dr. broke my mother's water during labor with me and all her contractions stopped.

They were able to get things moving again after new positions, but it took about an hour and I was almost a c-section baby. 

JuliaBug

I worry about having my OB break my water, because that puts a dealine to how long I can labor before they will want to do an emergency c/s. I think it's 24 to 36 hours after the water has broken. I'd rather have be given pitocin to be induced and end up with an epi than have my water broken to be induced and end up with a c/s. 

Find out what your doctor's policy is before you consent to it.  

lily225

I had mine broken with both of my girls when I was at 7cm. With both I was feeling intense pressure and the urge to push. They broke it to see if it would get me to 10 faster so that I could push.

With DD1 I went from 7-10cm in 30 minutes

With DD2 I went from 7-10cm in 5 minutes

So for me, I don't mind getting it broken at the end if my body is wanting to push but I "can't".  Before that, though, I wouldn't want it done. It makes the contractions more intense, so if I'm not close to the end, why would I want to deal with the extra pain and also be put on the clock?

Mrs.Greeko

There's really no reason to break a woman's water.  With my first the OB broke my water when I was pushing because "the bag of waters was bulging and holding her in."  I was not in a position to question her or even think about it.  She broke my water and my daughter came literally flying out like a water cannon according to DH the next push.  There was no ring of fire or anything resembling the ring of fire.  Sounds great huh?  Yeah not so much I ended up with a third degree tear and some internal tearing. 

With my second my midwives didn't break my water.  It broke naturally awhile after I'd been pushing.  I pushed for longer (I think) with my second and I definitely felt the ring of fire for what felt like forever.  But I didn't tear.  I think breaking my water the first time allowed my baby to come out too fast and not stretch me as I naturally would have stretched. 

However, my first DD was born at 41w4d and I was scheduled to be induced at 41w6d.  If I would have gotten to that point I was going to have my water broken to try to jump start labor a bit more naturally than pitocin. 

d.cubed

This is a great post because it helps me think about what my "game plan" would be if I get close to 42w!

I also read the Henci Goer book, so I'm not so keen on breaking water.  I think that, if I HAD to be induced (i.e. my levels were low - not just because I'd reached a certain "day"), I'd do the following:

1. More "natural" remedies - acupuncture, primrose oil, sex, tea, walking, walking, walking, etc.

2.  If those didn't work, I'd have my cervix checked for effacement before proceeding...

3.  I'd go with cervidil to try to get my cervix "ripe."

4.  I'd consider artificial stripping of membranes - but not the rupture.  I don't want to be put on that clock!

5.  I'd consider a low dose of pitocin, if my cervix was ripe enough. 

For me, I think that I'd take pitocin over artificial rupture because I wouldn't want the infection risk or to be "put on the clock," if I was under 4 cm dilated.  As stated before, artificially rupturing doesn't really do much to speed up labor until after 4-5 cm.  After that point, though, it can really speed things up!  

kesrya

While there are many non-necessary reasons why a doctor may break your water, there ARE a few medically necessary reasons - so those who are saying there absolutely are none are mistaken.  I would agree that in most cases where this is suggested, it is not medically necessary and you should feel comfortable declining.

The most serious issue that I can think of is in the rare cases where a woman has too much amniotic fluid, which can happen for several different reasons.  If the membrane has not ruptured when contractions begin, it is possible for a contraction to create a a rupture that is so forceful the excess amniotic fluid may cause the umbilical cord to drop into the birth canal, or may push the baby into the canal in an unfavorable position - for example, it could push the arm or shoulder into the canal.

In this case, a doctor or midwife would want to rupture the membrane so that the amniotic fluid can be released in a controlled manner to avoid these complications and the baby can be monitored to assure that none of these complications did occur.

Because there are these few rare incidents in which it is medically necessary, if your doctor or midwife suggested it, I would ask them to be very clear about *why* they feel you need it, and make your decision based on that.

duncanpowers

Perhaps, but I'm not sure how they would prove that there is too much amniotic fluid first, or how they would control the release of fluid while you're contracting after the break. Conversely, the risk of AROM actually causing cord prolapse is much higher than allowing the water to break on its own. So I think the burden of proof would rest on them to prove that this rare condition was happening prior to my agreeing, otherwise they could just end up causing what they are supposedly trying to prevent, which is a common theme in birth interventions.