Artificial rupture of membranes - does it make contractions worse?

[mabel1973]

I had to have my waters broken in hospital with DS and I remember my contractions being so close together and strong that there was no let up and I ended up begging for an epidural.
Someone on my ante-natal thread has experienced similar contractions when she had her waters broken artificially. I am hoping to have a water birth this time and really want to avoid an epidural (I am due next week). I was asked last time if I would like them to break my waters, so I said yes assuming it would speed things up, (DS wasn't distressed at this point), so am I best to let nature take it's course this time, if they don't break naturally?

[tallulah]

My waters don't break, and for the first 3 kids the midwife broke them (I don't remember them asking either). I always found everything got more difficult and more painful afterwards. When I had the fourth I refused each time they asked to break the waters, until I was in second stage. The delivery was much quicker and much easier.

[poppiesmum]

My waters didn't break with dd - in the end the mw broke them when I was wlomst fully dilated. I don't remember the contractions being any more painful after that, but it did speed things up - I was fully dilated and cuddling baby 30 mins later!

[mrsnoah]

Yes. But then it speeds everything up too which is good .. isnt it ?
If they didnt break them, I assume the baby could get distressed (I am not qualified to confim that tho)

[liquidclocks]

Good idea to ask the MN crowd mabel - maybe it's just s though?!

[liquidclocks]

Oh, btw mabel - did you have your ARM to induce labour or were you already 'going' at the time - mine were broken to induce.

[mabel1973]

hi liquid - no I had already started I wasn't induced.
Incidentally my midwife told me this week when I discussed my birthplan that you shouldn't have your waters broken unless the baby is in distress, which DS wasn't at the time.

[mrsnoah]

mabel, if thats so I would query my own treatment. I had my waters broken with all 3 of mine and none were in distress. I had just reached a point in the labour where things were not progressing.. apparently

[samnbabes]

My understanding (could be wrong) is that

1. rupturing membranes speeds things up as the baby's head is no longer supported by the waters, so pushes down- this can either be good & fast, &/or a bit ow, depending on you
   
2. there shouldn't usually be any need to rupture membranes unless baby is in distress/there's a problem - although it sometimes is done to speed things up in 1st labours, i think this isn't 'best practice' - sure there's a m/w out there who can confirm?
   
   I had water broken artifically with dd2, due to a bleed in early labour) and she was born about 30 mins later - but pains never got HALF as difficult as it was with ds1(where waters broke naturally) in fact, it was only after the birth that I realised I hadn't had any pain relief (i only got pregnant for the gas & air )
   The consultant told me breaking waters wouldn't speed things up - but had the good grace to say 'whoops' when he saw me afterwards!
   
   IMHO, you're better off letting nature take its course - esp as second ones tend to be rather more speedy anyway!
   Good luck - hope the birth goes to plan for you this time

[cheeryface]

i remember already being in agony with ds2 when the mw asked me if i wanted her to break my waters.
i didn't know what to say, i just said, well, yeah if you think thats best. so she did. it did speed it up but i'm wondering now if she really should have done that?

[mears]

The research shows that breaking the waters only speeds up labour by 1 hour if you are lucky. It does inrensify painand it is MORE likely that the baby will become distressed because they are no longer cushioned. There is more chance of the baby's heart rate dropping because of presure on the cord. If nature is working properly the waters should not break until the baby is being born. I have seen a number of babies born in the sac.
If all is well, there is absolutely no need to break the waters at all.

[kdinas]

so what if you waters break naturally, before you go into labour?
Does this cause the baby to become distressed, and cause a more difficult labour?
Sorry for hijack, and also for being thick.

[liquidclocks]

Kdinas - as long as it's just nature taking it's course I think you're ok, it's when it's artificial you can run into problems.I had my ARM to actually get labour started - it was extremely painful and DS did become distressed at points, my midwife said that if you're ever given the choice don't have an ARM, let them go naturally.

[Joolstoo]

how can you measure that?

you can only measure the pain if you had the labour both ways and that every going to happen!

Some bod might suggest its more or less painful but no-one really knows - how could they?

[Joolstoo]

ain't ever going to happen

[liquidclocks]

Loads of ways pain is measured in research Joolstoo, all of them pretty subjective so you're right, no absolute way of knowing but generally agreed in research community that as long as it's the same subjective measure being used and you're only looking for a difference between two 'same' groups as oppose to comparision between different scenarios, the results are fairly reliable. Have been through 2 labours though (can't believe I've set myself up for a third go!) and the ARM one was far far worse. Also I'd tend to trust the midwive's opinion, they see enough of it after all - more than I'd want to anyway!

[mears]

It has been studies in great depth and it has been shown women who have their waters broken artificially need greater pain relief.

When the waters break before labour starts it is often because the baby is not lying in a good position. A well fitting head encourages an even bag of waters to form, like blowing up a balloon. If the head doesn't fir well (like OP), the bag of forewaters is irregular and the greater pressure on one particular area encourages them to break before labour establishes properly. Some women go on to labour without any problems. Some need to have their labours started by a drip.

When the waters have broken early, there is less cushioning for the baby and sometimes the heart rate has decelerations. That is a response of the baby to the pressure exerted by the contractions - doesn't necessarilt mean the baby is in distress.

I would stress again, if labour is normal, leave the waters alone.

[agalch]

My membranes ruptured during labour with ds1 and ds2.

Ruptured 2 days before i had dd1.I felt contractions were bearable till i was 8/9 cms.

With dd2 i had to have my membanes ruptured in theatre as i had a poss vasa previa.I was 4 cms when i had them done at 10pm and things progressed as normal but i felt contractions were more intense right away,but not unbearable.Had dd2 at 1am so 3 hours to get from 4cms to actual delivery so not really quick either.

I wouldn't have chosen to have my waters broken but safer to have it done.

[agalch]

Oh and i used the pool and entinox for pain relief so used less pain relief than when waters went naturally.

[pebblemum]

My waters ruptured naturally with ds1, 3hrs before contractions started, still ended up having a long painful labour (21hrs, no pain relief).
With ds2 my midwife broke my waters half hour after getting to the hospital, id been labouring at home for 4hrs. I didnt notice any increase in pain (at least not enough for me to want any pain relief) but it did speed things up, ds2 was born 30 mins later, . I did notice that my waters were more bloody this time around but ds2 wasntin distress and i was assured it was ok. Apparantly although i was almost fully dilated my waters didnt seem ready to pop which is why they offered to do it. I dread to think how long i would have had to wait if i let nature take its course. DS2 was already 8 days late, i just wanted to meet him

[blimey3]

Hi Mabel1973,

I would trust the midwife looking after you during your labour. They really are there to help and advise you at the time.

I had my waters broken with all 3 of mine - perhaps they don't break by themselves? Was painful with 1st, but actually labour got easier once they were broken with 2 & 3?

Asked my Health Visitor about your question as I was curious too, she said she knew of no correlation between breaking them and increased pain, it's perhaps coincidence in that the pain increases the further along labour you are anyway, and this is when you're also more likely to have waters broken. She added that would only break waters if it was in best interest of baby & mother - i.e. having waters intact was slowing down labour.

Hope this helps. Good luck with the birth.

[MummyPig]

I had ARM in my first labour and there were no probs with the baby, and it was a pretty quick labour too. I wish I hadn't agreed, but I was keen to get everything over with and that was the angle the midwife used to persuade me. The contractions did get far worse. In retrospect, I would have preferred the midwife to have encouraged me to move around more, instead of breaking the membranes, but they were focussing on me having the heart-rate monitor strapped around me (which I hated) and so I was mostly lying on a bed. I also remember her saying that if I lay on my back it would mean I was less likely to tear - but what my dp remembers is her saying something along the lines of 'to be honest, it makes it easier for me'

Second labour was at home, I was able to move around as much as I wanted and get into whatever position I wanted and I had made very clear to the midwives that I didn't want my waters broken, but then I don't think they would have done anyway. They were absolute stars and if (when) I have dc3 I will definitely want them around.

[mabel1973]

Thanks everyone - this is really interesting especially what Mears said. I had no idea that ARM would effect my labour when I had DS, nothing was explained to me at the time, and I will definately try and let nature take it's course this time and add this in to my birthplan.
Blimey3 - I know you are right in theory, but due to certain other 'issues' I had with the midwive who looked after me when I had DS (not reading my birthplan, making comments such as 'these scissors are a bit blunt' when doing my episiotomy.....), I'm afraid I prefer to be armed with as much information as possible this time, rather than trust the midwives to look after me..

[Xavielli]

My waters broke naturally with both mine. DS about 2 seconds before he came out and DD at the start of labour. I have to say DD's was more painful... or maybe just more recent!! lol

[Joolstoo]

the only time I had my waters broken was with ds1 - it was agony but labour was painless - I had an epidural