Anyone been induced by just having their waters broken?

[CloudyVanilla]

Hiya,

I was induced with my second DC but using the usual procedure of pessaries and building up to waters being broken.

This baby has an unstable lie; an ECV was successful but he has flipped right back into a transverse lie again!

I've been told the plan is to turn him again and then induce straight away by breaking waters so he can't move into the wrong position.

I'm quite nervous to be honest, it sounds like a quick jump and a recipe for a failed induction and EMCS.

I don't want to refuse though as I have been having some signs labour could be round the corner and have been told due to the risk of cord prolapse I would need to treat it as an emergency if my waters went at home. I also no longer have the option of turning him and waiting for natural labour as this was done before and he turned around again.

The ECV was painful and stressful (his heart was very fast on the monitor afterwards) and while I'm willing to try again in pursuit of a natural labour, I'm scared of the consequences of going straight to having waters broken to start labour - I have read this isn't really recommended?

I've had 2 straightforward deliveries before so I was really hoping to avoid a c section, but does it maybe sound safer to skip the ECV and induction and just book an ELCS instead?

Don't have much time left now to decide and I'm getting a little stressed!

Sorry I meant to post this in Childbirth not Chat

Blimey. I wouldn't fancy that. I'd go straight for ELCS in your shoes. Have your treating team advised what the odds of success are, and talked about risks vs benefits of both approaches?

My second DC was induced by just breaking waters. He came 3 hours 20 minutes later. You are usually a few centimeters dilated already with subsequent children so you don't always need the pessaries/drip etc to start with.

Actually they haven't really!

Nobody has said much apart from it would be an ELCS if they can't turn the baby but as he has already been successfully turned, they haven't even really spoken about that at all.

I know I did say when I found out his position at 37 weeks (he was head down on 34 week growth scan) that I wanted to avoid a C section, but not at any cost. However no one has even discussed the option of skipping the ECV and going straight to CS, come to think of it.

@chocolatepudandchocolatesauce yeah I did at first assume that was the reason but on googling I'm still a bit worried about going straight to ARM. It's really reassuring to hear you had a good experience though, thank you :)

I was going to be induced by having my waters broken. I was 2 dilated so they said there was no need for the pessaries part. Luckily for me I asked for a sweep prior to the induction I had booked three days later and the sweep put me into labour.

I had my third induced by breaking waters and he arrived a few hours later. It was a very quick labour once it got started.

Don’t feel pushed into doing something you don’t want. If you feel there is an alternative and don’t want baby turned again, your feelings and preferences must be considered before decisions are made.

I had my waters broken when I was about 3gm dilated and my contractions started within 5 minutes.

Thank you so much for the replies they are very helpful.

It sounds like perhaps, given it is my third baby, they are expecting it to go smoothly and fairly quickly?

Can I ask for an epidural before or very shortly after they break my waters? I am just very aware this could end in CS and I have an enormous fear of GA so I want to be ready to be taken for one without having to worry about potentially needing to be put under GA.

I think this is my main source of stress really.

Of course you can - they can recommend whatever course of action the medics recommend but you still have to consent to it. You can insist on an epidural prior to ARM, or on an ELCS. At the end of the day, the medics and you both want the baby out safely and your concerns are very reasonable. Definitely discuss your concerns with them, and push them to explain the benefits and risks to you, and what they would do in different scenarios, eg if an EMCS was needed. But it’s fine to have some “red lines” if you don’t feel comfortable with what they recommend and would prefer to go straight to section.

My DC were both transverse. Not once did the midwife or Dr suggest trying to turn them, they said they don't like doing it and they more than often turn back. They said if they hadn't turned by 36+4 they would schedule c section. Luckily one turned at 36+2 and the other 36+3 (that was horrible as there wasn't much room so I was really violently sick as they pushed the contents of my stomach out as they turned!)

I would definitely ask for c section.

I had a planned c section for transverse lie a few weeks ago, and honestly I would recommend it.

The chances of needing an EMCS after turning and inducing the baby are very high, so I decided I'd rather skip those bits and go straight for a planned section.

It was great - calm, very little pain, and recovery so far has been straightforward.

Just to add-you can request an epidural (I’m an anaesthetist and cover labour ward a lot) - you cannot insist on one however as someone suggested up thread. I see this on MN a lot where people suggest insisting. You can refuse any treatment you choose, you cannot demand a particular treatment is offered.

Anaesthetics may not be terribly happy to site an epidural (and expose you to risk) if the ARM fails to start labour and the epidural itself may slow your labour down if done that early. You also cannot insist on a epidural for emergency section-brilliant if there is enough time for the drugs to work (10-20 minutes easily not including 10-15 minutes to site it) but if there is a cord prolapse after ARM then the only quick and safe way to deliver may be general anaesthetic. Or an epidural may be fine. Of course you can refuse general anaesthetic but the risk of harm to baby would be extremely high. We avoid general anaesthetic in obstetrics as far as possible-when we do it it’s because the situation is critical.
I would have a conversation so you fully understand your options if you proceed with ecv or if you refuse and you can always ask to speak to anaesthetists now to see what they recommend in your specific situation.

I did but I was already 4cm dilated after about 3 days of on and off very light contractions. Breaking waters made them very painful and no gap between them but ds2 was born 1.5 hours later so can’t complain really!

I did.

Waters were broken using a long knitting needle looking thing then they told me to ‘go for a walk around the hospital’
However, I couldn’t as the fluid was literally pissing out of me, I was soaking the big pads so had to just lie down.
Pains started an hour later then she came about 2 hours after that.

I did for my third child.

As above, they optimistically told us to go for a walk. I’d made it as far as the hospital cafe when the contractions kicked in big time. She’s recorded as a ‘four minute second-stage labour’ as that was about the interval between making it back to the bed and her turning up.

It was pretty intense and painful but at least it was quick.

Thanks all this is very informative

@Veganmedic oh dear that information is super useful but quite scary :S

I don't want to sound insane and it's very morbid to say, perhaps isn't appropriate to post here and could do with it's own thread but I've had a horrible gut feeling throughout this pregnancy that something bad would happen to the baby :(

I definitely understand that if cord prolapse happened they would need to do whatever they could ASAP, however I was kind of assuming that they wouldn't break the waters unless he was successfully head down and not too high so was hoping if I needed a c section it would be due to lack of progression rather than anything else.

I'm getting really nervous now, I'd like to speak to my midwife who is lovely before any of this happens as I am scared of a c section but also scared of a complicated labour.

Pregnancy has been so stressful at the end this time round

Of course you are anxious, nobody wants this for their pregnancy. Cord prolapse is one of those terrifying obstetrics emergencies-when it appears out of the blue. In your case they know it’s a risk, a controlled ARM would happen in theatre and if anything untoward happened the baby could be out in minutes. I definitely think you need to better understand your options-an obstetrician is possibly best placed you go through these with you but obviously also your midwife.

Honestly, I would just go fir an ELCS, I’ve had 2, they are calm, painless and extremely safe way to deliver a baby. I’d you’d had a gut feeling all pregnancy I would 100000% percent listen to that and go fir the safest route, which looks like ELCS.

Thank you guys, yes I think the focus of conversation with medical staff has been on the ECV and risk of cord prolapse if I happened to have my waters go if I was at home and had to get to hospital. Not much has been actually explained to me about the induction process or any alternatives, which is actually a bit weird I suppose.

I am still willing to speak to them on Weds and see what they think but I'm definitely leaning towards asking for a C section. It just doesn't feel right and since I'm instinctively hoping the ECV fails! So maybe best avoid it.

Personally my main concern would be the risks of another ECV. I don't know anything about the risks of going from ECV straight to ARM. Although I recall they are meant to monitor the baby for some time after an ECV. I think you need to talk through the risks with a consultant.

I had induction via ARM and it was fine, I would definitely recommend it over having the pessary/drugs which I have heard can be very painful.

I don't think there is necessarily any benefit to having an epidural prior to labour, as if they have to move to emergency c section I think that needs a spinal block, not an epidural? And they can do the spinal block v v fast. This happened to me, I was told they would make two attempts at spinal block and then go straight to GA as it was an emergency. Luckily they got the block done straight away. I had some particular issues that made it hard to put the block in.

I've had 3 inductions 2 by only water breaking. Both times I was 3cm when they broke my water and labours were really quick 2 hour and 1 hour !!

Sorry I cross posted, from your last post I think c section sounds like a very sensible option.

If you're nervous about GA, an advantage of ELCS is that you would likely have it under spinal anaesthesia.

Thanks @HotPenguin, yes I'm also a little worried about ECV. Sounds strange but I have a lot of water and when my son was born, the midwife commented that it was the longest umbilical cord he had ever seen. I'm not an expert at all but it just seems all this turning and the water and the cord, it just feels like a risk.

I would love to have a quick and straightforward induction and in fairness they have been very reassuring. I shouldn't have said I would be induced straight after, I mean that they will turn him on Weds and admit me to hospital, then if he is still head down in the morning they plan to do the induction. I'm worried about loads of stuff including whether he will stay in place long enough, as obviously my induction could easily be postponed in a busy hospital!