Artificially breaking waters in labour

[digggers]

Is it good practise for a midwife to artificially rupture a mither's waters in childbirth? Under what circumstances might this be necessary?

Mine were artificially broken, in the hope it might induce labour naturally. When that didn't work, I was induced via drip.

Couldn't advise as to whether it was good practice or not, but I certainly wasn't mithering

Depends on the situation.

My waters did 'break' but after over 24 hours of rubbish contractions and then another 12 hours of drip to get things going they examined me and then realised they hadn't broken fully and that the baby's head wasn't pushing down properly on my cervix to encourage dilation.

As soon as they nicked the waters under my baby's head she was out 20 mins later! For me it worked fine but it really depends on your birth plan and how it all goes!

it didn't help me but then it was a last ditch attempt to get things going before they put the drip in.

I have had my waters broken twice, first time with DD2 I was 10cms dilated but waters still intact and her head not engaged. Waters broken 5 mins later she was born.

DS I was induced and after first pessary was contracting nicely but was getting fed up so asked to be examined and was 7cms nut again no head engaged, I basically told MW to break them, 4 mins later he was out, was 4th baby though, nos 1 & 3 had waters break by themselves at the start of labour.

I had my waters broken in labour with dd in hospital. The explanation behind it was that I was in the final stages and had started pushing involuntary. It did seem to speed things up contraction wise, and dd was born 30 mins later.

I had ds at home and the labour went along the same lines as with dd, except that the mw's refused to break my waters, saying that it wasn't good practice at a home birth. It also wasn't necessary. My waters broke on their own in the end after much walking about and hanging off dh .

Mine partially went at the start of labour, then my midwife realised after transition that they hadn't fully gone and - much to my fearful protests - decided they needed to be broken to speed DS along. He was actually stuck sideways and by removing my waters she removed the last chance he had of getting in a correct position. So I had a section shortly afterwards. Humph.

I personally was glad my waters were artificially broken during the birth of my last baby. I had a hard, fast labour and was ready to push, except the waters had not broken, mw popped them, and I gave birth less than 20 mins later. They were not ready to pop themselves, so who knows how long it would have taken, or ds may well have been born with waters still in tact, as mw thought might well have happened.

Like many interventions, it is an option you can choose to take or choose to refuse.
In my case, when my midwife suggested it, I asked her why she was suggesting it at that time and, based in what she said, we decided to have them broken, for me I think it helped and dd was born about an hour later. A fellow NCT group member was in at the same time and she had a much longer labour, she refused to have her waters broken, and this may have been a factor.

Is it good practise? I'd rather say it is an option you may choose to take depending on your circumstances at the time.

Are you concerned about it, apprehensive about it, wishing you'd had it done or regretting having had it done?

Why no waters broken at a homebirth? DD2 was a homebirth and the MW asked me if I wanted her to break them to speed things up. I was contracting back to back in agony if she had offered to cut my toes off to make the baby come quicker I would have agreed.

I was being induced. FOUR BLOODY DAYS!! of that gel and I was only one frigging cm dilated.

So they took me down to break my waters.

And they gave me gas and air.

And I started to giggle, called the (gorgeous!) dr "little bo peep" and asked him where his sheep were.

That was at 9am. That evening I was ready to push.

Then my baby's shoulder got stuck and they pulled so hard that they caused nerve damage and left him with erbs palsy.

I can't help thinking that they should have left well enough alone.

Mine were broken to try and induce labour. We were trying to avoid using drugs because I was holding out hope for a VBAC but I was developing pre-eclampsia and baby had to come out quickly. I had already been contracting a little and was 3cm dilated and it did encourage more action, but in the end not quickly enough and I had to have a drip too. If I hadn't been unwell and so under pressure to deliver soon I would have refused.

Oh, and they also stuck me on a drip. something beginning with S?

That baby did NOT want to come out!

sweetkitty - I was told that if labour is progressing normally, that they prefer nature to take it's course in a home environment as long as there's no cause for concern. Can't really remember much more detail as I was badgering them to do it as I knew that ds would be soon on his way once the waters had gone

Ds2 was induced 15 days over. My labour wasn't long and i think that they wanted to speed it up because they needed my room on a very busy labour ward. They said it was lack of progression. It bloody hurt and i didn't want it done but maybe i wouldn't have come home the same day if things had happened an hour slower so there were pro's and cons!

I had my waters broken with both my labours, which were both progressing quite nicely (I thought!) both times DC's arrived within a couple of minutes...

I had my waters broken both times.

I was fully dilated and pushing involuntarily as Pavlov has described. Both were short, intense labours (dd1 4 hours, dd2 under 2 hours) and baby delivered shortly after waters were broken.

I had no pain relief either time and felt some relief with the waters breaking so I was happy to have it done.

Certainly helped in my first labour - was very slow dilation before waters breaking, then when they broke the waters everything doubled up in speed and ds was born 7 hours later. I've been told it's not 'good practice' to do it too early, but this opinion might vary. I'd certainly have it done again in a similar situation.

I haven't had my waters broken but I have become more interested in this topic.

My second was a home birth of under 2 hrs which was a BBA. My waters did not break until I was already in the pool and by then dd had already begun to descend into my vagina.

It turns out that she had a velamentous placenta and artificial rupture of membranes could have caused her near certain death.

If you look at my profile you'll see her placenta. A quick google found this rare but : These unprotected vessels may rupture at any time during pregnancy, causing fetal exsanguination and death. Although spontaneous rupture has been reported before labor and with or without intact membranes, this accident occurs most often during amniotomy.

I think in home births they can break membranes artificially but most mothers who choose home births also chose them because they want labour to progress without intervention and ARM is an intervention.

The reason I'm asking is that a friend experienced a homebirth when her waters were broken when she was 8 cm dilated after 14 hours of labour, and it caused a spiral of intervention that resulted in hospital transfer and instrumental delivery. I don't know why her waters were broken. I'm trying to work out why.

We did ARM towards the end of my homebirth labour, after much consideration of risks and other options.

I'd had lots of stopping and starting of (back labour) contractions and although me and DD were both doing OK, we were concerned that I was going into my third night without proper sleep and might get too tired to push when the time came.

We thought it over for 6 hours before going ahead. It speeded labour up immensely. I was in transition within 20 mins of the procedure, transition lasted for ~10 mins and I pushed for ~10 mins.

DD was born with her hand abve her head, a position she'd previously been in on scans. We think that she'd been pushing herself up off the cervix with her hand and slowing down the contractions. Once the waters were gone she could no longer do this and just came straight out.

I think that if I hadn't opted for ARM I would have eventually had to go into hospital for an epdidural and some sleep.

At the time, the back labour contractions (manageable when stomping up and down stairs but agonising on the few occasions I was lying on my back), and the fact that my mother experienced 4 failed epidurals made the idea of lying in a hospital bed to deliver DD seem more like a threat of torture than a promise of relief.

It was a hard decision. I hope I don't have to make it again.

Mine were ruptured on DD1 to 'speed things up'...it was a long labour.
Also had ARM on DD2 as I was pushing and the blasted things wouldn't go on their own!! Must have leather membranes!!!

Mine have been rutured with all 3 of my dc's, because they just do not break by themselves. I make very thick amniotic sacs. I am quite sure that when dc4 is born in January that I will have to have ARM again. I did have a lot of further interventins with my first 2, but DD was B2B and my first labor (at 16yo!) and I was being induced at 34+4 due to pre-eclampsia (she was absolutely fine BTW). And DS1 was B2B and brow presentation, with his hand on his head! I had syntocinon drips with each, due to looong labours (24 hrs with DD, 72 with DS1). With DS2 however, I was in labour, 10cm, waters still not rutured, so agreed to ARM. No further interventions, as one contraction after ARM, he was out!

mine were and it was fine, speeded things up, baby born 3 hours later all natural

Mine were, after about 14 hours of contractions but no progression. There was very little fluid, didn't do any harm but didn't help either.

Mine were broken to try and encourage things along with DD. She was undiagnosed OP and it stopped the contractions completely for 2 hours (only got going again with a drip). The midwife had been gagging to break them for a couple of hours because she was fed up with nothing happening. The way I have subsequently heard it explained was that, it is possible that, with the waters, even though DD's position was dodgy the general mass was still pushing down. Once they were gone. Nada. Queue spiral of intervention.

It is going in my next birth plan that I do not consent to ARM unless it is believed to be medically necessary as a result of direct risk to me or baby. Failing that, I will not consent to ARM again.