Refusing to have my waters broken

[thefurryone]

Hi All,

Due to a rather painful and unsuccessful attempt by the doctor to break my waters when I was being induced with DS, I have written on my birth plan for this one that I do not want them to make any attempt to break them this time round.

Does anyone know of any reason why I may need to change my mind about this when the time comes?

TIA

I felt a lot of relief when my waters were broken, then the contractions got much stronger. Good thing I suppose!

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Interesting links EdlessAllenPoe ...I was being nosy on this thread as my waters didnt break until head came out! Good luck op!

Same as tanyaah, I didn't relish the idea of waters being broken, but labour was so blooming slow, that waters were broken to help make progress.
I have a feeling it's much down to the skill and care of the person with crochet hook, as to how much it hurts. For me, compared with all the working out how dilated I was was so much worse than the crochet hook but may e I was just past it, or plain lucky ....

It didn't hurt at all either, I liked the feeling of the warm water coming out as well!

I had my waters broken the first time. I had one midwife attempt it without success. She just kept stabbing me with this crochet hook and waving it inside. It was agony. I finally stopped her and asked for someone else. The second midwife just inserted the hook once, pulled it out and out came the waters. It didn't hurt a bit. I think if it hurts, they're not doing it right!!

I'm quite jealous of those that found it didn't hurt at all The doctor attempting to break mine seemed personally affronted by the unbreakability of the sac to the point where he seemed to totally forget that I had nerve endings, it made subsequent VEs so awful that I've given consideration to refusing consent to VE this time round. Before this I never really had any issues with gynae proceedures before this and I'd always be happy to let med students have a go in the name of education, now I just cross my legs at the thought of it. Hopefully, I can avoid induction this time round there just won't be the need for as much poking around up there.

Thanks for the links Edless, I also did a bit of googling and found this which was really interesting www.midwifery.org.uk/index.php?option=com_content&view=article&id=182:artificial-rupture-of-membranes-breaking-the-waters-&catid=91:hidden-archives&Itemid=110

I'm going to leave in that I don't consent to this process, but as with all things keep an open mind should a need arise.

You know they don't need to do VEs to see how far along you are - a reasonably experienced MW should be able to tell from the noises you make, the way you are breathing, transition, even by the bottom line as well as a whole host of other things.

My MW with DD2's HB could tell from the other side of the cloakroom door DD2 was imminent (she was born 4mins later) just by the noises I was making (and my irrational ramblings). This is even though they had sent the 2nd MW off a few minutes previously as according to the VE performed birth was hours away so didn't need 2 MWs hanging around with nothing to do - the MW had no reason to thing baby was on it's way except for the lowing noises I was making.

Good articles here and here.

yep, it really doesn't seem to be good practice unless there is a pressing reason to do it... good article.

I refused with DS2 and will with this one.
I coped brilliantly with labour up untill they broke my waters quite early on with Ds1 after that the pain was too much and I freaked out. With the second they didn't break them and they broke naturally while pushing him out, I was able to stay calm and comfortable up until then, so no, no water breaking for me!

I refused to have them broken with dd2. I don't even know why, as they were with dd1. I think I was scared of things getting more painful! Good job I did refuse, they went literally two pushes before she was born and it turned out I had some condition of the placenta that meant had they ruptured my waters the umbilical cord could have detached. I still let them do it with ds1 and ds2 though. Strange, but true!

I had it done with DD1 and it totally stalled my labour. I also believe strongly that the lack of waters made it harder for her to turn from her awkward OP position. With DD2 I had it in my birth plan that I would not consent to ARM. In fact, things went much more smoothly and my waters went right at the end of labour naturally. I think this is what should have happened with DD1 and I am livid to this day that they pressurised me into having ARM without talking about potential negative consequences.

For my (still hypothetical) third child I would refuse them under all circumstances. No one has yet told me of a reason why they would be necessary. Except possibly to deal with a shoulder dystocia if they hadn't broken as you were actually delivering (not sure if there is any truth in that?).

I also find all internals bloody painful. I had none with DD2 and wouldn't have them again unless there was a very pressing reason. Also, do you like gas and air? I find it really helpful, and would never permit another internal without it - if they think it's important enough to do the internal, they can get the gas and air even if they don't think I'm in labour as far as I'm concerned! I would also refuse all sweeps and pre-labour exams.

I love gas and air! I'm going to stay on the fence about refusing VE as I think part of me may still be desperate to find out how far on I am at some point, and I don't want to refuse consent for too many things on my birth plan, in case they just start thinking I'm a bit of an awkward one.

So for now I'll just leave it as no ARM and no stirrups.

Thanks everyone.

i had to have mine broken as i went over 2wks overdue and am allergic to the prostin gel so it was the only way to get labour started, well i could have waited but waited almost 3wks past my due date with one baby and still didnt go into labour.

anyway if you do need it done (and you can refuse if there is no need) then i also recomend gas and air, ihad that each time i had my waters broken with dd i apparently had very tough membranes and it took 3 different people to have a go and lots of rummaging around, thank fuck for gas and air is all i can say!

Mine broke spontaneously at about 2-3cm with DD and it seemed to really speed things up - I was holding her 3 hours later. It did seem to have a really strong effect but it was spontaneous. Because DS (first child) was born via EMCS they want to schedule ARM in at 41 weeks this time round but I plan to decline if it goes that far.

I think if you are being induced via syntocinon then they have to rupture your membranes, as otherwise the contractions don't always settle into a regular rhythm. But otherwise I think you're entitled to refuse.

fishandjam I was induced via syntocin when they couldn't break them and contractions were fine, well not fine in that they hurt a lot but no issues with rythmn, it was actually quite straightforward 6 hours of contracting, good dilation and positioning. DS did have decals at the end but that wasn't until my waters had gone on their own accord when I was in transition. But that maybe unusual.

Really really don't want to go on the drip again though so if I was hideously overdue I might consent to ARM in the hope that I don't have to.

How do you know they will need breaking this time? Have you been told you will be induced?

With ds my waters went as I was pushing him out. So it will depend on how your labour is going. The mw didn't believe me when I said it felt like he was about to fall out of me and asked to check me. They hadn't already as I'd only been there 20 mins.

Well of course I don't know if they will need breaking, I'm just trying to prepare myself for having to stand my ground if they start trying to insist that I need to have them broken, as I want to make sure I can tell the difference between a genuine need for them to do so and standard proceedure IYSWIM.

I am quite concerned that I am going to be under a lot of pressure to be induced as my EDD was altered at my 20 week scan and now falls at what is actually 38+6, which would mean that I'm only going to be 40+4 at the time when induction would be scheduled as standard.

My community midwife believes me that this EDD is physically impossible but for some reason the local hospitals appear to have a bit of a bee in their bonnet about the 20 week scan providing the definitive date. At the moment I'm quite prepared to stand my ground and refuse induction until I'm at least 42 weeks proper, but I just don't know if I'll be able to actually carry through this strategy when the time comes. When I mentioned being induced early because of the change in date after the scan, stillbirth risk was mentioned at least 10 times, getting DH incredibly worried that if I refuse induction I'll be putting the baby at unnecessary risk. I'm also worried that being worried about being induced is going to stop me going into spontaneous labour.

Aaaargh, sorry for the long veering off the subject post I'm clearly a lot more concerned about all this, and a lot less over my first labour than I thought I was!

furry, I really sympathise re not wanting to go on the drip. I was induced last time (at 38 weeks due to pre-eclampsia) - first they broke my waters, and when that had no effect whatsoever they put me onto the drip. And turned up the dose. Going from a few Braxton Hicks-type tightenings to full-on contractions in the space of around half an hour was just awful, especially with no amniotic fluid to cushion my cervix from DS's head. Never felt pain like it (and I'll chin anyone who says "ooh, labour pain isn't that bad, you're exaggerating"!)

I've been reading up on induction in case I have to have it again, and the WHO guidelines (here at P-17) definitely say that in cases of induction or augmentation of labour, ARM should be performed. But that seems to go contrary to the NICE guidelines which say "Amniotomy, alone or with oxytocin, should not be used as a primary method of induction of labour unless there are specific clinical reasons for not using vaginal PGE2, in particular the risk of uterine hyperstimulation." Maybe the difference is that the NICE guidelines aren't covering induction in all cases (they do say they only cover the following cases: prolonged pregnancy, preterm prelabour rupture of membranes, prelabour rupture of membranes, presence of fetal growth restriction, previous caesarean section, history of precipitate labour, maternal request, breech presentation, intrauterine fetal death and suspected macrosomia i.e. large fetus).

So basically I'm confused!

But in your case, it sounds like you can quote them the NICE guidelines and say "Is there a clinical reason why you can't start me off with the gel/pessary? Because unless there is, you can put that crochet hook away!"