Rupturing membranes to start labour?

[weeblueberry]

Tomorrow they're going to start my labour by rupturing my membranes artificially. The OB said pessary wouldn't help at this stage and she'd recommend breaking my waters instead.

I just wondered if anyone had stories of this being the first movement of labour. Most of the stories I'm finding are of women who had it done to speed things along once labour had already started. Which it hasn't in my case

Am 41 weeks today.

Did she say why a pessary wouldn't work? I'm not a doctor, but it seems a little strange that she thinks breaking the waters will work instead, when like you all I'd found was its use for shortening labours (I refused in my labours, having read that it wasn't associated with any better outcomes, and with more pain)

I think you might need to have a bit more of a chat about your options, because I can't help be feel uncomfortable with the idea myself.

Oh, I was 41 weeks with my first, not at all dilated, no contractions, and they used pessary (well, it was more like a little tampon in my case) first, and when that didn't take hold, syntocin (and when that didn't work either - still no dilation after 2 days!, c-section).

I don't honestly remember if they suggested breaking waters as an alternative. My second they did (40 weeks, natural labour, but not dilating again after days of strong, regular contractions), and I refused given my experiences with my first labour, and went straight to c-section

She said that because my cervix was already softening and stretchy the pessary wouldn't do anything that wasn't already happening?

My understanding of induction with the pessary ect is that it prepares your cervix in order to break your waters (ie forward and open). If the doc is already able to break your waters then you miss this first step.

I had my waters broken to start labour as I was already slightly dilated so no need for the pessary. I was also hooked up to a drip to start/speed up contractions

Its not really recommended as a first step to inducing labour these days. If the baby is in anything but the ideal position it can lodge the baby into an unhelpful position which can make other interventions more likely. It can also bring on strong and not necessarily effective contractions. Its usually used these days after pessary or during labour to speed things up in conjunction with artificial oxytocin. If your cervix is ripe why not just wait?

Thanks all. I should mention (should have said in OP) that the reason they're being a bit skittish is that I had a period of reduced movements yesterday so as soon as that's flagged they want things to happen fairly quickly. All is well now though :)

I had my waters broken to start contractions.

I was at a routine appointment and they wanted to induce in the next couple of days - but when they did an exam I was already 5cm dilated, but not getting any regularm contractions (or any at all from what I could feel).

Eventually, after making me walk up and down for hours they broke my waters as a step before giving me syntocin. I went from no contractions to 30 seconds between them almost instantly. DD appeared 45 minutes later..

I got the impression (foreign country my language skills weren't up to medical talk) that the midwives seemed to think that water breaking were the only thing that would have brought on proper labour for me (On DD1 my waters broke at 36 weeks without any contractions and I went straight into contractions 5 minutes apart)

My DS2 was induced by breaking my waters. A previous sweep had confirmed I was already 2-3cm dilated, so they said there was no need for the pessary. I'd been feeling BH/mild contractions, but hadn't gone into labour, but was around 2 weeks overdue. After two hours, if I wasn't in active labour, the doctor had recommended syntocinon. However, no-one actually bothered to check, which probably worked out for the best as I hadn't felt any real change in the contractions at that point, although half an hour later, my DH and I agreed we thought I was in labour now. And 2 1/2 or so hours later, DS2 was born. I did find it a bit more intense than my previous labour, although I think that was partly that it was faster, and partly that the mw was pretty unsupportive and acted like I still had a long way to go (when she was even around). But I got by with G&A, and we were both ok. I since learnt on here, that the NICE guidelines do not recommend being induced by AROM (see p.16) - they suggest you should still have the pessary first, although I'm not entirely clear why. But if I were to be induced again, this is something I'd want to understand more first.

Dc2 and dc3 labours were started by breaking my waters without a pessary and there were no complications with either.
still had to go on the drip though as waters breaking did absolutely nothing! Dc2 was born 7 hours after drip started and dc3 was about 3.
everyone told me being induced meant more pain and possible complications etc however compared to dc1 it was a walk in the park!

I understand your concern. I'm due to be induced at 37 weeks on Wednesday and I'm told that they'll probably just break my waters as this is DC5 and the peasant could overstimulate contractions. Baby is currently OP though so I'm not loving the idea!

Peasant! Stupid autocorrect - pessary!

Maybe not helpful but I had reducd movement the day before I went into labour with both babies. Had monitoring for both then home to await labour.
Would you consider holding off on induction to see if things happen on their own. Unless you've had consistent reduced movement that is. then I could completely understand their keeness to induce.

I agree with a pp who said to be as sure as possible that your baby is in a good position before doing this. I will never forgive the old school locum midwife who bullied me into ARM with a back to back baby.

They've definitely given me the option but I have a strong feeling that nothing will end up happening by itself. They said that they'd like me to go in every day for monitoring to check all is well but having a toddler that would be really difficult in terms of care for her.

The midwife kept saying (in front of the doctor who was VERY keen for the induction but that's a whole other discussion) that it was up to me and we discussed various possibilities. But even she said she could understand why they'd want to keep an eye on her heart rate and movements at this stage. The doctor also said she would prefer to induce women before the 14 days but, like I said, she was clearly very much in favour of a more medicalised birth.

By tomorrow I'll be 41+1 and if nothing seems to be happening at all by this point I just feel it's unlikely it will happen naturally. We're giving it our best shot tonight though (spicy dinner, sex and a walk) and since the doctor gave me a really rough internal earlier it's clearly acted as a sweep because I've had a bloody show this afternoon since I originally posted. So we will see what happens. Id loved for it to have happened naturally but am equally okay with helping it along if necessary.

I had ARM induction on DC2 at 40 + 12. I avoided drip and epidural as I wanted it as natural as it could be as inductions go. My advice would be to do stairs climbing. I clicked the hospital stairs literally for hours. Bounced on a ball. Then hopped in a bath when contractions picked up. Another woman in same position beside my bed stayed in the bed and got the drip. Two different routes but same outcome I guess. She had her baby well before me! Had ARM at around 10 am and gave birth at 19.30. It was a long day but I got it the way I wanted.

Just remember OP that once they break your waters the clock starts ticking...hospitals don't like to leave you very long with nothing happening after breaking waters, due to a slight increase in the risk of infection. You may find they start pushing for further interventions that you're not so keen on. Maybe discuss this before anything is done? Good luck.

I'm a bit sceptical about the idea of rupturing membranes to start labour given my personal experience.

DS1 - waters broke spontaneously at 33 weeks. Labour started spontaneously at 34 weeks. If I had been full term when my waters broke, then they'd have induced labour within 24 - 48 hours because of the risk of infection once waters have broken (they waited with DS1 because the risks to the baby of undeveloped lungs outweigh the risk of infection in premature babies, assuming no infection symptoms are present).

DS2 - waters broke spontaneously at 37 weeks, although less dramatically than the first time. Labour did not start spontaneously, so within 48 hours I'd been given a pessary (didn't work) and then hooked up to a drip to bring the contractions on.

So waters breaking did not equal imminent labour for me. No idea if that's typical though.

Thank you all for your experiences. I really appreciate hearing them all

123 thank you. I actually had spontaneous membrane rupture with no natural follow up with my first birth so am clued up on the guidelines for my area. DD1 didn't make her appearance until 48 hours after my waters went and I did end up needing the drip. Thankfully I managed with no intervention or drugs but I'm obviously aware things could well be different this time. Definitely keeping all that in mind.

For dc2 I had a pessary for about 8 hours. Then the doctor ruptured the membrane. I went into labour an hour later and dc2 appeared 45 minutes after that. The midwife said that she thought the cushion of the membrane and amniotic fluid was the only thing that had stopped me going into labour naturally.

Best wishes for tomorrow.

Yep, ruptured in theatre due to baby having unstable lie and opportunity taken at 39+6 when he was head down. Was given am hour for contractions to start on own but was put on drip as they didn't.

Waters broken before noon, baby born at 2 am.

Was vaginal birth and all Ok in the end. I did need epidural as baby was back to back. Doubt that was anything to do with waters rupture, he was just an awkward bugger in terms of position from 20wks on really!

I was 2 cm dilated before going in to theatre though with a high cervix. It was 8 wks ago now and tbh I'm just looking at it now as a means to an end. Whilst it wasn't the peaceful water birth I would have loved, it was actually a positive experience, the midwives were great and the baby was born well and I felt great too.

Good luck for tomorrow x

Thanks all. The midwife ruptured my membranes but unfortunately it didn't do much. Two hours later I started on the drip and about 2 hours after that she was here. Was pretty intense and went from 0-60 bloody fast!! But at least she's here now and she's fab.

I was already 2-3cm dilated and contracting irregularly when they ruptured my membranes. I had been contracting for 5 days at that point and labour clearly wasn't happening on its own. Established labour started immediately and DD was born 8 hours later. No drip needed.

Congratulations op!

Does she have a name?

Not yet Teddy! She's a wee chunky monkey (not like her tiny sister!!) and we're not sure any of our names fit!