Induction - gel versus having waters broken?

[Distracted]

I am being a bit premature here, as I'm not booked for induction until next weekend and hopefully it won't come to that, as dd1 came at 10 days overdue.

However, I've been told that I should have an internal/sweep on Thursday and if I'm less than 2cm then I am booked to go in for induction with prostin gel on Friday night. BUT, if I'm 2-3 cm then I get to wait until Saturday and go in and have my waters broken instead (I'm already 1-2 cm as this is my second pg).

I've not heard of this approach before. Can anyone tell me if having your waters broken results in a more natural labour than using prostaglandin gel? I read in one of my pregnancy books that breaking waters results in the baby's head really banging hard against the cervix as it is no longer cushioned and so can result in a faster labour with stronger contractions. But perhaps that's no different to gel induction as I know that too tends to result in a quicker stronger labour.

Does anyone know?

I've had my waters broken each time (first was a slow progressing natural labour, second was as part of an induction process) but found it made little difference in either case. Think you do need to be partially dilated to have waters broken though.

I'd been in labour for 18 hours and was 8cm dilated when the midwife suggested breaking my waters. My contractions, although painful, were not helping to move the baby down and she said that the minute i had my waters broken, everything would speed up and get much more painful... she was damn right!
I asked about having the gel and she said that in this situation, it wouldn't be of any use and a waste of time. I took that to mean that the breaking of waters is more effective...i could be wrong though.
Good luck x

Message withdrawn

The gel would ripen your cervix.... you can have your waters broken IF your cervix is favourable... if it isn't then an ARM would not work as well. That's why they are saying this.... all will depend on your cervix, they will have a Bishop's score which will help them decide which way is the best way (most chance of success) to induce you.

With my last pg I had to be induced at 36 weeks, They gave me gel, which I thought had no effect, but in fact i had dilated to 4cm after only a couple of hours. They broke my water and ds was born 22 minutes later.

I had neither when I was induced (althogh my waters were already broken). They used a Pitocin drip to get things going, and boy did it ever!

Sorry, not much help, just another example of the difference between things in the UK and the US.

Kate we would the same in the UK if we were in the same situation...

Had all three:

DS1 cervix was favourable, my waters broke on their own so I was given the drip. Absolute agony right from the start - NEVER AGAIN!!

DS2 waters started leaking at home, cervix unfavourable (1cm dilated). Had gel, laboured gently for a couple of hours (not considered active labour), had waters broken again by doc, DS2 born 3 hours later. Much much better labour, contractions were much more intense and painful after waters were broken but I managed with Gas and Air and enjoyed it almost to the end.

I was just reading all your replies.... you are all correct as all your situations were all different.
The gel is ONLY used to induce when nothing has happened (so you would NOT use the gel in a labour). The purpose of the gel is to ripen, soften, thin the cervix as well as start dilation... when that is on its way you get your waters broken (if things aren't strating on their own after the gel alone)... and if after 1 hour you are still not contracting they put the drip in (called Pitocin in the US and syntocinon in the UK - it's pharmacological oxytocyn).

It is common for women who have had 1 or more child before to already be a bit dilated, it doesn't mean that the cervix is soft though.

Thanks very much for all your replies. Sounds like my fears of having my waters broken inducing a very strong labour are realistic on the whole. However, it doesn't sound like I have a choice as it will depend on whether my cervix is 'ripe' or not (and sl. dilated) and I suppose if it is there is no point in the gel.

At least I understand a bit more now on the rationale of one vs the other and that I'm not really going to get to choose. Should just accept that either way it's induction, with the downsides that go with it. Think if it comes to it then I will just request an epidural at the earliest opportunity!

In the meantime, I've got a second sweep tomorrow (had first one last Friday), so fingers crossed. After that I think I'll try a reflexologist if I can find one locally.

I should have added that I have preciptious labours anyway. The first three were non induced and 2h20, 1hr 50, and 1hr11, so my 22mins is probably faster than the norm iyswim!

I had gel with my 2nd baby and it didn't make the contractions very fast. I was 14 days late and had only one dose about 11am and it took till about 2pm for the contractions to start. However it was all quite slow, just like normal labour. I think for me because I only had one dose it just kicked me off and everything else happened on its own. I had a sweep before then that didn't work. Generally the later you leave it the more likely induction will be easier as long as there are no medical problems of course. The hospital wanted to induce me at 10 days but I pushed them till it was 14 days.

About 2am my waters finally broke themselves but only partially and the midwife broke them completely and dd was born just over 2 hours later. All in all it was quite easy and not at as interventive as I had expected.

Good luck whatever happens

Thanks Eulalia for that more positive story - perhaps if you only have to have one application of gel it is more likely to be a 'natural' labour? Does sound more likely that I will have to have waters broken though as am already 1-2 cm and if I'm more than 2 cm by Thursday then they will break waters rather than use gel.

Hopefully I won't make it that far.

i was induced 2 weeks early and was given gel for a day and when cervix was open 2cms they broke my waters.They also had to give me a drip to start contractions. I went 12hours of this then had a section but i think he just wasnt ready to come with being early. I was told that usually if the gel is used then u need help with breaking your waters. Good luck

Distracted, your labour will be more natural if the cue comes from the baby.

had gel with no 4 at 41plus weeks. Had three lots and nothing much was happening. Midwife tried to pop my waters but couldn't. Was experiencing very mild pains (could still walk to cafeteria for coffee) and did a little dance. Asked for gas and air as a little more pain but nothing much and sent dh home. Waters broke and dh only just made it back - start of full labour to end of process 40mins. Certainly a good experience for me after previous 3 labours.

Waters broken and given drip almost straight away - went from 1cm to 9cm in just under two hours...(agony!!) Just avoided the C'section!

Oh dear - really think I want to avoid it! Had a second sweep yesterday and did think things were kicking off last night, but all stopped. However, I am now 2+ cm so already know it will be waters broken rather than gel at the weekend.

Going to try some reflexology this afternoon as another alternative to avoid having waters broken.

i'd say in my case the drip was what speeded the whole thing up and made it so bl**dy painful (I had no build up in contractions - one moment I wasn't, then I was at about 2 minute intervals!) I'd had a sweep about 6 days before (and think it probably would have worked if they'd left me, but they wanted ds out and they wanted him out fast!)....

My baby boy was born 2.5 months ago, i was 17 days late and finally agreed to be induced. First, they gave me the gel, which I thought was very painful and uncomfortable. I had a lot of backpain and cramps immediately. That was at 4 am, by 9 am the Dr said i was ready to go into the labour ward to have my water broken, but they didn't have room till 430 pm....
When the midwife broke my water, the baby's umbilical cord fell down and it was a crazy emergency, because if they cant get it back up, they have 4 minutes to get the baby out (by c-section) or he gets brain damage...
Luckily, when I turned onto all fours, it went up. I still needed to have a c-section because his hand was up near his head and he would not have been about to get out vaginally that way.
I would have loved trying birth naturally, i hope next time i will, but i think after 2 weeks it was safer to get him out.

Oh keren that sounds pretty terrifying - glad it was all ok in the end! I've got 3 days to go now, so still hoping things will happen spontaneously and may have another sweep tomorrow as last attempt to avoid induction!

Just to put one in one final word on this thread in case someone else looks it up in future for same reason as me. I did have to have my waters broken in the end and didn't have any gel or drip induction, but I did then go into a very rapid labour - contractions 3 minutes apart from the start. So I think it probably did result in a stronger faster labour, although the midwives tell me it should just result in a natural labour, so could be just the way it was going to happen with me (although first birth was 26 hours - this one was 3 hours 25 minutes). Not that a rapid birth isn't a much better way to go - just found it hard to deal with contractions so close together as were only 3 minute intervals to begin with and then much closer and back to back for quite a while.