artificial rupture of membranes - had to have it twice, will it happen again and do I have to have it done??

[mabel1973]

With Ds1 my waters didn't break during labour and I had AROM done, as I was under imformed and didn't know I could refuse it, and was told it was the best thing to do to speed labour up, consequently I ended up have an epidural, because the pain was so severe. It was only afterwards that I read alot of information saying that it was unecessary and increased pain.
With DS2 I hoped for a water birth, but after being in the pool for 4 hours, I was examined and told that he was almost back to back and that my waters hadn't broken, which was stopping things from progressing, so it would be best to break them. I agreed, feeling I had no other choice. So I didn't get my water birth, and i felt the pain increase almost instantly.
I am now 36 weeks pg with DC3 and need to write my birth plan (for what it's worth!), I am working on the assumption, that again my waters won't break, I am hoping again for a water birth, but not sure how to tackle the issue of AROM, if I refuse to have it done, could I be putting the baby at risk, or just end up being in labour for hours longer (I have had long labours with both DS's as it is), I just feel so ill informed about the whole subject. I have also been told that the hospital I am going to this time have a policy that you can't stay in the pool longer than 6 hours.
Any advice or experience would be great TIA

My first 4 were normal births and my waters never ruptured. Like you I thought I had to have it done because the mw said so, and each time it increased the pain and made the whole labour feel out of control.

For number 4 I said no. The mw twittered and kept offering and I stuck to my guns. It was much more bearable and that was the only labour with a fast 2nd stage (6 minutes).

i've had 2 ARMs... both in posterior labours.... dd turned and got tangled in her cord and had to be resusitated. ds stayed posterior and was fine.

however i've since read alot about posterior births and ARMs and its terrifying how much more dangerous the situation becomes after an ARM.... the safest course of action is to wait it out for the baby to gradually turn itself, kneeeling with your bum higher than your head in the early stages can even encourage baby to turn after which things will naturally speed up.

with those births i didn't know any better and was grateful for how quickly things went after days in labour when they broke my waters for me. now i know better i'd prefer days of labour to the complication that can arise from an ARM and will be refusing one this time if it's offered.

hth

You can of course refuse. But before you do I would just ask the MW to confirm that there is no risk to you or baby by doing so.

Normally, as you say they do it to try ans speed up a lengthy labour - so as to help mum out and prevent a protracted labour.

In my first labour (DTDs) I had 1 set of membranes broken....but I had reached pushing stage and they still hadn't gone. MW was about to break second set when the force of a contraction flooded the MW/obs anf floor (they were kind of bulging un-ladylike out of my fanjo by this stage ).

With my 2nd labour my waters went on their own between 4-7cm. The pain increased significantly even though it was a SROM not AROM. I guess a SROM usually happens in the later stages of labour when cervix is no longer supporting membranes because it is 7/8/9/10cm dilated....so the length of time you have ti endure the increased pain is limited. I guess with a AROM it can be done earlier and put mum in greater pain than natures way ^usually does IYSWIM.

The reason the pain is increased is because baby can now sit directly on cervix instead of being cushioned by a bag of fluid. It is more intense WRT because there is more pressure with each contraction which in turn makes each contraction more effective and therefore should make labour shorter. I think that when teh membranes rupture (by whatever means) additional hormones are released increasing pressure hormonally.

I think it is a trade off...do you take less pain for longer or more pain for a shorter duration.

I have never had a AROM where the intention was to speed up labour...but I think given the logic behind it I would not take it in early labour (less than 5-7cm I guess) but would consider it in later labour if I was not progressing particularly fast.

Thanks ladies

Dracula - I can see the logic why it would increase the pain when the cushioning isn't there anymore. I guess there's no way of telling whether the pain is more intense if membranes are ruptured artificially or allowed to rupture naturally, as we all experience pain differently anyway.
Catweazle- interesting what you said about a fast 2nd stage though, that sounds like my kind of labour!!!

Does anyone know whether if you have AROM and want a pool birth, are you allowed to get back in, or will they not allow it for some reason?