Why aren't they paranoid about labor during "false labor"?

[its_our_family]

I have been having issues with false labor this past week. The contractions get as strong as they did with my son. They'll go on 3 minutes apart and strong for about 3 hours and then stop and come back again in 4 or 5 hours.

So, I got to thinking about it. If rupture is such a "common" thing. Or such a concern for obs and such. Why don't they get paranoid when a women has false labor or lots of contractions before labor?

I've never had an ob say..Come in right away if you have any contractions so we can monitor! But they insist on efm when you are in the hospital. I don't really see much of a difference. yes, the duration in real labor is longer and the strength of contrax is different...but still.....

[cottonwood]

That is a really good question. My cynical mind wishes to say that it is because doctors know which conditions rupture is more likely in -- when the labor is being induced or augmented and women are doing purple pushing etc. If you ask a doctor, s/he's probably say something like, "oh, statistically you are more likely to rupture late in labor." What they are probably not going to mention (assuming they are bright enough to understand it themselves) is that this is because of conditions imposed by them, not because of natural labor itself.

[Peppermint]

I agree with the PP that Dr.s know full well that rupture is more likely when given labor inducing drugs, etc. That said though, it is perfectly true that even in ruptures where things went naturally, it is generally in the later stages of labor. When I had intended to go into labor before having this baby, the OB and I discussed rupture, and she said, it rarely ever happens in early labor, and are more likely in the very intense stages.

[its_our_family]

The obn I saw last week was talking and I told her that once I hit X weeks if baby isn't here I'm having a repeat and she said..."No we won't do a repeat. We'll induce you with pitocin." When I told her I refused she was like...duh why? I just looked at her....cause my chance of rupture increases and pitocin was the main reason for my c/b in the first place.

Stupid woman...I hope she is no where near me when I have this babe!

[Peppermint]

IOF- I think that is a very good plan. I know others would disagree, but I feel that VBAC with pitocin is just asking for trouble, the best chance for success is to go into labor on your own, stay at home as long as you can to avoid interventions, and stay strong on the avoidance of interventions. I also would not allow any pain meds that migh mask the signs of rupture (although lots of OBs like to put an epidural in -just in case- and they claim that fetal distress will be the first sign, even before the major pain hits). But, anyway- as you know without labor inducing drugs rupture is highly unlikely

[Clarity]

one OB writing in a book about high risk pregnancy said something like "false labor is a myth, contractions are contractions..the intensity, length and duration, and presence of cervical changes are what's of concern." He felt that using the category of braxton-Hicks or false labor meant a lot of preterm labor is overlooked. There's normal and not normal. I think it's fine to send women home if they're not in active labor, but using the words "false labor" I think just discourages them...better they be told the advantages of being at home until later in labor. (assuming of course they plan on going to the hospital at all.)

early ruptures are definitely associated with infections...even ones without symptoms esp. vaginal or urinary. And you can't find those over the phone. I think some docs are starting to use the hmm...fibronectin test? something like that...elevated levels are associated with PTL.

When you in your heart know something is not right, and you know what signs to look for and how to try to mange things (water, rest, etc.) - I always encourage women to go see their practitioner...it is usually nothing, but then you get feel better and get on with the business of pregnancy, right? You can always choose not to treat the contractions, or treat them without medications....some docs hand out anticontrax medications to anyone, but I'd rather make that decision.

[its_our_family]

I'm jsut past 36 weeks and I'm not stopping anything if it starts and finishes. I'm doing lots of starting but no finishing

[copslass]

section v. induction?

Megan, I hope you don't mind my asking, but why would you want to schedule a section if you are "overdue?"

Why would you want to risk surgery or artificial induction instead of waiting for your body and your babe to work in their own time?

[its_our_family]

Pitocin is blamed for my first c/b. I guess I'm super-sensitive to it. So, I would rather have a repeat instead of pit. I'm hoping I won't need either anyway. I bordered on uterine rupture with my son because of pitocin. So, the c/b is really "safer" for me than induction.

I'm wondering if I get close to that repeat date and Im dialted to at least where I was with Tracy if I can get them to maybe break my water to see if that will get things going before doing the repeat.

[copslass]

surgery and induction

I'm a bit confused...

Certainly feel free to tell me to mind my own business, but it sounds to me like you are planning an induction of sorts, then repeat surgery when you are near your expected due date?

I'm truly trying to be helpful here, or just inderstand what advantage it could be to you or your babe to have your membranes ruptured due to being near due, so to speak?

I'm just concerned for you that if you really, truly want a vaginal birth you might be sabotaging yourself, as these are the types of procedures which so often lead directly to cesareans.

I myself have had a struggle to get my vbacs, quite a while ago when vbac weren't touted as an option in my area, and ended up with one repeat after early labor, which I've regretted for 18 years now.

Please feel free to pm if you want or need to talk, or you can just tell me to butt out right here, and I'll respect that.


(I'm really a very old member, recycled)

[cottonwood]

I can understand opting for a c-sec instead of induction in your case, as long as intervention is necessary. But (I'm curious too) why *any* intervention simply for being overdue?

[dotcommama]

In answer to the OP my midwifes claimed there was no greater risk of uterine rupture durning labor then at any other time during the pregnancy provided there are no drugs (mainly pitocin) administered during labor.

[its_our_family]

If it the day before the schedled c/b and I'm dialted to say...5 and not in labor I will try "things" to get myself that way.

Yes, I want a vbac but I still have a choice in the matter. If I get to that scheduled date I can still cancel. It just all deends on how thigns go. Nothing can be predicted so I'm preparing for anything.

-----------

I had wondered about rupture during pg but I don't if I've ever heard of it happening (except on the movie "The Hand that Rocks the Cradle" ).

[Peppermint]

As I understand it, there is the risk of rupture at any point, but it is certainly more during labor, and far more during labor with drugs. Still, a very small chance even with all of that. But, I do believe that labor(especially during the later harder contractions) does make the risk higher than at any other point in pregnancy.

[its_our_family]

Re: surgery and induction

Originally posted by copslass
I'm a bit confused...

Certainly feel free to tell me to mind my own business, but it sounds to me like you are planning an induction of sorts, then repeat surgery when you are near your expected due date?

I'm truly trying to be helpful here, or just inderstand what advantage it could be to you or your babe to have your membranes ruptured due to being near due, so to speak?

Ok, I'll try to explain. If I get near the date of the REPEAT not my due date I was going to see IF I was dilated (past what I got to with my son...which was 3cm without help) but not in labor see about maybe breaking my BOW or something.

The only thing I'm doing now is evening primrose oil which my mw told me to start. Other than that I'm doing nothing. So, I'm only talking MAYBE intervention at the end...but nothing before my due date.

Does that make it a bit clearer?

[Kari_mom]

IOF, my heart goes out to you. You are so close to your birth, your head must be crazy right now. Good luck, I hope everything goes the way it is suppose to for you.

As far as your original post, I think you are right to wonder, I have thought the same myself. My guess is that it comes back to liability. If you rupture during pregnancy or 'false' labor (an event which I have seen documented in studies but I don't know where I saw it anymore) it is just one of those things. If you rupture during labor, then the OB/midwife/nurse/hospital has responsibility and lots of questions come up about monitoring, predictability, saving lives etc. At least that is the way I see it playing out.

I think you are also correct, that the length and intensity of contrations makes a difference. I have seen studies on the ICAN site that show that prolonged ACTIVE labor increases the risk of rupture, and my midwives say that this is part of the thinking behind the 'trial of labor' theory. For example, when I go for a VBAC in May, I will not be allowed to stay at 6 centimeters for 6 hours without serious monitoring and discussion of surgery. And since the studies show that the rupture rate doubles or triples during prolonged active labor, and my risk is increased since this is my fourth attempt at a vaginal birth, that is just fine with me.