Why do they break the waters?

[cloe]

I have been reading and everyone seems to have their water broken. I have read that it can speed the labour but my last pregnancy I was fully dialated and the doc broke the waters. What is the purpose? I am sure it is a new thing and during the middle ages they would not have done this so why do they do it as standard procedure now? Thanks for any ideas..

[rootzdawta]

Moved from I'm Pregnant to Birth and Beyond.

[MaerynPearl]

With my son I was induced and they broke my waters... and after they broke my waters I quickly had the urge to push show up. With my daughter, the water broke on its own and was actually right at about the same point in the labor as it was with him... so im not sure if they broke it thinking it wouldnt or because with artificial induction your body doesnt do it the same? I dont know... but thats my experience.

[Mrsboyko]

Originally Posted by cloe

I am sure it is a new thing and during the middle ages they would not have done this so why do they do it as standard procedure now? Thanks for any ideas..

Because they like to put women on the clock so they know when they will have that room free. 24 hrs after water broken and no baby at most places = c-section for failure to progress.

[GuavaGirl]

After 34 hours of labor, I just wanted/needed to be done, so I asked my CNM to break my water to help things speed up. Soon after she broke my water, pushing started for me.

That is probably the only circumstance in which I would have it broken, that I can think of.

[mambera]

Sometimes they do it to move the labor along or speed it up.

In my case, my MW broke the bag when DD was crowning. I actually asked her why but she just said "because it's time." At that point I was in no kind of condition to argue so I just said fine, . I still didn't get it though.

So I'm watching this thread with you!

[CherryBomb]

It depends on the situation.

I was 9cm with a bulging bag and that was VERY uncomfortable, so I asked the OB to break it. I was fully dilated and pushing within minutes (which was the other reason I wanted it done, I knew being that close to 10 arom would get me to pushing quickly). I might ask for it to be done at 7cm next time.

AROM can also be used to induce vbac moms (who can't safely be induced most other ways) if the baby is low enough that cord prolapse isn't an issue.

Commonly it's used to augment labor if mom is dilating "slow." I think a lot of that comes from them wanting to check you constantly, though, which seems common if you're being induced. I went into labor naturally and didn't have any augmentation (prior to the arom). One of the ld nurses checked me when I came in and then I wasn't checked again until I asked to be (and that's when they said I was 9cm with a bulging bag). With my first I was induced and they checked me like every hour, I think. I would assume they tend to check moms that are being induced more frequently.

[womenswisdom]

Water would probably be broken when fully dilated just so it doesn't break on its own and soak everybody in the way (not that it's necessary, just that's probably the reasoning).

[RedOakMomma]

I've been reading almost all the birth stories posted in each DDC recently ( can't resist birth stories), and it seems like this happens at midwife-attended home births, not just hospitals. I don't think it's just about putting people on the clock (that seems too critical of hospitals, imo).

In the threads I've read, it seems like people do it to speed up labor (especially when mom is getting tired). Sometimes a bulging bag of waters seems to take longer to pass than a head, so they break it before pushing starts (or after pushing has been taking a while). Another thing I've seen is that the bag is preventing the baby's head from pushing against the cervix and moving down, which is stalling dilation. Breaking the water removes that cushion (for some women), allows the baby to descend, and helps labor along.

If homebirth midwives are doing it, my bet is that it's very often a useful way to help labor along...not just something "to do."

[MamaChicken]

With DS1, I was induced for Pre-e. The MW broke the water to help speed things up because I wasn't doing well - going in and out of consciousness.

With DD, the MW asked if I wanted her to, and DH told her that it didn't seem necessary. Indeed it wasn't, labor with her was 4 hours from contraction #1 to birth.

I asked that the bag be broken on Twin A after being stalled out at 9 cm for 5 hours. I was ready to be DONE! Twin A slid his way out 35 minutes later. Twin B's water broke on it's own as his head was crowning.

So, for us it was simply to speed things up. And other than DS1 (when I was severely altered) I was asked very politely if I would like to have it done. My wishes were respectfully honored each time. All four were beautiful hospital births, with the twin being born in the OR "just in case". Even sitting in the OR for HOURS I never felt any pressure to hurry up.

[*MamaJen*]

In hospitals, it tends to be part of the philosophy of "managed labor" rather than "physiological labor" (aka normal birth), and it's an intervention -- and interventions have risks. Ideally, interventions should be used judiciously, when indicated, rather than routinely.
There are valid, evidence-based reasons to do it *sometimes*, but it's tremendously overdone, IMO. I had it in my birth plan not to break the water unless medically indicated.
It can make labor more painful, and if the baby is in a bad position, it can get stuck in that position, whereas if the bag was more intact the baby might move into a more favorable position. It also increases the risk of cord prolapse, if I'm not mistaken. And if the water is broken too early, you increase the risk of infection.
My baby was born in the caul and I think that's one of the reasons why my labor was so easy.

[MiaMama]

I declined having my water broken twice during my hospital induction. The first time was "to speed things up." I had been at 4cm for 8 hours, but the baby was -2 station, so I decided the risk of prolapse was too high. I opted for pit instead, because pit can be turned off in case of distress, but ruptured membranes can not be undone.
(*side note* the research I've done says that failure to progress should not be diagnosed until after 5 cm, up to 5 can take a long time and many consider it before "active labor" Also, Pit can be used to get TO 5cm, and bodies often take over from there. That is what I did, they turned it off after less than an hour at my insistence.)

I also declined to have my water broken when they tried to put in an internal monitor. They didn't bring it up that they would have to. The conversation went like this:

"we're putting in your internal monitor now so we can keep a closer eye on the baby"
"don't you have to break my water to do that?"
"oh, its not already broken?"
"no"
lol

I had SROM a few hours later, and labor got much more intense after that. At 8cm, I started thinking I wanted pain meds, so the CNM checked me and found a bulging fore-bag (I guess all the fluid didn't come out) and asked to break it. I said yes at that point. DD was born less than 20 min later (no time for meds ).

[SleeplessMommy]

[QUOTE=RedOakMomma;15178242]...it seems like people do it to speed up labor (especially when mom is getting tired). Sometimes a bulging bag of waters seems to take longer to pass than a head, so they break it before pushing starts (or after pushing has been taking a while). Another thing I've seen is that the bag is preventing the baby's head from pushing against the cervix and moving down, which is stalling dilation. ......[/QUOTE

With my homebirth, (second child) the first stage took a looong time, bag intact, with the head being very slow to engage. I was really expecting/hoping for it to go so much faster. Sometime during transition, the midwife broke the bag of waters after an exam (i had to ask for this) and thing speed-ed up greatly.

If I could have a "do-over" I would request AROM much earlier.

[1babysmom]

With DS (born 12 days ago, UC) I was complete for 6 hours but his head wouldn't descend past about a +1/+2 station. (turns out because it was huge ) I wanted to break my water for quite some time since with DD2 (another UC), she came out 2 minutes after my water broke. But at the same time I was scared because to me, laboring with ruptured membranes KILLS compared to intact membranes, so I didn't want to break them and still have to labor for a while. But finally, 6 hours later I reached in and broke them and he came out in less than 3 minutes.

[RedOakMomma]

But finally, 6 hours later I reached in and broke them and he came out in less than 3 minutes.

1babysmom, I was thinking of this "why do they rupture the water" thread the whole time I was reading your birth story!

[cileag]

I haven't seen it mentioned yet, but another reason they do it both at home and in the hospital is to check for the presence of meconium (or baby poop) in the amniotic fluid. Some home birth midwives cannot continue with a labor where thick meconium is present and hospital staff like to know so that they can have the right personnel/equipment set up to deal with it.

I asked for my bag of waters to be broken after a couple hours stalled at 6-7 with a very uncomfortable bulging bag, and I had my daughter within two hours.

[MammaB21]

Usually the bag of waters will break before baby is born, but after labor has begun. Mine didn't break until right before DD crowned. Broke on its own, and she was born VERY shortly afterward. The bag of waters is there for a reason. It's to cushion mom AND baby during contractions. It helps to keep the cord from compressing during that time. It helps mom stay a little more comfortable. And if left to its own devices, it will usually break at the right moment for that specific labor.

I think the main reason for OB's/midwives breaking it is to speed up labor. I don't thin that there is ever a good reason to break it. I fought long and hard to keep mine intact throughout my long labor, and I'm glad I did.

[mntnmom]

My understanding is that first, they believe there are no negative side effects. But that it's either done to speed up labor, or to avoid the mess when it breaks on it's own at crowning. I actually had my water broken to induce labor with my second child because I was dilated to 5 and not having contractions. I would *not* recommend doing that!!

[thismommy]

My waters broke spontaneously pre-labor with ds1, but I broke them immediately before pushing with dd and when I was fed up with labor and had been stuck at 6cm for a while with ds2. With dd I tried pushing a few times pre-break, but it was hard and I felt like it would take forever and I was just DONE. I'm totally happy with my decision. With ds2 I knew he was posterior and I thought that combo of him being posterior and the water bag bulging might be holding up labor (had been in labor for 3 1/2 days at this point) so I broke my water. He was born probably less than 2 hours later. And I found after breaking the water that he had a nuchal hand too. Fun stuff.