Should I allow my membranes to be ruptured?

[catholic74]

Hi Ladies,

     I'd like to hear what you think about my situation and I'd like to hear any information or experience anyone has had that may be similar to mine.  With my last baby, my midwife discovered that for about 2 weeks before I was due, I was walking around 4 to 5 centimeters dialated!  She was surprised and strongly suggested I allow her to break my water because she knew my history of birthing very quickly and had a feeling she'd never make it if I went into spontaneous labor.  Well, I refused because I just don't like to mess with nature and sure enough, I went into labor and my son was in my hands within 30 minutes.  My midwife didn't make it. In fact, she and her assistant didn't get there until half an hour later.  Now, the labor went just fine and there were no problems at all.  It was pretty cool delivering my son alone with my husband, but still, it was not my intention to birth alone and I would prefer that she had been there. 

     I am pregnant again.   I am seriously considering allowing my midwife to break my water if I find myself once again 4to 5 centimeters dialated late in pregnancy.  I'm told that because I am so dialated that there is minimal risk and that the baby would just "fall out" once again.   Is it true that the risks of AROM are more likely with a woman who is not dialated at all or not dialted much?   Has anyone ever had their water broken when they were that far dialated? 

Thanks so much for any help

[phathui5]

The risks of AROM are: cord prolapse if the baby's head isn't well applied to the cervix and the possibility of getting the baby stuck in a less than ideal position (posterior, for example) if someone breaks your water when the baby is in that position.

[Bird Girl]

The risk of cord prolapse is much higher if the baby is not engaged in the pelvis. I can't imagine that you'd get to 4+ centimeters if the little bub didn't have his head pushing down from the other side! I wouldn't worry about that risk if your midwife can tell you that the head is engaged.

[~~Sarah~~]

I would almost ignore the risk of cord prolapse, it is such an incredibly low risk - I believe the stats are at 1 in 400. Presumably your midwife knows when it is safe to rupture membranes and when it is not?  

What you do have, is a very real "risk" of giving birth at home (or elsewhere?) alone as you did last time. Weigh that against the risk of "messing with nature". I'll assume you are pregnant with at least your third baby - therefore your risk of the artificial rupture of membranes, combined with a very dilated cervix, not putting you into labor is rather small. In the end - it's up to how you feel about giving birth alone vs being "messed with".

[mclisa]

I wouldn't worry about a cord prolapse.  If your midwife is competent she would check to make sure that the head was well applied before she broke your water and that there wasn't a palpable cord there.

My worry would be that she broke your water and it didn't trigger labor.  Then you are in a pickle of a situation.

[catholic74]

Ultimately, that is my worst fear....that my water is broken and labor still doesn't start, after all, plenty of women have their water break and don't have labor pains for days......on the other hand, it's true that I am at high risk of birthing alone at home or somewhere else. My husband says I"m not leaving the house the last few weeks!!    That would drive me crazy!  I've birthed alone before, though it wasn't planned and I'm not afraid of that, I just would prefer that a professional be there.  Near the end of my pregnancy, I will see how dialated I am and how engaged the head is and then make decisions from there.

Thanks

[Kokopelli-mana]

I wouldn't want it. I think there's alot to be said about allowing the baby to come when ready. My unassisted birth was the single most amazing experience of my life. One thing that kept me from worrying during labor was that if things are progressing well and quickly, it is a good thing. It means labor is normal. So if it were me, I'd just leave well enough alone. Good luck to you

[CookAMH]

Ask her how long she'd let you go if you don't go into labor after she breaks your water. My midwife gives me 72 hours. If there was freedom with the timing to let labor start, I'd consider it based on your past experience.

[MsFortune]

I'd be worried about what happens if it does not trigger labor.  You are open for infection and then what?  I assume you really don't want a c section, but you can't let the baby hang out not protected, so that might be an eventuality.