post #21 of 21

AROM- artificial rupture of membranes.  Often described as "breaking your water".

 

It's sort of the least invasive of the "medical" induction methods (or the most invasive of the "natural" induction methods).  It's not something I'd suggest "just because", and it has some pretty sigificant downsides depending on your circumstances (it can reduce the babe's ability to turn out of a poor birth position so labor can be longer/more painful or even "not gonna happen vaginally", it removes a barrier to infection so many providers will put you on a "clock" after your water breaks in order to try and limit the chance of infection, some providers wont allow a mom into a tub if her waters are broken, it makes for an annoyingly wet labor since you'll keep leaking fluid till the babe is engaged and "plugging it up", if it doesn't work as an induction you've got the double whammy of no contractions and no bag of waters which often means that further interventions will be "required", etc).  Like I said, it carries some specific risks, but since I was right up against the deadline to have a midwife attended VBAC, I'd had non-progressing labor for weeks, and because my water had broken on it's own prior to the onset of contractions in all of my other births, I figured I'd give it a try.  And in this case, it worked like gangbusters.  LOL

 

But for a VBAC mom, a foley catheter and AROM are just about the only options for induction/augmentation, if that ends up being necessary.  A foley cath is sort of like a balloon... it's inserted up into the cervix and manually dilates the cervix.  It's sort of like having your membranes stripped, but really slowly and for several hours.  The goal is to use the dilation and the hormone surge caused by that to jump start contractions.  And AROM can bring the babe's head down onto the cervix and keep the dilation ball rolling (so it can either start labor, or intensify it).  Chemical agents, like pitocin, push the risks of uterine rupture waaaaaaay up, though some providers feel that a low dose of pitocin /can/ be used safely in a VBAC once labor is already established.  Personally I'm not convinced and I would sign the rc/s paperwork prior to accepting a pitocin induction, but that's just my own risk/benefit balance talking.  So anyway, for all the VBACs out there... VBAC success tends to go up if you start labor on your own, but if you need an induction or augmentation for some reason, a foley cath and AROM are probably your best bets.