another question

[huggerwocky]

What would be a legitimate reason to open the bag of waters? Is there any besides wanting to speed things along?

[Sagesgirl]

Well, I don't think wanting to speed things along is a legitimate reason! There's no actual clinical evidence that that works, for one thing.

AROM, like anything else, is something you have to weigh on a case-by-case basis.

I suppose that if there were signs of fetal distress, a medical professional might want to break the BOW to check for signs of meconium staining, but I don't know if that knowledge would ever actually be helpful or not.

In my VBA2C, my waters were artificially ruptured to facilitate placement of a pressure catheter inside my uterus. This to keep an eye out for early warning signs of rupture. This is something that perhaps most women here wouldn't feel necessary or warranted, but I was comfortable with it.

[mistisa]

I am trying to find this out also. When with ds, I was contracting, my bag was already leaking at the top and I was at 5 cm when I checked into the hospital w/ the mw's. But he had not dropped and they told me that unless they broke my bag so he could drop and they could check for the cord, they would not let me walk around. So I consented to them breaking my bags all the way. He came out 15 mins later!! There was no fetal distress, the only reason I was given was so I would not have to be monitored. Thinking back now, I think they said that so I would consent to it.

But after reading, it makes me wonder if I should have just waited...I was 36 weeks but he was fine.

Hopefully someone else will know more here cause I am really interested since #3 will be here soon!

[nikihodges]

i had arom with my last birth then delivered 8 hours later...out of my other two labors this was the most uncomfortable

[krismarie]

a friend of mine just had her waters broken as a way of starting labor at 42 weeks... (she would have rather not do anything and just wait till her labor started but was working with an ob and her choice was induce w/ meds or break waters). luckily it worked and she ended up with an unmedicated hosp birth.

personally, i don't think i can think of any reason to break waters...but other mamas probably know more than me

[SashaBear]

If you need internal monitoring, your water would be broken.

[SublimeBirthGirl]

Not something I can foresee consenting to.

[megjo]

If the external fetal monitor shows some distress but the baby's heart rate on the monitor doesn't pick up continuously, they may want to put in a fetal scalp electrode which would produce a slow leak (and ouch on babe's head!). Another is to put a different monitoring device along side the babe's cheek to monitor oxygen levels (similar to a pulse ox.) These are reasons they may want to break waters but I don't think they are always valid reasons.

Both of my previous pregnancies I had a high leak and they broke my bag of waters. Come to find out I had two bags? I kind of wish they would have just left me alone since I was early and not contracting that great. I think that contractions are more uncomfortable without the cushion of the bag.

[SuzymomofLaura]

no good IMHO

I don't know of any valid reasons, and yes, it's mostly done to speed things up but it doesn't even necessarily do that either. Studies have shown that AROM <5 cm dilation has no positive effect on duration of labour. It might limit the time you'll have to labour, by seriously putting you at risk of infection (anyone should ask their care provider beforehand how long they'll let you go once your membranes have ruptured!) I found out recently that even with VBACs internal monitoring is questioned nowadays, as being not reliable in predicting rupture, and hightening the infection-risk.

[Shelsi]

Originally Posted by Sagesgirl

In my VBA2C, my waters were artificially ruptured to facilitate placement of a pressure catheter inside my uterus. This to keep an eye out for early warning signs of rupture. This is something that perhaps most women here wouldn't feel necessary or warranted, but I was comfortable with it.

I attended the VBAC of my friend and this is what was done to her. She was completely prepared to go natural, did the bradley classes, her boyfriend was the best non-professional support person I'd ever seen. It was her 4th baby, her first was a vaginal birth where she broke down and got the epi like 20 mins before she was born, and her next pregnancy she was a surrogate for twins so they did a c-section. She wanted the natural birth SO badly. She asked tons of questions to make sure she was prepared and yet she never asked about AROM and they never told her they would do that. She was doing awesome, was at 4 cm, and they did the AROM and she just fell apart. Ended up with demerol at 5 cm and eventually an epidural

[huggerwocky]

Interesting.

[Sagesgirl]

Originally Posted by Shelsi

I attended the VBAC of my friend and this is what was done to her. She was completely prepared to go natural, did the bradley classes, her boyfriend was the best non-professional support person I'd ever seen. It was her 4th baby, her first was a vaginal birth where she broke down and got the epi like 20 mins before she was born, and her next pregnancy she was a surrogate for twins so they did a c-section. She wanted the natural birth SO badly. She asked tons of questions to make sure she was prepared and yet she never asked about AROM and they never told her they would do that. She was doing awesome, was at 4 cm, and they did the AROM and she just fell apart. Ended up with demerol at 5 cm and eventually an epidural

Shame on them for not informing her about it! This issue was discussed with me as I was checking into the hospital--and yes, I know how very lucky I was with the hospital I wound up at.

In all honesty, having my waters broken did not increase my perception of the pain any, but I was out of my mind with it already--the whole reason I went in to the hospital. I know that for both of my female cousins, they never felt the contractions until their water was broken. I think for the eight or so kids they have between them, each and every one had AROM, and I don't think there was any real reasoning behind it beyond "this is what we do," and sadly they are both the sort to accept obstetrical dictates unquestioningly.

[mikayla's mama]

Originally Posted by Sagesgirl

I suppose that if there were signs of fetal distress, a medical professional might want to break the BOW to check for signs of meconium staining, but I don't know if that knowledge would ever actually be helpful or not.

I had meconium with my first birth and they inserted a saline pump to try to clear the meconium from the uterus. Also, they had me stop pushing when her head came out so that her lungs could be deeply suctioned, which wasn't a problem since I had mild shoulder dystocia with her. She also had the internal monitor attached to her head... I believe that the pitocin that was administered was the reason for the meconium but that's another story.

[pamamidwife]

there's no reason except mom's request.

[AugustLia23]

I had my water broken when in labor with my 2nd son(first birth, ds#1 is non-biological) to "speed things up". I was 8-9cm and things had slowed down. It didn't help at all, he was born about 13 hours after it happened, the waters breaking didn't cause anything to speed up. In retrospect, I would not do it again, since my contractions had gotten very spaced and mild, if I had known better I would've taken it as the break I think it was meant to be. I would not conset to it again.

[mwherbs]

defineately with mom's permission--
maybe - I am saying maybe polyhydraminosis -- needling the bag to help bring a presenting part down into the pelvis--

something to try before transferring when mom has been stuck at same dilation like 8-9 for many many hrs and is getting tired out- before she is completely worn out and before you leave to go to the hosptial--

possibly at mom's request- depends on what stage of labor she is in-- I may try to talk her out of it---

there is a big positional problem with AROM and that is that a mom is usually lying down when you do that and it is not the best position to be - more danger of cord prolapse- \

I know that there are policies that birth centers have , and what some mws do is AROM to see if there is mec-- if mec is present they may have to transfer care--- not really shown to be a good reason to AROM but it is done.