Jul 22

Thoughtful Thursday! “…It Would Be In Your Best Interest To Let Your Water Break On It’s Own”

“I think it would be in your best interest to let your water break on it’s own. It’s more gentle on your perineum and you will cope easier with it still intact. If it wants to break, it will.” -OB to mother who was impatient to be done at 6 cm and wanted her water broken.

3 people dislike these words.

There are 13 comments to this post.

Jane had this to say, Jul 22, 2010 @ 8:41 am (Quote)

So much nicer than “You know, if you’re ready to push and the water hasn’t broken, we HAVE to break your water otherwise you’ll get an amniotic fluid embolism.” (Yes, was told this.)

It’s so much easier to labor with the amniotic sac intact. So much easier. Good for this OB for leaving the hook in its package.

[Reply]

Serene Reply:
July 23rd, 2010 at 4:30 am Serene(Quote)

All 3 of my labours it was broken for me, but I never heard of an amniotic fluid embolism?!??

Ive never even seen it in my text books!

[Reply]

Jane Reply:
July 23rd, 2010 at 4:43 am Jane(Quote)

That is a genuine obstetric emergency and usually results in a dead mom. If the sac ruptures at the same time as the placenta sheers of the uterine wall, the amniotic fluid can get sucked back up the arteries and stop the mom’s heart and lungs. There’s more to it than that, but that’s the nutshell. It’s very, very rare.

A woman on my due-date group died of this. She had polyhydramniosis and the doctor did an uncontrolled AROM, and as the uterus decompressed from all the fluid releasing, the placenta tore away. (Doctor should have had mom on all fours, butt in the air, and ruptured the membranes with a pinprick so it wouldn’t gush out.) Baby survived.

[Reply]

Chelsea Reply:
July 25th, 2010 at 9:17 pm Chelsea(Quote)

Well maybe and maybe not. But I would imagine breaking the water before it’s ready to break would make it more difficult.

That said, my water broke on it’s own before I went into labour with my first and that labour was easier for me compared to my second labour where it didn’t break until minutes before my second daughter was born.

But, my second labour was so fast I didn’t have time to process it or find my groove, so that could be why it seemed harder.

[Reply]

CCindy had this to say, Jul 22, 2010 @ 9:01 am (Quote)

I love this doctor. He/she not only knows his/her stuff, but is willing to teach and explain.

[Reply]

Emily had this to say, Jul 22, 2010 @ 9:10 am (Quote)

great advice! my water doesn’t break until the VERY end (on it’s own) and when it does you had better watch out because a baby will be shooting out right behind it… and yes once it is broken for you I think it hurts a lot worse!!!

[Reply]

Elizabeth had this to say, Jul 22, 2010 @ 9:12 am (Quote)

I think if I got to a 6 and got STUCK at 6 I’d ask them to break my water but not just for the heck of it. Makes things messier than they need to be.

[Reply]

doulakate had this to say, Jul 22, 2010 @ 9:13 am (Quote)

This ones mine! My jaw dropped a few times at this birth… this OB also told the nurse she didn’t need to replace a heparin lock that fell out during pushing! He said, “If she needs pit, I can give it in her thigh”. AND when the mom requested EVOO compress during pushing, he said, “sure we can do that, but in my experience warm water feels better… shall we try both and see which one you prefer?”

This ended up being the most un-intervened birth I’ve seen at a hospital… with an old male OB.

[Reply]

Elizabeth Reply:
July 22nd, 2010 at 3:38 pm Elizabeth(Quote)

Wow, that’s amazing! I bet you’ll be referring a lot of business to him!

[Reply]

Kat had this to say, Jul 22, 2010 @ 9:32 am (Quote)

I think if I got to a 6 and got STUCK at 6 I’d ask them to break my water but not just for the heck of it.Makes things messier than they need to be.

But how would one define “stuck?”

If a labor is taking time to progress from 6 cm, maybe it’s an indication the mom’s body is tired and needs to rest. Maybe it’s an indication that a change of position would help, or getting up and walking is in order to help the baby move down.

Breaking the bag of waters removes the cushion it provides for the baby (risk of fetal distress), opens an avenue for the introduction of infection, and can also lead to cord prolapse (a life threatening emergency).

Since it carries those specific risks, it seems to me it should not be done routinely, and shouldn’t be used as the first response to “You’re not laboring on our timeline, so we want to do something to make ourselves feel proactive.”

Normal Labor doesn’t always follow “the clock” and that’s a good thing! Not an emergency requiring intervention.

[Reply]

CCindy Reply:
July 22nd, 2010 at 9:57 am CCindy(Quote)

You are absolutely right.
On the other hand, Mom knows when she is stuck. Trust mom’s gut. If after the doctor told her it was best to wait, Mom once again said she felt breaking the waters would help then the doctor would need to be open to that dialogue.
When I was stuck at 6 with my final trail at VBAC and told the doctor “This isn’t working I think we need to do a c-section.” He tried to balance me out and make sure it wasn’t just exhaustion talking. But I had already been through all the details in my mind, and it turned out I was right. My uterine scar was open and my labor was funky because my body wasn’t going to push that baby out the wrong whole. You gotta trust mom’s gut. You also have to know mom well enough to know if it is exhaustion talking, etc.

[Reply]

Anne Reply:
July 25th, 2010 at 1:20 am Anne(Quote)

I was “stuck” @ 6 cms for 17 hours before the sliced & diced me. I had a posterior baby but was made to lie on my back on the bed for most of those hours (with only gas & pethidine) so the doctor could keep the EFM in place. I feel that if I had been allowed to move I would have shifted him and might have avoided the mother of all interventions.

[Reply]