Posted by My OB said WHAT?!?.
Jan
30
Posted by My OB said WHAT?!?.
“…I Could Break Your Water…And You Can Have This Baby Today…”
“Well, I could break your water now and you can have this baby today, or I can let you be, and you’ll have this baby tomorrow.” – OB to mother in labor.
There are 24 comments to this post.
What this doctor is not saying is that she will have this baby today “one way or another” because once her water is broken she’s on a clock. 12 hours goes by and it’s a section.
Breaking a woman’s water is effective many times in helping labor speed along, but if it doesn’t work it’s gonna be surgery, sadly.
Which is why no one ever breaks my water.
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Now see, my midwife (ACTUAL MIDwife) said this same thing (minus the second part) to me the day before I had my son. I was 3-4 cms and not in labor, but she said “i could break your water and you would have him today”… i said no thanks, and had him that night. it didnt bother me that she said it, but i know if its on this site then it bothered whoever said it.
now again, the same midwife has already offered to induce me, and she does not offer to induce many. i am pregnant with my third, and my second was a VERY fast birth (50 minutes from first contraction to birth) and it ended up being unassisted. i am not going to take her up on that offer, but i know she is worried about another unassisted, unplanned homebirth.
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It’s a beautiful fallacy in every respect. it’s obvious that the waters need to break at some point between now and when Mom is holding the baby in her arms. Therefore rupturing the membranes for her checks one item off the list and baby is that much closer to being born!
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At the risk of being pelted with soft tomatoes, I’ve been at births where breaking the waters did seem to be a good thing. This mom goes to eight, and gets stuck. Cervix soft as butter but baby high and floating and goes nowhere, even with movement, etc. Then they break her water and she has her baby 3 contractions later. This was #9 so a pattern seems to have been established.
On the other hand, sometimes it is not a good thing, and could be dangerous. I was recently called by my client’s husband who said, I think you should come now. They just broke her water without asking first. She ended up with horrible decels while pushing because of cord compression.
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Kate, Ren's Mama Reply:
January 30th, 2011 at 9:57 pm (Quote)
Yeah, as soon as you said “high and floating” in conjunction with possible AROM, I started worrying about cord prolapse. Then the second part of your comment reinforced that worry.
If baby is not well engaged, isn’t AROM somewhat risky? Not not mention putting mama on the clock, introducing bacteria, etc. And if baby IS well engaged, doesn’t that indicate progress, a lot of the time?
That being said, I have seen AROM help a mama who was stuck with a lip, with baby well engaged, but the midwife I work with doesn’t use it often.
(No tomatoes here, just honest concerns 
)
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Sheva Reply:
January 31st, 2011 at 4:49 am (Quote)
I should have said high, but not floating. The mom in the first story (with baby #9), her baby was at -2 station when they broke the water. In the second, I wasn’t there when they did it, and they would never tell me, as the doula, if baby had really been higher than that.
I guess my point is that as a general rule, AROM is a bad idea, but there are some cases where it can be safe and can actually be useful. (Kind of the same with almost all interventions. NOT all. Almost all.)
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Kim Reply:
January 31st, 2011 at 9:51 am (Quote)
Every birth is different in it’s own way. The only thing I’m taking away from this is the way it seems to have been put to the mother. Not as a choice really but almost as if she will be punished by her own labor if she doesn’t bend to the will of this OB.
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road2vba2c had this to say,
Jan 31, 2011 @ 4:48 am (Quote)
I’d like to think of myself as the eternal optimist. I see this as a good comment. The doctor is giving her options. Of course, if he said this during a vaginal exam with amniohook in hand, it may not seem like an “option”…
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Jynxx had this to say,
Jan 31, 2011 @ 5:46 am (Quote)
It -can- be a good thing. With my son (first and only baby), I started contracting at 2am, got to birth center at 8am, and had him at noon. My water didn’t break, so they did it, and he was born very quickly. But it was the fact that, as soon as the midwife did it, there was a huge release of pressure, which felt immensely great, that was good for me.
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The Deranged Housewife had this to say,
Jan 31, 2011 @ 12:55 pm (Quote)
It *can* be a good thing, yes – but that is no doubt based on an invidual assessment of the patient and her baby. Although with that should be the reasons why it might not work/is dangerous, and let mom make the decision (in a perfect world). Saying this as a blanket statement to coerce mom in hopes of getting it over with? Inappropriate. But I’m preaching to the choir.
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This one is mine!!! My first child was born at a “respected” teaching hospital. My husband and I wanted a natural birth, but being first time somewhat anxious parents, we wanted to have our first in the hospital “to see how it goes” (feel free to roll your eyes!).
I went to the hospital in early labor since we lived a fair distance away, and had labored pretty well despite the monitors, unkind nurses, and everything else for about 8 hours when this doctor came buzzing into the room. He barely introduced himself, checked me, and said this little gem. I was in very uncomfortable BACK labor, with just as uncomfortable monitors strapped around my stomach, and barely hanging on to the “relaxation” techniques I learned in our Bradley class. I am extremely suggestible in labor, and after 8 hours of back labor, I wanted it to be over with and let him do it. Unfortunately at the time, I didn’t realize that breaking your water also meant a 1000% increase in pain!
About an hour later, I ended up with the epidural that I wanted to avoid. I had a maternal temperature and needed antibiotics, which was a problem because I’m severely allergic to most antibiotics. And after the birth, I had major blood pressure problems due in part to the epidural and the hemorrhage that this doctor caused by ripping out my placenta (I ended up nearly dying later that same week due to a *huge* amount retained placenta). It was a complete nightmare!
Thankfully, this experience taught us quite a few very valuable lessons. We used a midwife, and had a birth center birth (too far from a hospital for a homebirth). We are expecting our third in April and will have another birth center birth with our midwives!
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Laura Reply:
February 1st, 2011 at 5:55 am (Quote)
I should add a few more details. I was 4 cm. when he wanted to break my water, and had been in early labor since 11pm the previous evening. I was tired, struggling to have a “relaxed” labor (labor is work, somehow I missed that concept in my Bradley class), and am extraordinarily suggestible in labor. He could have told me ANYTHING and I would have believed him. I did in fact have the baby “that day”, at 9:30pm. Baby was engaged when he broke my water, so prolapse wasn’t as much of an issue. They didn’t use any pitocin, no internal monitors, and I didn’t need a c-section. While he put this statement to me like it was “my choice”, it was a coercive measure. Most women wouldn’t choose to labor on for over another 13 hours (it was about 11am then), especially when they are in desperately uncomfortable back labor.
Like I said, I had my second son at a birth center, and my water broke on its own 10 minutes before I had him. It was a MUCH more manageable labor and birth (I actually only arrived at the birth center 15 minutes before I had him!).
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AROM can be a great tool or a horrible one.
My BP was rising rapidly. I was 38+5 and 3/80%.
My OB ruptured my BOW at my request, I was in labor 90 minutes later and had my baby less than 3 hours after that.
It all worked out great. Much better scenario than pit or waiting for labor and ending up with pre-eclampsia again and on mag.
That was *my* individual situation. That doesn’t extrapolate out that it is good care to AROM all women at 3cm.
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