# Is there ever a good reason to have AROM?



## allborntogrow (Dec 31, 2007)

Is there ever a time when having your membranes artificially ruptured would be a good choice? If so, when?

Thanks!


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## Arwyn (Sep 9, 2004)

Potentially, to check for meconium, to speed labor, to insert a scalp monitor, to help a baby decend/help a vertex stay a vertex. I'm sure there are more.

All of these have big potential downsides and excellent arguments against their use, but it is possible that some rare times the need might outweigh the dangers.


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## whalemilk (Jul 11, 2008)

If I were having a medically indicated induction and had gotten to 6 cm or so and stalled, I would probably consent to AROM simply because I know as soon as my water broke with my first child, my labor shifted from dinky into turbosuperspeed within 5 minutes.


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## amymaew (Apr 25, 2007)

I had AROM as an induction with #3 - I had been 7cm for a week and was 42w3d. It was all I needed to push me into labor - less than two hours later I was holding a baby!


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## Peppamint (Oct 19, 2002)

I think it's one of many tools that can be overused but also proves useful at times.

My year as a midwife assistant has taught me that flexibility is important.


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## sbrinton (Jul 17, 2008)

I had AROM with my 2nd when labor had stalled a little after checking into the hospital and dealing with getting on the IV and monitor. The hospital makes me anxious and always slows labor down. I was dilated to 6cm and had been in on again off again active labor for 5 days. I felt like this was a natural way to encourage the rest of labor without going to drugs. For me, it helped the baby get lower in my pelvis and put me almost immediately into transition.

Although it made contractions more painful, it also helped me relax because I knew that this was really it, that I wouldn't leave the hospital without a baby again!


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## fruitfulmomma (Jun 8, 2002)

I had AROM with my third pregnancy to induce labor. I was close to 44 weeks, ultrasound showed potential birth defects, and I was dilated to 4 and not in labor... the machine showed some contractions while they were monitoring me but I could not feel them and they stopped after a while.

I had already tried several "natural" induction techniques because we were hoping for a homebirth but they didn't seem to be doing anything. At our second ultrasound (no problems seen on the first) we opted to transfer care to the staff on duty at the hospital. IMO AROM was better than a drug induction and I was able to labor and birth without any further interventions and no pain relief drugs needed.

I asked lots of questions before I consented to it... could I still get in the tub - yes, how long was she going to let me labor - 12 hours and would only intervene then if there was no change. So I was pretty happy with the way it went. Labor started pretty soon afterward and they let me walk and use the tub a lot. I think she was born about 6 hours after they broke my water.


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## Girlprof (Jun 11, 2007)

I had AROM with both births. The first time around it was the only intervention. I was at 9-9.5cm with a cervical lip and we hoped the AROM would take care of it. I'm not really sure it did anything, but it also didn't hurt anything.

The second time around I had a medically indicated induction - super high blood pressure. I had to be induced with pitocin. My very low intervention MW suggested it as a way to kick things into gear. Even with the pitocin, contractions were pretty weak. With one go, she broke my water and inserted an internal fetal monitor. She had checked dilation to be sure I was making progress because if I hadn't been, she would not have started the 24 clock that her practice felt comfortable with after AROM. After that, I was free of the external monitor and labor picked up. I had my baby an hour and a half later with no further interventions.

I suspect in my case the pitocin induction saved me from a cesarean - the blood pressure issue was pretty dire. And the AROM saved me from more pitocin.


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## onetwoten (Aug 13, 2007)

Quote:


Originally Posted by *sbrinton* 
I had AROM with my 2nd when labor had stalled a little after checking into the hospital and dealing with getting on the IV and monitor. The hospital makes me anxious and always slows labor down. I was dilated to 6cm and had been in on again off again active labor for 5 days. I felt like this was a natural way to encourage the rest of labor without going to drugs. For me, it helped the baby get lower in my pelvis and put me almost immediately into transition.

Although it made contractions more painful, it also helped me relax because I knew that this was really it, that I wouldn't leave the hospital without a baby again!

This is very similiae to the last birth I attended as a doula. Mom was laboring fantasticly and was 4cm, but contractions had started slowing. She was VERY tired at this point, and said the thought of 'stopping labor', sleeping and then starting up again was horrifying, so she asked lots of questions, prepared herself for it to possibly feel more intense, and asked to have her water broken so that hopefully the contractions would pick up again. This was at 11:15am, (in labor since 5:30pm~) and she had the baby in her arms at 2:50pm.


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## durafemina (Feb 11, 2004)

I'm completely against unecessary intervention and I had AROM in labour. Homebirth, about 18 hours of intense labour, stalled at 8cm for 4 hours with baby still not well applied to cervix. I was exhausted and not contracting regularly, so mws and I decided to AROM. After that, baby's head plopped right onto the cervix and I finished dilating and pushed her out in a short period of time (and then hopped right into bed. bliss). Very judicious and helpful use of it, in my opinion.
I'm sure that things eventually would have happened on their own, but I was so tired by that point that I needed some help and in my books that waaaay beats an 'epidural so I could get some rest' etc!


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## kltroy (Sep 30, 2006)

I requested AROM when I was about 8 cm and wanted to move things along with my recent VBAC. It was late, I was tired, and I couldn't see any harm in it that late in the game. I'm not sure it sped things up at all, but it certainly didn't hurt. They had been talking induction/augmentation earlier with me for legit medical reasons (I got them to hold off as long as things progressed on their own). If I had no progress within 6 hours I agreed that we would try AROM first to get things going.

Once you get to about 8 cm I don't really see any harm in AROM. It's a personal choice of course. OPs have described other good uses for AROM. It can be one of the nicest ways to induce/encourage labor progress if you need to do that. Usually if you need to do that you're already "on the clock" so the whole 24 hour rule probably doesn't matter anyway.


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