Breaking water vs. Pitocin???

[dancingingrace]

I'm scheduled for an induction after 41 wks, and when I asked how they would do it, the nurse midwife said they will use Pitocin. At my check last week, I was 4 cm and she said the bag of water was "right there"...she didn't say how effaced or what station (not sure how much the bag of water being "right there" indicates?), but the week before, I was 75% effaced and -2.

With my first, I was 4 1/2 cm and 100% effaced at 38 weeks, and they broke my water. I'm wondering what the difference is in breaking the water vs. pitocin (other than the technique, obviously), which is better, and is there a reason for doing one rather than the other? I got an epidural with my first, and I was fine with the water being broken. I've heard that it is really, really painful with pitocin...would an epidural help just as much with that? I'm thinking about whether or not I should ask them at my last appointment this week why they can't break my water instead of using pitocin, but I don't know which is better. Thoughts? No flames for the induction or use of epidural, please...thanks!

[palsmama]

I had to make this same decision just 2.5 weeks ago. I was 41 weeks 4-5 cm and my bag of waters was "right there". My reasons for opting to break my water was that with pitocin you have to be monitored and hooked up to an IV continuously. With breaking the waters you can be free to get up and move around and only be monitored intermittently. When I went in I was having some contractions but just wanted to be done, since I had been contracting for the 3 weeks prior. My doc broke my water and I had a natural delivery less than 3 hrs later. I was able to be off the monitor and move around to be in whatever position felt comfortable! It was awesome!

[dancingingrace]

Originally Posted by palsmama I had to make this same decision just 2.5 weeks ago. I was 41 weeks 4-5 cm and my bag of waters was "right there". My reasons for opting to break my water was that with pitocin you have to be monitored and hooked up to an IV continuously. With breaking the waters you can be free to get up and move around and only be monitored intermittently. When I went in I was having some contractions but just wanted to be done, since I had been contracting for the 3 weeks prior. My doc broke my water and I had a natural delivery less than 3 hrs later. I was able to be off the monitor and move around to be in whatever position felt comfortable! It was awesome!

So, maybe this varies by provider/hospital, but is there any reason that they should or would not let you request one over the other? I haven't tried, so I'm not saying they would or wouldn't, but would there be any reason for them to say no if I ask to have my water broken instead of pitocin? Thanks for your input!

[MunkyCrazy]

When I went over options with my midwife she said she didn't like breaking water and preferred to just give a bit of pitocin to get things moving and then turn it off once you're regularly contracting. She didn't like breaking water because then you're committed to having a baby and up the chance of infection.

[EmmaGM]

Unlike PP, once they started me on pitocin they were unwilling to turn it off or even leave it. It was turned up every 15 minutes until.. I can't remember, something magical happened, like me deciding to never give birth in a hospital again. So you might want to ask your provider about that.

[palsmama]

Originally Posted by dancingingrace So, maybe this varies by provider/hospital, but is there any reason that they should or would not let you request one over the other? I haven't tried, so I'm not saying they would or wouldn't, but would there be any reason for them to say no if I ask to have my water broken instead of pitocin? Thanks for your input!

I think it depends on your provider but it should be up to you. It's your birth experience. I went over my options with my provider and he gave me pros and cons to both. He was very supportive, and thought for sure breaking my water would result in having a baby. As pp said, once you break your water your committed to having a baby. I limited vaginal exams to only when I felt the need to push.
My provider said that if I went the pitocin route he suggested what pp said about starting it and stopping it once a good contraction pattern started we could turn it off. But personally I wasn't comfortable with pitocin and its potential side effects so I opted for breaking my water.
Fwiw- my labor with my first started with spontaneous rupture of my water and I had him without pitocin.

[Yarnjess]

I think the issue is that breaking your water isn't a sure fire way to start labor that hasn't started yet. Pitocin will. A lot of the time they'll break the water if labor has started but hasn't progressed to active labor yet and they want it to for whatever reason. With me, I had been in early labor for close to 24 hours when they broke my water (I was laboring at home the majority of that time, so I wasn't "on the clock" at the hospital, as it were). I had been planning a home birth, but my midwife recommended a transfer because my early labor was slowing and she was worried the baby wasn't handling labor well. So, we had an ultrasound and an NST (which we passed), they broke my water and that sent me into active labor. When they broke my water the plan was to give me a few hours to see if it worked before bringing in the pitocin. Pitocin wasn't necessary because I immediately went into active labor. The OB knew I was wanting as natural a birth as possible and was willing to work with me, which is why I think he didn't immediately reach for the pitocin. When they broke my water there was thick meconium, so it was a good thing we were already in the hospital because my midwife would have transferred me if my water had broken at home with thick meconium. Anyway, my point is, I think breaking the water is used more to augment labor that's already started rather than a true induction.

[keonli]

With my first, my OB broke my waters (didn't even tell me he was going to, just did it!). He told me to head to the hospital and they started me on pitocin right away. They kept upping the amounts. Nothing happened. I was contracting but not dilating. My son arrived 18 hours later.

[DesertRat]

I don't think breaking your water is guaranteed to start labor. So you may end up with pit anyway. For me, breaking my water means I'm having a baby within 90 minutes, but I've also been partly dilated and in 2 births, having ctx already.

OP-- what happened last time they broke your water? Did it speed up labor?

[Edensmomma]

There are risks to breaking your water, such as having the baby engage into the pelvis in a less than optimal position, such as AOP (posterior) You may want to ask what station your baby is in before they break your water. The higher the baby is up the more chance you have of engaging in your pelvis in a posterior position. I personally have had this happen to 2 clients and the baby came down far enough to where we could see the babys' hair but the skull bones wouldn't pass the spiny bones in the hips, even with assistance from the OBGYN. Both deliveries ended in Cesarean. Also, the minute your water is broken, you have 24 hours to deliver or they will give you a c-section due to the risk of infection.
I don't say this to scare you, I just really want women to be educated on the risks of such procedures and often hospitals/doc won't take the time to tell you these things.