Growing up, I assumed all women went into labor either in a fancy restaurant or standing in line at the grocery store. I believed this because Hollywood movies, for whatever insane reason they have, ALWAYS portray the start of labor with some overly dramatic water breaking scene in a public place. It’s enough to make any woman in her 9th month stay locked in her bedroom. In reality, Hollywood is dead wrong. Research shows that just 1 in 10 woman experience a dramatic gush of amniotic fluid before labor starts. Usually your water will break with a trickle, not gushing effect, and after you’ve already been in labor for a while. That said, I was one of those rare mamas-to-be whose water did break before I went into labor. Not good news for me, because health care professionals panic if your water breaks before labor starts. My midwife and the nurses at the hospital where I gave birth told me that if labor didn’t start on its own soon, they’d induce, a common practice in America, mainly due to fear of potential complications such as infection and placental abruption. Luckily, new research shows that this older train of thought may not even be helpful, which in turn can help you avoid an overly painful labor.Sorry, there are no polls available at the moment.
Researchers agree that preterm rupture of membranes (water breaking) affects just 1% to 5% of all pregnancies but they disagree about how to manage it. The American College of Obstetricians and Gynecologists recommends inducing labor when your water breaks while other societies take a more conservative approach, allowing a mother-to-be more time to go into labor naturally. Now a new multicenter Dutch randomized trial finds that the American approach might be wrong. To explore the debate researchers performed the PPROMEXIL trial, a randomized trial conducted at 60 Dutch hospitals that included 532 women. All of the women experienced their water breaking before labor started, at some point between weeks 34 and 37 of gestation. The women were randomly assigned induction of labor with either prostaglandin or oxytocin or received no induction and instead had their pregnancy monitored. Women in the monitor group stayed monitored until they had a spontaneous delivery or until 37 weeks’ gestation, when labor was induced according to national guidelines. Overall, the women who were not induced experienced a longer pregnancy (by three days on average) and experienced no more ill effects, such as higher cesarean delivery, neonatal sepsis, or respiratory distress syndrome rates than the induced group of women. Although the researchers feel this issue needs more study, overall, induction of labor did not appear to substantially improve the outcome for either the woman or her baby compared to labor starting naturally.
What this Research Means to You
As anyone who has been medically induced will tell you, induced labor sucks big time. I found this out first hand, because although I tried everything after my water broke, my labor didn’t start naturally. A half day after my water broke, my midwife did induce and it was horribly painful, but I only had myself for comparison. Later when I worked as a doula and was in college for nursing and midwifery, thus talking to many women about their own induced and non-induced labors, almost all the women I spoke with who experienced both medically induced labor and natural labor said their natural labor went faster, with fewer complications and was much less painful. Of course, you should always discuss labor issues such as early water breaking and induction with your midwife or doctor. Still, be aware that American health care providers are quick to jump to induction, even when it may not be necessary as this new research shows. Induction methods, such as pitocin, are known to cause insanely painful contractions that come with fewer waves of rest than natural contractions. Pitocen can also result in some major complications for your baby, including fetal heart abnormalities, low APGAR scores, neonatal jaundice, brain damage and more (even death). Additionally, inductions, like any labor intervention tend to make other interventions more likely, such as c-section, epidurals and more. Because medical induction is linked to further complications and a more painful labor, it’s in your best interest to avoid medical induction or at the very least think it through carefully.
Lead image by Flickr User bradleygee