QuestionI am 38 almost 39 weeks and my doctor and I have been planning on breaking my water to induce labor. I am wondering if this is okay or if it could be harmful to me or my baby?
AnswerWhile AROM (Artificial Rupture of Membranes) is very common, it is not without risk. First, you are trying to induce labor. This means you are forcing your baby to come before it is ready, and you are forcing your body to deliver before it is ready. This comes with a fairly high failure rate, because your body is going to try very hard to do its job, which is to keep the baby safely inside while it finishes growing. If you succeed with the induction, you run the risk of having a premature baby. Normal gestation can be as long as 42 weeks. If your baby needs that extra time, and that is why you haven't gone into labor yet, your baby could have breathing, feeding, or temperature problems after birth, requiring a stay in the NICU while he finishes maturing.
There are also mechanical problems with breaking your water. First, you are removing a cushion from the baby. Babies need to be in a very optimal position for birth. Often, during early labor, they will wiggle and rotate to get their heads in just the right spot. When you break your water, you remove a lot of their ability to do that. If the baby is not in the right position, removing the water cushion can lock him into a bad one, making delivery impossible. Another consequence of removing that cushion is that baby is no longer protected from the stress of contractions, which are often harder and longer after breaking the water. This can lead to fetal distress. Finally, if your baby's head is not fully engaged when the water breaks, you run the risk of cord prolapse, where the umbilical cord washes out of the vagina with the rush of water. This is an immediately life-threatening condition for your baby, requiring a crash c-section to prevent death from asphyxiation.
One last concern about breaking your water is that it puts you on a timetable for delivery. Once you water is broken, doctors like to have the baby out within 24 hours because of the risk of infection. This means you have no margin for error. If you tried to induce with pitocin, and after 12-24 hours you were getting nowhere, you could always turn the pitocin off and just go home and wait. If you have artificially broken your water, though, you don't have this option anymore. No matter what, you're going to have to deliver, which means if your body and baby aren't ready, you just set yourself up for a c-section.
Normally, your water will break naturally during active labor, when you are between 5cm and 10cm dilated. At this point, you will have avoided all of the risks I laid out above.
