ARM Induction - Your experiences?

[SwissArmyWife]

Hi, I am currently 40+8 with my second. I had a sweep on wednesday, but nothing has happened and they have suggested induction next week. I am already 2-3cm dilated so it will be an ARM induction.
This has got me worried as I had my waters broken halfway through my first labour and it really sped things up, the pain was unbelievable and I've also heard it can cause fetal distress, and problems if the baby isn't in the right position, not to mention the fact it is considerably more painful than labouring with your waters in tact.
It also means I won't get the lovely mlu water birth that I was hoping for which is upsetting.
However I have suffered with PGP throughout this whole pregnancy, and I am housebound because of it. I'm in two minds about what to do, as I really want to have this baby but am scared of induction!

Please could you share your experiences of ARM induction? Is it really that bad? Wwyd in my situation?

My first was a on time water birth and I can't quite imagine doing it differently this time, especially if there is a chance it will end in emcs or something. I'm very confused about it all.

[shinyblackgrape]

No experience but just wanted to say good luck!

I can see why you are in 2 minds. Have the hospital discussed alternatives with you such as expectant monitoring? I'm 39 weeks today and may very well agree to be induced, if needs be. However, I would definitely want to discuss all the risks (as you point out) and the alternatives before I did so.

Why does it have to be an ARM and can't you have the gel? One good thing about our local hospital is that you can apparently have one go of the gel in the MLU. Not sure if that is an option for you?

[shinyblackgrape]

Aaaah - think I've been thick and it's ARM because you're a bit dilated.

[SwissArmyWife]

Thank you shiny, yes it's ARM because I'm dilated enough, the midwife didn't mention any other form. As much as I want to have the baby, I'm just worried it's going to cause a horrendous labour/birth if I agree to it. If I wasn't in so much pain all the time I would just wait it out, and of course there is a chance I could go naturally before the hospital decide to call me in, but I'm doubtful. :(

[crochetcircle]

I was induced by arm for my second and it was great. Regular contractions started immediately but built up slowly and it was all pretty manageable and over in 2hrs 20mins. The pool was full and waiting for me but no time to get in it!

Also, easy to arrange childcare as knew when I was going in.

I had never heard that arm causes stronger contractions. The drip definitely did (birth 1), but that time pessary and arm were ineffective at starting labour.

[Flisspaps]

I had ARM with DD.

It did absolutely sod all, and I ended up on the syntocinon drip

[5madthings]

I had arm.for four of mine and it was fine. I was also still allowed to use the birth pool.

But if yoi dont want you can refuse and ask for the prostin gel to see if that will kick things off or just refuse induction,ask for expectant management and give yourself time to go into labour naturally. How overdue will you.be when they induce you? Hospital policies vary but if all is well i woyldnt even consider it until after term plus 14 days. At term us 14 onwards i woyld want expectant management and then providing all was well i would wait and have regular monitering.


If it helps ds2 arm labour seven hours, mainly in the bath, gas and air delivered kneeling on.bed 9lb 3oz.

Ds3 arm labour three hours in bath, gas and air again delivered kneeling on bed 9lb 5oz.

Ds4 arm labour under an hour, in birth pool, ds4 born in pool 10lb 13oz.

Dd arm labour three hours, ended up with syntocin i think because she was back to back laboured on birth ball, moving about etc with gas and air and drlivered kneeling up. Even with the syntocin drip it was ok.


Another thought once they break your waters the clock is ticking, different hospitals seem to have different policies for how long they leave you, if you.dont get contractions wirhin so many hours they will be wanting to start syntocin, again you can say no/ask for more time. I did this with ds3 as not much happened, it was then fine in the end but i had to get rather stroppy with dr.


Good luck and sending labour vibes xx

[HorridHeffalumpsWickedWoozles]

I had a full induction including arm with DD1, not great but then probably not the situation most relevant to you atm.

With dd2 I was already 3cm when I went in for induction so they just did arm. It was fantastic, arm at 18.30 and dd born at 21.00. I was allowed in the water which was the main thing for me after being so so desperate to have a water birth ever since denied it with DD1.

Yes it was quick, we went for a walk to get things going immediately after the arm and only got half way round the hospital before I was having full on contractions, DH had to run me back to the ward in a wheelchair or I would've had her in the corridor! However pain wise it was totally bearable once I had the tens strapped on, if I hadn't been allowed in the pool I feel sure I could have managed with just the tens.

Is it the policy at your hospital not to allow water birth after arm?

You are perfectly entitled to refuse any sort if intervention, although obviously this carries potentially higher risks so it depends on your feelings towards this.

Anyway now I'm going on a bit, in a nutshell my experience was very positive and I hope yours will be too :)

[SwissArmyWife]

Thank you for sharing your stories.

I have been told that if I'm called in to the hospital, I will not be able to go to the birthing unit, where the pools are! I am desperate for a water birth, as it was such a lovely experience first time round. It's good to know that you were able to move around after though, I was worried I might be strapped to a monitor and unable to do anything.
At the moment my mind is all over the place, this whole being over due/possible induction scenario is completely new to me! MW said hospital will call me "sometime next week", I will be 42 weeks on Friday. The only chance I'll get to go into mlu is if I go in to labour by myself before they call! Aaaaah.

[shinyblackgrape]

It's really difficult. I feel for you as it's really hard to make a decision. Both have pros and cons.

I am desperate for a water birth too. We went on a tour of our local hospital and most of the rooms in the ward (as opposed to MLU) had en suite baths. I know it's not the same but if I have to go in to the ward, I will be insisting on getting in that bath. I don't care what the policy is! They can wheel they damn drip in there! I got a good tip from a friend of taking loads of face cloths too as yiu can use them in the bath to cover you and bump so you feel more submerged. I've also got loads of electric candles to try and make things a bit less stark and am taking in my aromatherapy diffuser thing.

The thought of an induction makes me want to cry but my sensible friend (who had to have one too) has pointed out that if I go in on that basis then everything will be 10x worse.

That all said, I'm not going to immediately agree and I think the advice on the thread re the expectant management is all v good.

Also, just to check. What's the reason that gel can't be used if you're already a bit dilated?

[shinyblackgrape]

Ps - If you decide to go for expectant management, coukd you get better pain relief in the interim for the PGP? It's a shame the lack of that understandably impacts on your decision.

[Flisspaps]

The gel is usually used to get you to dilate so they can break your waters.

The ctx cause your cervix to open, if your cervix is already open then they don't need to help it along. I suppose it's cheaper, plus there are none of the associated risks of hyperstimulation etc

[shinyblackgrape]

Aaaah - thank you flisspaps. Now I know in case I need it.

So, basically, they start if with the gel (if not dilated or just a teeny bit) and alligator just go from there without the need for any other type of intervention. But, if not, they look at ARM and syntocin?

[Flisspaps]

That's about it, yes.

[SwissArmyWife]

Well, still no baby so it's looking like induction is rather likely. I will also be insisting on getting in the bath if I end up in hospital, I'm just so disappointed that my choice of a water birth will be taken away if I agree to induction! Especially considering the mlu is next door to lw!!
I think I'm just going to go with gut instinct on this and not think about my decision until asked as I keep winding myself up about it all. I just want my baby to arrive safely.

[AnaisB]

I had expectant management from t+10. The t+14 scan showed low fluid levels so i was induced at t+17.

I was already 2cm dilated and had a sweep and a gel pessary that did nothing. The mw on the induction suite knew i wanted to avoid unecessary intervention and phoned the mlu to see if they'd break my waters there - they were quiet and said they would.

Ds born 30 mins after my waters were broken. The labour was fine - once i got on the gas and air, but the pool was not filled in time.

I'd ask for expectant management, but from my experience of arm (having been terrified of induction) it was fine.

[shinyblackgrape]

That's a good story anais. Can I ask - was that your first DC?

Just popped back to say good luck swiss - will keep fingers crossed that something' might still happen naturally

[AnaisB]

Shiny - no it was my second.

First labour was about 16 hours and began following sweep at t+10 appt.

[AnaisB]

And good luck swiss. Hope everything goes well for you.

[katieelh]

I had an arm induction with my 4th, it worked very quickly and my labour was over in 2 1/2 hours.good luck

[SwissArmyWife]

Baby arrived on 23rd after spontaneous labour, so no induction needed :)

[ghoulelocks]

I had attempted ARM...until they finally believed me that my waters had trickled away.

However I was in hospital last week and the woman in the next bed had had, the midwives were talking with her over how quick it had been (nosey!)

[shinyblackgrape]

Hurrah swiss! Although I was selfishly hoping you might have it and report back as I'm now overdue

[FoxyRoxy]

I had arm and syn drip as i was already 3cm, had an epidural an hour and a half after my waters were broken and gave birth 2 hours after that. No distress and I really enjoyed my birth despite the intervention.

[SwissArmyWife]

shiny it was a very close call - I was due to have the induction that day so only just managed to avoid it as he arrived at 6:26am! I hope you get to meet your baby soon :)