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That's why i think it's important that an experienced midwife who knows the woman needs to be making this sort of suggestion and not one who is "changing shift" and wants the birth over with. If the MUM is exhausted and wants things speeding up and the midwife agrees that her labour is one which is likely to benefit then and only then should AROM be considered. Doing it because you can is plain stupid.
My labour had no "padding" of waters and was not especially painful until i was instructed not to push. Even then, it wasn't so much more pain as the same pain (mild chinese-burning feeling at the cervix, no other pain) heightened with mild panic because it was so hard not to push when she was through the cervix already. Not every woman feels labour as more painful once the waters break, not every labour with accelerate dramatically. I have a friend who had AROM and felt much better for it (the pain over her bump during ctx lessened) but her labour then stalled and her ctx vanished for 40mins.
"First do no harm" - that means that the chance of benefit to the MOTHER and the BABY needs to be strong before ANY intervention is considered. Sadly many practitioners consider AROM a non-issue as interventions go because there are no drugs involved. I know of many women who had it done without even being consulted. Really there is nothing special or different about the female body in labour that warrants any treatment you wouldn't have given her in the 22nd week of pregnancy. Even if no professional ever LOOKS at the vagina (inside or out) the baby will still emerge from it in his or her own sweet time.
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I truly do think that when you are in well-established labour, the water breaking will speed things up. With my first DD, my waters broke at home after about 2 hours of contractions. She was born 4.5 hours later. (not too bad for a first baby!) With my second, I laboured for 6 hours before my ob offered to break my water, if I wanted. I said sure! DD2 was born about 45 minutes later. With my third, I laboured for about 10 hours without "progressing" (stuck at 4cm). At about 6pm (I think!) my midwife agreed to break my water (I asked), and things became MUCH more intense from that point on. DD3 was born about 1.5 hours later.
In my experience, it definitely speeds things up. Whether it's a good idea or not is an entirely different question.
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My dd was just about to pop, and my waters still had not broken. The MW took care of this, and DD was born about 5 minutes later.
15 hour labour.
I have no idea if it would have sped anythign up, but i do know that having it ruptered just before she said hello to the world made the process very wet and slimy - there was absolutely no pain when she came out, just felt like a big blob of jelly!
