bag of water breaks... go to hospital???

[shannon_na_gig]

I've been trying to do research on this, but haven't found any specific answers online. Maybe you all can help?

My hubbie and I are doing a homebirth, and it's my first birth. I'm pretty positive and confident about it, but hubbie asked me to tour our hospital (which is our Navy hospital) in case of transfer.

Of course the staff was all worried about the idea of a homebirth, but after talking to us for awhile I think we reassured them. It defintely helped that my hubbie is a med student who will be doing his OB rotation right before I am due.

The one piece of advice the head OB nurse gave me was "if your water breaks, you HAVE to come to the hospital. It's very serious."

I know that they are worried about infection, and I've read that you need to have the baby out within 24 hours or so to prevent it.

Is this accurate? Can I stay at home and labor? Do I have to head off to the hospital? How easy is it to detect infection, and what is the treatment if you get infected? Anyone know of any studies on this I can show to my hubbie (he likes his studies

Also, if my water breaks, and we do stay at home, is it safe to labor in a birth pool? It seems likely to increase the chances of infection to me.

Thanks for your help!

[jennyfah]

Most hospitals (according to their *policy*) "allow" a mother to go 24 hours from the time the waters release to the time the baby has to get out. IMO total bunk. There is a risk of infection when amniotic fluid is leaking, but the major source of that infection is vaginal exams done by---guess who?---hospital staff!

Staying home, using your own (clean!) bathroom, and keeping things out of your vagina are all good ways to keep the risk of infection low.

There was a thread about this recently which might be helpful:

http://www.mothering.com/discussions...php?p=13338386

And I am sure others can add their own experiences and advice too. Best wishes!
Jen

[mother culture]

I think that if you can feel your baby move or have a doppler to get a goot heart rate from baby you should feel comfortable to stay home until you are in a regular and progressive pattern. If you go to the hospital you will be subjected to exams and probably pitocin. It can take up to 12 hours for labour to start.
My first birth was premature waters and no labour for 12 hours. Then not knowing any better I went in for pitocin and it was hell from there on.
So I woud suggest you plan on staying home and labouring as usually.

[JorgieGirl]

My water broke in the middle of the night. Labour started a half hour later and I hopped into the pool just fine.

Do you have a midwife or are you UC'ing?

[hikingmommy]

That sounds like bizarre advice. If you're GBS positive and your water breaks more than 24 hours before giving birth, the chance of the baby being infected goes up. Like others have said, vaginal exams, which most OBs love to do regularly, greatly increase the risk of infection. If you're GBS positive, you can use Hibiclense at home, which studies have shown to be quite effective. Some MWs can give you IV abx too, which is the standard in the US. Have you discussed this w/ your MW? There are lots of things you can do to decrease your likelihood of being GBS positive and of passing the bacteria on to your baby if you are.

[fruitfulmomma]

No, you are fine unless there is meconium. Stay home and don't allow anything into your vagina, including vaginal checks. Your midwife will have more specific instructions for you.

Yes, you will be fine to birth in the pool. I was induced by AROM at the hospital with my third baby and the doctor had no problem with me using the tub for laboring in.

[SeekingJoy]

What about this study?

With expectant care about 70% of women will give birth within 24 hours and 85% within 48 hours. The majority of these women will derive little, if any, benefit from induction and a routine policy of induction of labor after PROM cannot be justified on the basis of the data that are available.

[fruitfulmomma]

Here is some more info...
http://www.gentlebirth.org/archives/prom.html

[acp]

My last birth wasn't a home birth, but it did start with my water breaking. I went into labor about 5 hours later, and gave birth about 28 hours after my water broke. Induction was never mentioned, I never got an IV, etc.
It was a hospital birth, but they had no problem with me laboring in the tub, and just did occasional intermittent heartbeat monitoring with a doppler while i was in the tub - which could easily be done at home (and my midwife also told me to go ahead and labor in my bathtub at home before coming in - I specifically asked her about the risk of infection since my water had broken, and she said that was an outdated fear).

So... If a hospital (albeit one relatively friendly to natural birth) was fine with that, I can't see any reason why you would need to rush to the hospital and give up on your home birth just because your water broke. I'm planning this birth at home, and if it happens the same way (water breaking first) that doesn't change my plan any.
I would talk to your midwife about it, and about your fears, and how she manages risk of infection - but in general, I don't think you need to follow the advice the hospital gave you.

[Devaskyla]

Just hospital scaremongering. Infection is really unlikely with no exams. Just before I had ds2, I read a birth story from a mama who waited 21 days to go into labour after her water broke. Mom & babe were fine. It was 88 hours until I got contractions after my water broke with ds2 & another 20 hours of labour. I had ds3 22 hours after my water broke.

Nothing in the vagina, including for vaginal exams, take vitamin c every 2-4 hours & monitor your temp. If it starts getting high, you probably have an infection. And birth pools aren't a problem, water doesn't really go into the vagina. I had a water birth with ds3 & spent part of my labour with ds2 in the tub.

[Ceili]

Originally Posted by Devaskyla

Nothing in the vagina, including for vaginal exams, take vitamin c every 2-4 hours & monitor your temp. If it starts getting high, you probably have an infection. And birth pools aren't a problem, water doesn't really go into the vagina. I had a water birth with ds3 & spent part of my labour with ds2 in the tub.

:

[UhOhWhatNow]

I labored in water after mine broke. You have 24 hours- it only took me two hours to have my baby after my water broke- maybe 2 and a half! Really, it's fine, most women's waters break at some point before the actual birth, I think. Avoid having someone check your cervix. Push when your body says to, and don't force pushes... let it happen. That's what I did, and we were just fine. I declined GBS testing, too, for the record- and we're both just fine.

[angelapittman]

Originally Posted by shannon_na_gig

The one piece of advice the head OB nurse gave me was "if your water breaks, you HAVE to come to the hospital. It's very serious."

Sounds to me like they really weren't convinced about you birthing at home and they are just trying to scare you...

[TzippityDoulah]

Originally Posted by angelapittman

Sounds to me like they really weren't convinced about you birthing at home and they are just trying to scare you...

or they honestly don't know better.

most obstetrical staff only knows what they are taught. and they are taught the "hospital method". I can think of abut 15 nurses I know from L&D where I worked who had NO idea you could labour without an IV... a ROM? yeah right! they would be convinced it would kill you. rarely have I seen a woman let go a whole 24 hrs before giving antibiotics for ROM... they are told they can and then not to gently encouraged every step of the way to hurry up and get the ABX... you get the idea.

people often only know what they are taught... not everyone goes into obstetrics to find out what's best for woman... many just assume that IS what is best so they just go with it.

[jennyfah]

I was thinking about what the nurse said too and it kind of makes me chuckle---it seems fairly obvious that the nurse knows next to nothing about homebirth. Apparently the only safe way to be born at home is in the caul?

Was the nurse talking about premature rupture of membranes, as in prior to 36 weeks?

OP, I trust that things will go well and you'll have a beautiful homebirth!

[munkeesmama]

I would search for water breaking or PROM precautions on this site. there are a TON of resources right here. you do NOT need to go to the hospital right away if your water breaks, but there are some precautions. If you're homebirth, why would you go to the hospital? Nothing in the vagina after water breaking, after about 12 hours I personally would begin taking vitamin c and checking my temp every 4 hours to check for induction. I would preferably be IN labor within 24 hours of water breaking, but not necessarily with baby out. My labor this last time was started by AROM, at home, and it was never an issue.

[TzippityDoulah]

Originally Posted by jennyfah

Apparently the only safe way to be born at home is in the caul?

that's kinda funny to think about actually.... b/c when it the last time you heard of a doctor not AROM when a mom is a labour and her water doesn't break with in a "reasonable amount of time".

I seriously think the medically community as a whole has so little understanding about birth that they try to make reasons for their own importance. like with the bag of water... and how it has to be managed with in exactly 24 hrs or you could DIE! like at home you wouldn't catch on the fever, chills and what not... ugh.

(anyhow I don't mean to sound like a complete cynic - there are some WONDERFUL and very smart people in L&D... they just happen to be few and far between )

[UhOhWhatNow]

I would have had a huge panic attack if anyone came near me with an IV!

Yeah, if your waters break before 37 weeks, my MW would have sent you to hospital- it was just a policy there. But otherwise, no.

[Burnindinner]

I know this has been expertly handled, but what you were told was so ludicrous I had to chime in with...

Wait, they said to go to the hospital when your water breaks? Regardless? Um, whatever. My water broke to start labor at 330 am. DS was born at noon, at home. Labor moved too fast for me to labor in the water though.

[NaturalMindedMomma]

if ACCORDING to them, you have 24 hours, why would they want you to RUSH IN?

Your fine to stay home, um at some point (unless your baby is born in it's bag of water, very rare) your water will have to break, under that nurses suggestion, there would be no way to have a successful homebirth? Probably her intention. Birth is a business. Remember that mama.