Going to the hospital if water breaks

[naturalnesting]

This is my first pregnancy. I am seeing a midwife group in a hospital. I would like to do most of my laboring at home and get to the hospital ideally at the last moment. However, my midwife tells me that I have to come to the hospital if my water breaks and stay there. I know that sometimes labor last for hours after the water breaks. Would it be terrible if I stayed home, even if my water breaks and wait for contractions to get stronger before going to the hospital? Or am I putting my baby in danger?

[blessedwithboys]

very very minimal danger. no sitting in a tub of water (this doesnt apply if labor is active and birth is close), no sex, no hands near the hole at all. stay home, stay clean, 9i used a peri bottle for pee instead of TP!) and wait until the contractions are however many mins apart you feel comfy waiting til.

when you get to the hospital, LIE ABOUT WHEN YOUR WATER BROKE. simple.

your mw or anyone else cannot tell you you must do anything in your labor and delivery. its all you unless a true emergency arises. remember, you are paying these ppl to perform a service for you. you call the shots, not them.

fwiw, with ds2 my water broke 10am monday and labor didnt even start until sometime tues afternoon. he was born wed morn at 3am, with some meconium, but no distress at all and no infection (they did a culture, but i refused prophylactic antibx while waiting the 24 hrs...good thing, too!)

[ema-adama]

My waters broke at 6am and my contractions started at 9pm-ish. I only went to the birthing cabin sometime around 2-3am. My son was born at 6:30 am.

Many people were amazed I was not in the hospital, however, the fluid was clear, the baby was moving and the attending OBGYN prescribed antibiotics as a precaution. I would not take them again - and just keep anything and everything away from my vagina. No internals, etc

It's terrible to say, but I will fudge the time the waters break if my waters break early again. The hysteria about DS being born 24 hours and 30 minutes after spontaneous rupture of membranes is something I hope to avoid (my birth transfered to the hospital during my 3rd stage of labour, and DS had to be hospitalised too). That extra 30 minutes put our records on high alert. Anything less than 24 hours is fine, anything over 24 hours is VERY dangerous, or so we were told.

[DisplacedYooper]

Disclaimer: I had a home birth with my first. But assuming I was planning a hospital birth...

I wouldn't go. My labor started with my water breaking. Well, leaking actually... You are accustomed to your home germs, and the hospital is filled with foreign germs. No one will be performing vaginal exams on you at home, you will probably have many in the hospital.

Many hospitals start the clock for when your baby must be born based on when your water breaks. Unless you are introducing germs (via exams and whatnot), there is no good reason for this.

A very mainstream website (http://www.med.nyu.edu/conditions-we...-cord-prolapse) gives the chance of cord prolapse to be 1 in 300. We can probably assume that it is much lower if your baby's head is engaged prior to labor starting.

[3sweetsurprises]

I naively went to the hospital when my water broke with my first. I ended up with pitocin and didn't get the birth that I was hoping for. I stayed at home with my second. My water broke at 3AM and I went to the hospital at 11 that same morning when contractions were 4-5 minutes apart. As long as nothing enters your vagina (which they of course they check your cervix in the hospital) then chances of complications are low.

[colleen2851]

I agree with the PP who said to lie about when your water broke!

My water broke w/DD at 7am and we didn't leave for the hospital until 3pm. I didn't have DD until the next morning just before 6am!

I'm so glad I had my doula with me who told me to stay mum, b/c the MWs at that practice are overseen by the OBs in the worst way. I'm happy that I'm with new practice where the MWs don't follow the medical model.

[VillageMom6]

With my last birth my water broke and I went straight to the hospital. I was worried because my previous birth was 45 minutes from the time the water broke (and I was at 4cm) until baby was in my arms!

So we arrived at the hospital and I never went into labor. I think I had stage fright. My midwives' policy is that Pitocin has to be started 24 hours after the water breaks. That's much better than the baby has to be born 24 hours after the water breaks.

I walked around the hospital, I ate, drank, rocked in a chair... but no labor. The midwives left me alone throughout the night so that I could sleep. But in the morning... still no labor. Finally, at the 16 hour mark I asked for Pitocin because there was some meconium and I wanted the baby born sooner, rather than later.

My plan this time is to stay at home as loooong as possible. Honestly, I would rather give birth in the car on the way to the hospital than get there and not be in active labor.

[RedOakMomma]

I lied. Both times.

The "problem" is that I have this weird pattern in labor of my water breaking, then almost nothing happening for the next 12 hours. It's happened twice now, and I know to stay home, stay hydrated, monitor movement, monitor temp, and WALK WALK WALK! Gravity seems to be really important to me once my water is broken. Both times it's only been walking that finally caused contractions to coordinate and intensify.

And yeah...even though I love my OB, and loved my hospital births, both times I've lied and said my water broke an hour before I went in. Both times I labored at home for a long while.

[MaerynPearl]

My doctors view on it was that I call her and let her know if my water broke but if I were far enough along (past 36 weeks) that they wouldnt worry about baby... she would have just had me stay home until the usual time.

Neither time did I have to worry about it as labor progressed to a very active labor long before my water broke, with DD it broke JUST before I started pushing and with DS they broke it for me (I was induced that time though) after I had already started pushing.

I figure its just them wanting to avoid you getting an infection and blaming them but to be honest, if your water breaks and you don't think its time to go in yet but are in labor/far enough along then I wouldn't worry about it myself and as the other ladies have said, I would lie.

[Italiamom]

If your water breaks, and the fluid is clear, then keep things out of your vagina and STAY HOME until your contractions are happening at the intervals that you deem necessary to head to the hospital with. When you get there, just lie. Lie, lie, lie. I would tell them my water broke in the parking lot

[redvlagrl]

I agree with PPs. If you go into the hospital right away they will for sure want to induce you which can lead to ultimately to a C section.

With DD my waters broke, I waited 24 hrs then went in, the induction totally failed and it ended in a c section.

According to my mw, the risk of infection (which is what they are worried about) increases with the following factors: vag exams/introduction of germs into vagina, 72 hrs after rupture, GBS+.

I am surprised your mw would insist you go to the hospital right away. most are willing to wait at least 24 hrs.

If the fluid is clear (if meconium is present, go right to hospital) then monitor your temp every hour or so - it shouldn't go up. Then get yourself moving and do everything you can to go into labour. Most people will go into active labour within 24 hrs, but I was one person who didn't. I rested and waited. If it should happen again I will be walking, getting acupuncture etc etc to try and get things going.

[lunarlady]

I wouldn't! My water didn't so much break as start to leak with DD. It started leaking on Thursday afternoon, and I didn't go into labor until Friday night. So I was outside the 24 hour window. But I was full term, and my MW was ready to start trying to kickstart labor if I didn't start by Saturday morning. If I went to the hospital (I had a homebirth) I would have been induced on Friday afternoon rather than having a natural birth Friday night. I've heard that if the water bursts in a big gush, or bursts when your cervix is dilated, you want to be checked for cord prolapse, so maybe that is what your MW is worried about? I think you could ask her for more details about WHY she wants you to go to the hospital so quickly.

If, however, my water broke with baby premee, I would be in the hospital in a heartbeat. They can do many things to help prepare a premee baby, and slow or stop early labor, so that baby can get a few more days to develop before the birth.

[etsdtm99]

my doctor with my 1st two insisted that cord prolapse was their main concern with the 'get to the hospital right away' thing.. they told us not to so much as pack a bag, if you water breaks - you run to the hospital.

with my 1st, that is pretty much what i did and my ctx. did not start, i was stuck in a bed because my water broke (freakin ridiculous policy), and obviously i ended up with pit, an epi, and a 19 hour labor ..

with my 2nd i had planned to stay home if my water broke, i have a doppler now and planned to use it to check on the baby periodically and lie about when my water broke. never had to worry about it though because i didn't go into labor, i was induced ..

this time i am having a homebirth..

[SeattleRain]

I don't know about anyone else, but I'm a little uncomfortable with a bunch of strangers telling someone to LIE to their HCP. Just because anecdotally YOU lied and nothing happend to YOU or YOUR baby, doesn't mean that something couldn't happen to this woman and her baby.

I don't believe in lying to your HCP. How can you expect them to treat you and help you medically if you don't give them the truth? If you believe that your HCP is being too conservative by making you come in immediately after broken waters, say so now and tell him/her you'd be more comfortable coming in later and laboring at home until you're definitely having contractions. If he/she gives you a hard time, you have two choices: 1) switch HCP to someone who is more in line with your choices or 2) do what you want and come in later, but don't lie. If doctors want to intervene afterwards for whatever reason, you can refuse to consent. But don't lie.

[HaikuMommy]

These responses just show me how little we all trust doctors (and generally, with good reason -- we've been mistreated and bullied in the past). And what the OB tells you in their office vs. in the delivery room are often VERY different things.

I think everyone is saying to lie because they truly believe the risk of infection from waiting (with clear waters and unadulterated by internal exam, with no fever) is probably going to be less risky than the chances of infections/complications that will happen when slow labor leads to induction, which leads to c-section. Tell doctor the truth, and mom often gets major surgery with all its bleeding and infection risks. Baby ends up staying a few days in NICU for observation (and exposure to all sorts of hospital germs) because their lungs didn't get the chance to squeeze out fluid like in a vaginal delivery.

Seems like these women are saying they want to choose which of these risks they prefer to take, as informed, empowered women giving birth to children in an over-medicalized environment...

That said, I really wish we COULD trust these doctors to listen to us and give us options rather than just pressure us! Prolapse and infection DO scare me. This is why I don't like the idea of giving birth all alone, especially with a drawn-out labor. An experienced midwife who can check on baby's heartrate, etc. would sure be a reassurance to me several hours after water breaking.

[RedOakMomma]

I don't know about anyone else, but I'm a little uncomfortable with a bunch of strangers telling someone to LIE to their HCP. Just because anecdotally YOU lied and nothing happend to YOU or YOUR baby, doesn't mean that something couldn't happen to this woman and her baby.

I love my OB, and I suspect HE suspected that my waters had broken a long time before I said they did. He tends to be very in favor of natural birth, and pushes the rules (will assist with breech babies, will allow extended hours of pushing...) HOWEVER, hospital policy for broken waters is 24 hours. That's ridiculous. Look at OB or midwife care in other birthing centers, countries, or practicies, and the timing is nowhere near that restrictive.

I'm a smart person. I've educated myself on birthing. Heck--I've birthed three children! I'd rather use my own decision-making than that of the hospital's set policies. It's not annecdotal that the risk of something bad happening is very, very low (especially with appropriate monitoring). Cord prolapse is very rare. I know my risks, I know how to protect my baby, and I choose to stay home.

[Greenlea]

I don't believe you should go in right away. With my son my water broke at 8:30pm. I called my midwife and she said it was fine to labor at home, just don't bathe but showers were okay. So we didn't go to the hospital until 3:00am, when I thought my cntx. were bad. My baby was born 12 hours later. Could you imagine if I had went in right after my water broke. I would have been in the hospital for an extra 6.5 hours. That's nuts.

[newmommy7-08]

At 36 weeks 6 days my water broke w/ a gush... I immediately called my midwife, she told me to head home (was on the way to work) Pack up my bags and head for the hospital. Also, to feel free to stop and eat something good on the way there That was at 8:28. As we were leaving the house at 10:54 contrax started w/ an every 4 min regularity lasting 45 seconds - 1 minute. We still stopped to eat at the hospital cafeteria (much to the dismay of several L&D nurses who could just tell I was in labor. Two of them told me I was nuts cause I was going to be puking that food up. I just kind of chuckled and told them I was following orders. They actually rolled their eyes at me! We got up to L&D around 2:00, into triage around 2:30 and checked for the first time at 3:30. I was at a 3 at that point. She only checked my twice more. Once at 10 (I was a 7 and once at 12:55 I was complete. There was never any mention of augmenting labor.

I think this is a conversation we should have w/ our HCP (ie. what is your policy if the water breaks before contrax start and how long are you willing to let labor progress w/o augmenting) The answer to this would be a big decider for me on how comfortable I felt w/ their plan of care.

[AmyKT]

Originally Posted by RedOakMomma

I love my OB, and I suspect HE suspected that my waters had broken a long time before I said they did. He tends to be very in favor of natural birth, and pushes the rules (will assist with breech babies, will allow extended hours of pushing...) HOWEVER, hospital policy for broken waters is 24 hours.

This is true. CPs who work in hospitals live in fear (rightly, I'm afraid) of what the hospital lawyers tell them the policies must be. While I'm not completely comfortable with lying, either, sometimes stretching the truth a bit may give truly good providers a chance to do what they really think is right. It is a very fine line to walk, for everyone.

[SeattleRain]

Originally Posted by HaikuMommy

These responses just show me how little we all trust doctors (and generally, with good reason -- we've been mistreated and bullied in the past). And what the OB tells you in their office vs. in the delivery room are often VERY different things.

I think everyone is saying to lie because they truly believe the risk of infection from waiting (with clear waters and unadulterated by internal exam, with no fever) is probably going to be less risky than the chances of infections/complications that will happen when slow labor leads to induction, which leads to c-section. Tell doctor the truth, and mom often gets major surgery with all its bleeding and infection risks. Baby ends up staying a few days in NICU for observation (and exposure to all sorts of hospital germs) because their lungs didn't get the chance to squeeze out fluid like in a vaginal delivery.

Seems like these women are saying they want to choose which of these risks they prefer to take, as informed, empowered women giving birth to children in an over-medicalized environment...

That said, I really wish we COULD trust these doctors to listen to us and give us options rather than just pressure us! Prolapse and infection DO scare me. This is why I don't like the idea of giving birth all alone, especially with a drawn-out labor. An experienced midwife who can check on baby's heartrate, etc. would sure be a reassurance to me several hours after water breaking.

Originally Posted by RedOakMomma

I love my OB, and I suspect HE suspected that my waters had broken a long time before I said they did. He tends to be very in favor of natural birth, and pushes the rules (will assist with breech babies, will allow extended hours of pushing...) HOWEVER, hospital policy for broken waters is 24 hours. That's ridiculous. Look at OB or midwife care in other birthing centers, countries, or practicies, and the timing is nowhere near that restrictive.

I'm a smart person. I've educated myself on birthing. Heck--I've birthed three children! I'd rather use my own decision-making than that of the hospital's set policies. It's not annecdotal that the risk of something bad happening is very, very low (especially with appropriate monitoring). Cord prolapse is very rare. I know my risks, I know how to protect my baby, and I choose to stay home.

I think both of you are making an educated choice and taking a calculated risk... for yourself. I don't think its right to advise a random person to take that risk herself. Give her the statistics that something could go wrong, link some studies, and let her make her own choice. I haven't seen anyone here doing that. The reality is that we don't know her medical history to know if maybe she SHOULD go to the hospital earlier than most. What if she doesn't and it leads to MORE complications/interventions rather than LESS? I'm uncomfortable with giving out advice counter to someone's HCP, I'd rather us just give evidence based information and let people make their own call.

Originally Posted by newmommy7-08

At 36 weeks 6 days my water broke w/ a gush... I immediately called my midwife, she told me to head home (was on the way to work) Pack up my bags and head for the hospital. Also, to feel free to stop and eat something good on the way there That was at 8:28. As we were leaving the house at 10:54 contrax started w/ an every 4 min regularity lasting 45 seconds - 1 minute. We still stopped to eat at the hospital cafeteria (much to the dismay of several L&D nurses who could just tell I was in labor. Two of them told me I was nuts cause I was going to be puking that food up. I just kind of chuckled and told them I was following orders. They actually rolled their eyes at me! We got up to L&D around 2:00, into triage around 2:30 and checked for the first time at 3:30. I was at a 3 at that point. She only checked my twice more. Once at 10 (I was a 7 and once at 12:55 I was complete. There was never any mention of augmenting labor.

I think this is a conversation we should have w/ our HCP (ie. what is your policy if the water breaks before contrax start and how long are you willing to let labor progress w/o augmenting) The answer to this would be a big decider for me on how comfortable I felt w/ their plan of care.