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After water breaks...

post #1 of 18
Thread Starter 
My dh and I are having a "discussion" about what happens exactly after the water breaks. He was told by his cousin that her water broke, she waited 24 hours to go in to see her doc, and the doc yelled at her because she had no amniotic fluid (resulted in a c-section, if you're curious). dh is sure there are some complications that would happen if a woman has no amniotic fluid. I've read that it's okay to wait up to 72 hours for labor to start before there's something to worry about...but what does happen and how does it affect the baby if amniotic fluid is very low or there isn't any?
post #2 of 18
Sounsd to me like a doc who got cheesed off because his patient didn't "follow the rules" and come in the second her water broke....

Risk of infection doesn't set in the moment your water breaks and is minimized by keeping things out of the vagina once it happens. Typically labor will start on its own within 12-24 hours after it happens, but it can take much longer (or happen much quicker). As long as there are no signs of infection and no foreigh objects being introduced internally, you can walk around with broken waters for a very long time. Your body will continue to manufacture amniotic fluid even post-rupture, so the chances of having zero fluid afterwards are pretty slim.

Namaste, Tara
post #3 of 18
I didn't go into labor until 48 hours after my water broke. My midwife wasn't to concerned about it. She told me to drink lots of water, not to take a bath or swim and to check for dicharge or any sign of infection.

When I DID go into labor my water broken AGAIN. Not much fluid the second time though, so genral conscience was that the sac had resealed and was begining to refill. Pregnant women continuosly make amniotic fluid, so it's not like a finite thing that once it's gone it's gone.
post #4 of 18
The bag of water can seal back over if it's just a small leak if you don't immediately go into labor. Just keep everything out of the vagina (especially hands - NO cervical checks), drink lots of water to help replenish the fluid levels, and rest so you've got plenty of energy for labor. Sometimes it can take awhile to go into labor. It's not that big of a deal.

Your DH's cousin's situation seems to be the case of an over-eager doc. Too bad she had a c/s.
post #5 of 18
I know of several women whose water broke around 16-17 weeks (PPROM) and had very little fluid the entire time, yet some of them still had healthy babies closer to term. At full term, the baby doesn't really *need* the fluid there as much. You need to watch for cord compression and cord prolapse, plus keep infection away (keep *everything* out of your vagina). The time the baby really needs that fluid for lung developement is around 18-22 weeks (otherwise, the baby could be born with lungs that physically can't breathe no matter what medical intervention is given - the baby can't survive). But who knows how much fluid is actually needed during that time, and it's hard to measure how much fluid is in there via u/s. Occasionally, the bag will reseal even after a gush, and a woman can go full term. Our bodies are amazing!

My water broke at 29 weeks, and I went 4 days before they "let" me deliver. Baby was in there kicking and squirming and doing all the usual stuff. I was on bedrest, so my fluid started to build back up again, but it was still very low, and I didn't have any gush of fluid when labor/birth commenced. My initial contractions (which they stopped with meds) started about 10 hours after my PROM occured. Of course, I was on antibiotics during this time, since PPROM often occurs due to infection, and they couldn't find one, but that doesn't mean I didn't have one somewhere. I did keep everyone out of my vagina though, much to the dismay of the nurses who *really* wanted to do a dilation check when I came in (even after the drugs had stopped my labor!!!!).

I'm sad for your cousin. The 24 hour mark is where they start to worry more about risk of infection, but as long as you keep everything and everyone out of your vagina, the chance of infection is actually pretty low. If mom develops a fever, then it's time to get baby out of there.
post #6 of 18
Your body continues to make amniotic fluid, even after your water breaks. I don't know how you could completely run out of fluid since it is comtinually replenished.

I would take a look at Henci Goer's book Thinking Soman's Guide toa Better Birth or her website, www.hencigoer.com
post #7 of 18
Every thing they said...

also, labor can begin immediately after waters break. My water broke spontaneously and I immediately went into hard labor (almost straight into transition). For some, it doesn't break until after labor starts, for some not at all (the baby is born in the sac).

Its good to know what your OB/MWs policy is though on how long they will "let" you go after breaking. It varies between practitioners. A good mw should be pretty laid back about it.
post #8 of 18

SROM, 8 days later: waterbirth!!

I went 8 days after my water breaking before contractions even started. I had midwives who were not concerned about this at all, the first few days. I was set on a NO HOSPITAL birth. They said that there is a small risk for infection after SROM/PROM. With an infection I'd have to birth at a hospital. So I followed their insructions to the T (keeping everything away from my undies!) and was able to have the water birth I'd been planning.
post #9 of 18
I read so many birth stories where mamas dash to the hospy for a hindwater leak and things don't end well. This might help you sort out whether you've had a hindwater leak or a full ROM, and what you'd like to do about it - if anything! Of course staying home to birth things are a little different but it's still useful to know in case you're a mama who has ROM and no labour for a while. It's all normal!

A hindwater leak occurs when only a small amount of fluid is released. There can be many reasons for this occurring rather than a full ROM.



Obviously, the risk of infection will be higher when there is a large opening in the amniotic sac directly over the cervix, and the risk of infection will be almost negligible when the fluid is leaking from a high leak in the hindwaters. Bacteria would have to be awfully clever to find their way against a tide of outflowing fluid to find a small opening high in the amniotic sac.

Some ways to tell that the fluid is coming from a high leak in the hindwaters:

Belly still feels full of fluid, and baby's body isn't clearly outlined in the belly
Without touching the cervix, do a vaginal exam with sterile gloves to palpate the lower uterine segment directly inside the vagina. If the baby is easily ballotable, meaning it kind of floats up a bit, then there's still fluid in the belly, and the leak isn't over the cervix.


There are two layers of membranes - the outer sac (the chorion), and the inner sac (the amnion); it is possible for the outer sac to break while the inner sac remains intact; this can still release some fluid that might have accumulated between the layers. This would tend to be a small amount of fluid, and generally there is not a continuing trickle.
It is possible for baby to poke a hole through the membranes at some point. Then, as fluid is released, the sac may double over on itself at that point and, like Glad Wrap, stick to itself, forming a seal over the leak. Again, this would tend to be a small amount of fluid, and generally there is not a continuing trickle.

There is no inherent benefit either way. Some women find drippy labours irritating after ROM, some women’s membranes do not rupture until crowning, some never do and the baby is born “in the caul”. If you’re birthing in a hospital, regardless of how much fluid has left the building, stay home until contractions are strong and close together or you’ll be on a timetable and pressured to induce. You will be told that you are at risk of infection.

NICE guidelines from the UK state that women can go up to 96 hours without being induced. The likelihood of infection is significantly reduced if you put nothing in your vagina (this includes VEs which are a major way germs are spread) and stay home in your own friendly germ environment as long as possible.


5.5 Induction of Labour in the presence of Prelabour Rupture of the Membranes (page 2

5.5.1 ....Epidemiological data on time interval from term PROM to spontaneous labour demonstrates that most women go into spontaneous labour within 24 hours of rupturing their membranes.

86% of women will labour within 12-23 hours
91% will labour within 24-47 hours
94% will labour within 48-95 hours
6% of women will not be in spontaneous labour witthin 96 hours of PROM.

USA Midwife Archives page on Prelabour Rupture Of Membranes:

NICE/RCOG guidelines on induction of labour (short form)

NICE/ RCOG evidence- based full clinical guideline on induction of labour

Premature Rupture of Membranes (PROM) By Elizabeth Bruce, on the Compleat Mother site. Discusses both prelabour and preterm rupture of membranes.

Preterm Prelabour Rupture of Membranes, from the Dartmouth Hitchcock Medical Center - Straightforward factsheet.

PROM guidelines from MoonDragon Midwifery Practice

Midwifery Today e-news on premature (ie prelabour) rupture of membranes

post #10 of 18
Well, I was advised to call my midwife when my water broke. So we did, right after it happened, and then my labor really picked up and about 2 hours later we had a baby. So for me, it meant baby moved down the birth canal and I entered a phase of very active labor!

post #11 of 18
Does risk of infection or problem go up if the waters are thick with meconium upon spontaneous rupture? My birth was a diaster and I wonder how much of it can be attributed to the fact that I had no preparation for something like that happening, so my planned natural birth turned into a med-wife, intervention-filled disaster. Of course, my baby nearly died due to her cord being wrapped around her face and getting stuck crowning for 30 minutes, so maybe the pitocin had been necessary. I just don't know what to believe.
post #12 of 18
Thick meconium means baby was probably in distress, and from the sound of her cord, that might have been why. When I say my water broke and I had the baby 4 days later - there was NO meconium. My baby was not in any distress.
post #13 of 18
If there is meconium in the water that usually means the baby is in distress sometimes it happens with over due babies as well. I would think that the meconium would make it more likely to develop a infection. I know for a fact that if it is thick and they breath it in and it isnt all squished out during birth that can cause major breathing problems. With my dd there was meconium but it was very thin altho it was major dark pea soup green :Puke they suctioned her well as her head came out and she didnt have any problems.
post #14 of 18
You keep making fluid to clean yourself out even when your water breaks. I know of two moms who simply monitored themselves for signs of fever for a week (it didn't happen) and gave birth naturally a week later. Of course, this is contraindicated if you rupture before 37 weeks. PROM is no reason for a C-section if the woman if full term, has clear fluid coming out and takes no baths or puts NOTHING into the vagina, certainly not a pair of latex fingers for a check on dilation.
post #15 of 18
My half-sister (she's 5), has a large scar on the top of her head (the size of your palm) due to the scar she has no hair there. I didn't meet her until she was 4, and when i asked about her head thing (I thought it was a burn scar), my step mother told me it was from a "dry birth", because she has no amniotic fluid for "so long" that when her dd came out she had no skin on her scalp?? She doesn't have that fragile skin syndrome or anything like that. Details are scetchy because we only talked about it once.
post #16 of 18
Could have been a case of PPROM - where the woman went weeks and weeks with very little fluid. That can cause some issues with the skin, from what I've heard. But I don't see how lack of fluid for a day or so could cause something like that.
post #17 of 18
I don't think it happens very often. On the prom list I'm on, I remember people mentioning it as a possibility, but so far haven't seen anyone post that it actually happened to their child. So it's probably something *very* rare, and probably from very long term PROM (like those who PROM around 12 weeks or so and remain at very low fluid the whole time).

So I wouldn't worry about that happening to your baby, Cyneburh
post #18 of 18
Yea, I lost track of the OP, Sorry!
It definitely was longer than a day or two.
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