What would you have done?

[momma2libby]

I have a friend who was trying to have a VBAC at a hospital (MW wasn' an option for her). Her water broke @ 1:30pm Fri, she was at the hospital within mintures even though she hadn't had a contraction. The doc didn't start pushing interventions on her until the next morning when she still hadn't progressed. She ended up on pit but then decided to have a repeat c/s soon after. This was 2:30 pm on Saturday.

So my question is...is it normal for a person's water to break and still not go into actual labor even 24 hours later? Is this common? What would you do? Stay home until labor started even if the water had broken? How do you prevent infection and notice signs of it if you were going to take the wait it out approach?

Thanks! I'm hoping to have a VBAC (out of the hospital though)...and I am not sure how I would handle it if my situation was the same.

[gcgirl]

Originally Posted by momma2libby

So my question is...is it normal for a person's water to break and still not go into actual labor even 24 hours later? Is this common? What would you do? Stay home until labor started even if the water had broken? How do you prevent infection and notice signs of it if you were going to take the wait it out approach?

It's normal. It happened to me, and I stayed home for ten hours trying to get labor started myself before going in to the hospital. The only reason I did go in was I was GBS+. (Yeah, I know I didn't have to go in; I wasn't willing to take the chance for reasons not pertinent to this discussion.)

I've heard a lot of mamas who stay home and wait it out and just watch for signs of infection or distress.

[salt_phoenix]

Well, my water has been broken now for 3.5 weeks and I haven't started active labor yet.

In my case tho, at least this time, it's a good thing. I know with my first, who was term when my water broke, I didn't go into labor for 24 hrs. It was a homebirth and it never worried me.

I would definitely take a wait and see approach, you can go for a surprisingly long time with ruptured membranes without problems. Just watching for infection and drinking lots of fluid and noticing how your baby "feels". However, everybody has to do what they believe is best.

[Ironica]

"Normal?" Dunno. Typical... no. 90% of women go into active labor within 24 hours of SROM.

What gestation was she at, though? If she was earlier on, it might have been more "normal" not to go into active labor (in which case, the "abnormal" part would be her water breaking before she was ready to go into labor). That being said, my water broke at 40+2 with my first pregnancy, and then I wasn't in active labor 18 hours later and consented to pit. (Yeah, we ended up with a c/s.)

[True Blue]

I think I would just wait it out as long as possible, as long as there were no signs of infection.

[wannabe]

From memory the % whose water breaks first is high - like 10-20%. Then virtually all of them have started labour by 24 hours - something like 95%.

Going for a check as soon as your waters break - prudent, especially if the baby's not engaged yet, because the cord can prolapse, which will kill the baby. In my two labours with waters breaking and same midwife I've been advised to go to the hospital immediately with one, told to labour/walk/rest at home with the other. The difference would be how engaged the baby was. Your midwife would be able to judge this for you.

The gold standard is (no meconium, no GBS, no fever, full term, no internal exams) to wait and see for a good 24 hours, with monitoring for the baby and mother. For me this was resting/walking/nipple stim at home, and a trip to the hospital every 12 hours to listen to the baby.

My midwife was happy for me to wait 36 hours before induction, I chose 24 hours, because I was already tired, and felt like the induction would take a while. It did, my waters had been broken for 60 hours when she was born.

The indicator of infection is fever. My temp was checked every two hours the whole time. If I spiked a fever and wasn't in transition or pushing, I'd be very scared and consent to a c-section if they advised it. Newborns don't do well with infections.

I have a question to add: is no labour after PROM a first time thing? My waters went with my second and contractions started within two hours.