How long after water breaks...

[Mountain_Mama]

I'm looking for some info on the realities of infection if my water breaks before I go into labour.

With my last birth the reason I was started on the pitocin drip ( end then the epi, and then the c-section) was because my water broke at 7pm, and by 6am I was 'only' 3 cm dilated. My doc told me he would only let me go 24 hours after my water breaking as it was too 'dangerous' otherwise. He also insisted that I come to the hospital as soon as my water broke to be checked (which my doula suggested I ignore...hindsight is 20/20)

So
1. How can I avoid infection if my water breaks before labour starts?
2. Realistically how long should one go before starting to get concerned about the risk of infection?

[alegna]

Risk of infection is pretty low IF -

#1. NOTHING goes in the vagina. No hands, no glove covered hands, no nothing.

and

#2. No fever.

-Angela

[georgia]

This thread has some very helpful info and personal experience:

http://www.mothering.com/discussions...d.php?t=810976

[SublimeBirthGirl]

My 1st was born 27.5 hours after my water broke. I started pit at 24 hours at 4 cm, mostly because I was so tired I needed labor to be over. I was complete about an hour later. That said, had I had her at home I could've slept the night before instead of sitting in the hospital trying to get labor going.

If I were to have another baby and have PROM, here is how *I* would handle it. I would not put anything in my vagina, and I would wait. I would not even consider intervention until 48 hours as long as I were staying hydrated and my fluid were clear.

Of course, the very idea of giving birth with an OB is somewhat horrible to me, so I would also be sure I had a midwife who was supportive of my preferences.

[jule]

My water broke 28 hours before my baby was born (homebirth) - like the pp said it is not a problem as long as you are careful with hygiene (no internal exams, no baths). Make sure you keep drinking lots, take your temperature regularly and keep moving to help your labor progress. Also you need to make sure any leaking fluid remains clear and doesn't smell.

[kltroy]

Right -
the guidelines I've seen for water breaking is:
1. NOTHING in the vagina (that means no sex either)
2. Be very careful about hygiene - wiping etc after going to the bathroom. Always wash hands carefully etc.
3. Monitor fetal movement - if it seems not right you need to go in.
4. No baths
5. Take your temp every hour. If it's above 100 you need to go in.
6. If there's meconium I would probably go in.

Otherwise, at least according to one study I saw, risk of infection doesn't go up substantially until 72 hours after membranes rupture.

[SublimeBirthGirl]

Where is everyone getting the no bath thing? I don't believe that's true.

[Fyrestorm]

My water was broken for almost 48 hours before labor started. DD was born via section 29 hours after that (not because of infection).

I agree with the other posters...NOTHING in the vagina! Do not let the 'check' you. It's just asking to be put on the clock!

[chandasz]

There is a study out there that I've read showing that even 96 hours after bow breaks- chance of infection does not significantly increase if the rules are followed. NOTHING in the vagina. No hands. No vaginal exams!!!

[xixstar]

our doula worked with a woman that went a couple weeks after -- We've decided that we're comfortable with doing the same assuming the advice mentioned above - nothing in the vagina and no signs of fever (hourly monitoring would be too much for me, but would do it a couple times a day). Plus, drink lots of fluids!

Brought this up with our midwife too and she's just as comfortable as we are with that plan.