Normal length of time after water breaks?

[GoddessKristie]

I'm wondering how long is safe for a woman to go after her water breaks. I've been looking for a really credible source but can't find anything discussing risks of prolonged active labor or how long it is safe to be in active labor with your water broken. Can anyone help me out with this? How long did you go after your water broke? Were you giving birth in a hospital, with a Dr or Midwife, or at home? If anyone can provide a very credible source (not a book or magazine-more like a medical journal or the website of a credible medical reference) where I can find this information that would be wonderful.
Thanks so much!

[samuel1:8]

Here is a good bunch of stuff on http://www.gentlebirth.org/archives/prom.html

Different midwives have posted there, it is interesting to hear their different protocols, but I think all of it is a good reminder that labor will start eventually, some give some tips for helping jump start it.

[MotheringMe]

I've been wondering about this, too. My midwives recently told me that they've let women go for as long as a week after. That really shocked me.

[laohaire]

Problem is, you're looking for a length of time, but the time itself is irrelevant.

You're looking out for infection, which could happen quickly or might not happen at all.

Tips:

1) Don't put ANYTHING in your vagina, not even fingers - and ESPECIALLY not a care provider's fingers.

2) Take your temperature every few hours.

3) Drink lots of water (to help replenish amniotic fluid, which is still replenishing even though the bag has broken).

[wendyland]

My hospital/doctor won't let you go past 12 hours after breakage. I fibbed a little on my time, but I was still induced. This time, if my water breaks, I'm going to wait longer before going in to see if contractions start. And if I do go to the hospital, I'll tell them it just broke.

[mysonshine]

With DS my water broke and I wasn't contracting. The nurse told me they want the baby *delivered* within 18 hours. I don't know if my +GBS played any part in that.
Current OB said last week that if my water breaks first, we won't discuss anything til 12-18 hours later, seeing how I do in the meantime. I'm GBS- this time.
Not sure how correct this all is or if it helps.:o

[dex_millie]

It feels like not to long I was wondering about this. Different Drs/Midwives say different things. My midwife let me wait it out(homebirth). My water broke with no contractions until 46 hours later:dizzy: I drank lots of water, didn't insert anything in my vagina. Then after 24 hours the midwife had me taking Vitamin C, taking my temp., taking a herbal tinture for infections every 2-3 hours, and she took a blood test to see if I had any infections, the heartbeat of the baby, and verified that the baby was still moving like normal. It was will worth it - after 46 hours I went straight into active labor for 20 mins, then started pushing. Everything took 2 hours - and it was my first birth. I'm sure if I was induce it was not going to be 2hours.

[ani'smommy]

I asked a midwife this question a week or so ago since my mom has a history of water rupture with no contractions -- she was induced with all three of us, so it's a fear of mine. Anyway, she said she would be comfortable with a week. She also recommends vit. C and no vag exams, etc.

[krismarie]

my mw has said similar things to pp... a week, but nothing inside the yoni!

[MotheringMe]

my mw has said similar things to pp... a week, but nothing inside the yoni!

:lol

[pamamidwife]

yep, most women start labor within 24 hours of water breaking, though some can take days longer...and as long as nothing is put in the vagina, it's ok. plus, being at home means less risk than if you were in the hospital being exposed to nasty bacteria from toilets, sheets and providers fingers.

I've always been taught that if nothing is put in the vagina, the signs of infection after water breaking typically happens in the first 12 hours after rupture....and this is usually because of an increase in bacteria that weakens the bag.

Once fingers or anything (even a sterile speculum!) go up inside the vagina, you're at a much higher risk for infection.

I've also noticed that sometimes with first time moms, if the water breaks prior to the onset of labor (for 24+ hours) it could mean posterior or malpositioning on part of the baby. A posterior baby isn't well applied to the cervix and fluid builds before the head. It's not a guarantee, but it's something I consider when this situation occurs.

Here is my informed choice agreement on prolonged prelabor rupture of membranes. (http://www.circleoflifemidwife.com/prom.pdf)

[JanetF]

Anyone who posted "won't let me" go back and rethink it ;) You're the boss, remember?

In the UK NICE Guidelines recommend 96 hours before active management but if it was me, I'd just be careful and leave it alone. I had a massive hindwater leak with my second baby and no labour for 8 days then she was born 2 days later :) It resealed. A lot of ROMs are actually hindwater leaks and that's very different.

http://www.joyousbirth.info/articles/isthataleak.html

[Fujiko]

Just a question, if your water breaks, shouldn't someone check for prolapsed cord, since it could "wash out" with the amniotic fluid? It's been a thought on my mind for awhile, something I would instantly worry about if my water were to break.

[pamamidwife]

if it's your first baby, it's unlikely to happen unless baby is breech because of the head being engaged.

it's very, very rare - and the risks of someone putting their fingers up there to check are much, much higher than the risk of prolapse.

[wasabi]

You know I can't honestly remember what they told me. It seemed so unlikely to happen because my water never breaks before labor starts. I do remember that my plan was to wait as long as possible before going to the hospital just like I did if my water didn't break and then I would tell them it had just broken in the car. With both my DDs I arrived very late in labor (8 and 9cms respectively) so the idea was that any timer that started wouldn't run out so no pressure to add interventions.

[nudnik]

And what is done if infection IS suspected (higher temps etc.)?

[pamamidwife]

if there are signs of an infection present (raised temp in mom, increased heart rate in baby), then we transport. IV antibiotics are given to the mother in labor and baby is sometimes treated with IV antibx after birth.

[nudnik]

OK, that makes sense. Thanks, I was really wondering!

[GoddessKristie]

Ok, so to be more specific I'm wondering about my situation. My water broke and 12 hours later I was in active labor, but not dilating very quickly. I was GBS+ and had IV antibiotics starting around 1pm. At 4pm, which was the 12 hour mark I was only dilated a "wiggly 1cm" so I was convinced I needed pitocin to speed up my labor. Basically they scared me into it, so in retrospect I'm wondering if that was the best decision or not. DS wasn't showing any signs of distress, and since I was abx I now wonder if there really was a risk of infection.
What do you think?

[JanetF]

Personally I don't believe in syntocinon, or pitocin as it's known in the US, for anything but PPH. I think it should be illegal to use in labour. And the evidence doesn't convince me about abx in labour for GBS anyway. Knowing your GBS status is not a bonus in the hospital system. Once they know, you'll get the pressure you did because of it even though the test is basically meaningless. Time limits in labour are dangerous and pointless. Labour takes as long as it needs to take. If someone took your temp now and then you'd have known if you needed help. Birth should be normal until proven otherwise. :hug I know many women who tested positive to GBS and have scarred bellies or vaginas as a result of the interventions forced on them in labour.

[beckyand3littlemonsters]

Here they say you have to go into labour by 48 hours after waters break but luckily i've never had this with my ds my contractions start 1/2 hour after my waters broke and he was born another 4 1/2 hours later

[pamamidwife]

Ok, so to be more specific I'm wondering about my situation. My water broke and 12 hours later I was in active labor, but not dilating very quickly. I was GBS+ and had IV antibiotics starting around 1pm. At 4pm, which was the 12 hour mark I was only dilated a "wiggly 1cm" so I was convinced I needed pitocin to speed up my labor. Basically they scared me into it, so in retrospect I'm wondering if that was the best decision or not. DS wasn't showing any signs of distress, and since I was abx I now wonder if there really was a risk of infection.
What do you think?


well the problem with your scenario is they kept checking your cervix. that increases the rate of infection GREATLY - but I have even heard of homebirth mws doing this. I just think that we need to throw out these "progress charts" of what women's bodies SHOULD be doing and honor what it IS doing.

you didn't "need" pitocin to speed up your labor. your providers needed it.

[crysmomofthree]

I had my water break with baby #2 at 33 weeks, no known gbs status no contractions, 10 hours later contractions started, 12 hours later I was offered iv antibiotics and 14 hours later baby was born very sick with a gbs infections and in the nicu for 2 weeks.

with #3 my water broke 35 weeks, no known gbs status (previous experience) I got the antibiotics immediately contractions started on their own 20 hours later baby born healthy 4 hours later

#4 I ruptured at 36 weeks gbs- stayed home had no exams waited 40 hours for contractions to start on their own and had a phenomenal birth :)

My midwife told me that if there is no internal exam, no temp, and gbs- she is comfortable waiting a minimum of 72 hours for labor to start on its own (providing the baby is doing well) she cited some study done but I"m not sure where I could find it

[pamamidwife]

I had my water break with baby #2 at 33 weeks, no known gbs status no contractions, 10 hours later contractions started, 12 hours later I was offered iv antibiotics and 14 hours later baby was born very sick with a gbs infections and in the nicu for 2 weeks.


Preterm babies are the ones at biggest risk for GBS infection...and infection in general.

I think that rather than assume that GBS is so powerful to hit all healthy, full term infants we need to look at what makes some babies so susceptible. I believe that GBS antibodies do cross the placenta for the baby - and there has to be reasons why some babies get sick while others, even with higher levels of bacteria colonization, do not.

[crysmomofthree]

Preterm babies are the ones at biggest risk for GBS infection...and infection in general.

I think that rather than assume that GBS is so powerful to hit all healthy, full term infants we need to look at what makes some babies so susceptible. I believe that GBS antibodies do cross the placenta for the baby - and there has to be reasons why some babies get sick while others, even with higher levels of bacteria colonization, do not.
Perhaps stress and poor nutrition, because I feel those are two massive factors that were involved in my case above with my 33 weeker

[ericswifey27]

Problem is, you're looking for a length of time, but the time itself is irrelevant.

You're looking out for infection, which could happen quickly or might not happen at all.

Tips:

1) Don't put ANYTHING in your vagina, not even fingers - and ESPECIALLY not a care provider's fingers.

2) Take your temperature every few hours.

3) Drink lots of water (to help replenish amniotic fluid, which is still replenishing even though the bag has broken).


:thumb