Water breaking- how long do I have after to birth? - Mothering Forums

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#1 of 23 Old 09-01-2008, 04:11 PM - Thread Starter
 
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I'm sure I have read the answer somewhere before but do you laides know what is the safe amount of time to wait after the water breaks to give birth? How long can I go after the water breaks?

I *may* have to give birth with an OB- I sure hope not- but in this case I want to be ready and well informed.

TIA!!!

wife to DH 2/03, mama to DS 3/03 & DD 1/09
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#2 of 23 Old 09-01-2008, 04:18 PM
 
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as long as nothing is entering the vagina there is still a pretty low risk of infection. as long as there is no infection (monitor temp) you can go days. however, if you tell an ob/hopital you will be on a clock. most say withing 24 hours, some are now saying 12 so be careful how and with who you share that info. also, congrats!!! happy peaceful birthing vibes coming at you!

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#3 of 23 Old 09-01-2008, 04:21 PM
 
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From Purebirth Australia
http://www.purebirth-australia.com/chil ... ranes.html

Premature Rupture of Membranes (PROM)

This is when your amniotic sac or membranes break prior to labour starting. PPROM is preterm premature rupture of membranes - this is said to occur if the woman's membranes break prior to 37 weeks of pregnancy.

A dribble of fluid is usually due to a break of the hind-waters and this often reseals itself quickly, and the body produces more amniotic fluid to replace what was lost.

See also: Premature Labour


PROM Concerns

One of the major concerns with PROM is maternal infection. This is not a major concern in an UP/UC as evidence shows that infections are usually caused by vaginal examinations, introduction of pathogenic bacteria to the vagina, and any other medical interventions that involve inserting objects into the vagina. Those things are not routine in an UP/UC.

Research has shown the risk of infection is only increased in a woman with PROM after she has gone 4 days without labour starting. Perphas this is because women get lax in their precautions so be aware of this and be strict about your hygiene.

If the membranes suddenly rupture and fluid gushes out, there is a risk of cord prolapse where the cord is washed out with the fluid. This risk of prolapse is greater in women whose babies have not engaged yet. Cord prolapse is rare.

Babies may be born prematurely if PROM occurs preterm.
Care & Precautions

Commonsense precautions until labour starts and the baby is on the way include;
Avoid vaginal & pelvic examinations
Avoid perineal massage
Avoid intercourse
Avoid sitting in water
Stay at home til labour starts
Avoid contacts outside your usual contacts
Check temperature regularly
Watch for symptoms such as pain or soreness in the abdomen, fevers or bad smells from the amniotic fluid
Drink plenty of fluids, especially water
Avoid antibiotic use
Get as much rest as you can


Treatment & precautions until labour starts can include;
Taking a natural antibiotic that does not destroy your beneficial gut flora (Echinacea root infusion or tincture, Grapefruit seed extract (GSE) )
Taking probiotics (Lactobacillus acidophilus, Bifidobacterium bifidis) and prebiotic foods (garlic, oatmeal, whole grains, greens like spinach, dandelion greens, collard greens, kale etc, berries, fruit, legumes like kidney beans, chickpeas, black beans, lentils etc) to build up and maintain your beneficial gut flora which will defend against infection.
Maintaining good nutrition, and increasing vitamin E, C and bioflavoid intake.
The white stuff on oranges and citrus fruit is very high in bioflavoids and is said to strengthen your amniotic sac. (Most people peel it off.)

Antibiotics are usually the standard method of treatment for PROM within the medical model of health care. Antibiotics and induction of labour if the mother is close enough to term. If the mother is not close to term, antibiotics and strict bed rest is usually prescribed.

Unless you are showing signs of an infection and want to opt for antibiotics, it is not usually a good idea to take antibiotics as a preventive measure.


(I'm pretty sure I read about one woman on midwifery today that went 6 weeks with prom. Ditto what pp said, be careful who you tell if you don't want a lot of interventions.)
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#4 of 23 Old 09-01-2008, 04:27 PM
 
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I think it depends on your doctor or midwife. I asked mine about this before I went into labor and she said if my water broke and there were no contractions, then she'd be at my house every day to check on me (no internal exams!). We'd be closely monitoring my temperature, the baby's heart rate and I'd need to drink a ton of water. But ultimately, unless there were signs of infection, etc. she'd let me go. I did read a birth story once where someone went 2 weeks.

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#5 of 23 Old 09-01-2008, 08:15 PM
 
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This is definitely a question for your care provider... one you should ask now rather than later.

Every CP differs, but if your water breaks prior to 36 weeks, most will try to keep the baby in to prevent prematurity. Usually though that will mean you're under OB care, possibly in a hospital, and once you pass the "magic" 36 week mark, they want the baby out.

After 36, most OBs (and some MWs) will want to get the baby out immediately. They start a clock on you and if you're not in full-blown labor by then (12-24 hours from ROM usually) they'll start talking C-section. Some MWs take more of a wait and see approach, monitoring mother's health. Like a pp mentioned though, the most important thing to do if you suspect ROM is to keep everything out of there, and that includes anyone's hands.

If you suspect this may be a problem, shop around now. Ask your CP and any potential CP what they do in this sort of situation. Go from there.

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#6 of 23 Old 09-01-2008, 10:31 PM
 
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I think I have heard 12 hours... My water broke and my OB let me go home with instructions to come back if my temperature went up. I had my daughter 35 hours later and all was fine.. Also, when I was in the hospital at first for them to see where I was at I only let them check me once just to see if we could go home. I think risk of infection is low as long as you don't let them check you to much.

:
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#7 of 23 Old 09-02-2008, 12:37 AM
 
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nak
It used to be 24 hours, some have shortened it to 12hrs.

With dd2 (at home) my water was broken 36 hours before labor started. Tried to start labor with breastpump, homeopathics- didn't work. Just waited for labor to start on its own. No VE's, checked temp frequently, drank lots of water. When labor finally started it only lasted 4 hours.

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#8 of 23 Old 09-02-2008, 01:00 AM
 
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it is 24 hours AFTER the first vaginal exam! Quite a bit different than the protocal in most hospitals in the US. Is there anyone from the UK who can tell me if this is true?

Sharon

Birth doula, doula trainer, ican leader, lamaze childbirth educator, and most importantly, mom of 2 great girls!
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#9 of 23 Old 09-02-2008, 01:44 PM - Thread Starter
 
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I did ask my care provider and he basically said that if my water breaks and I don't deliver the baby soon after that they will start with pit. He didn't go into details about HOW long after I have but he made it sound like he wouldn't let me go even 24 hours.

Thank you for all the info and advice!!

wife to DH 2/03, mama to DS 3/03 & DD 1/09
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#10 of 23 Old 09-02-2008, 01:55 PM
 
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My sister-in-law "was allowed" 12 hours to start labor after her membranes ruptured with her first baby. She didn't, was induced, and ended with a C-sec. I think 12 to 24 hours is pretty common.
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#11 of 23 Old 09-02-2008, 02:56 PM
 
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My daughter was born healthy 36 hours after my water broke.

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#12 of 23 Old 09-02-2008, 04:08 PM
 
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My water broke 25 hours before my son was born and we were both completely healthy.
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#13 of 23 Old 09-03-2008, 01:54 PM
 
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Around here the OB/CNM policies range anywhere from "Come in the second your water breaks for Pit" to more flexibility based on individual situations. I got Pit at 24 hours. A birth I attended, she was at 31 when she got Pit. If I were to have PROM again, I'd be willing to wait indefinitely if there was nothing odd going on (decreased movement, meconium, whatever).

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#14 of 23 Old 09-03-2008, 11:04 PM
 
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In the US hospital where I gave birth it was 70 hours from rupture to birth.
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#15 of 23 Old 09-03-2008, 11:45 PM
 
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With dd#1 waters broke at the grocery store. I went into hospital shortly afterwards, but wasn't in labor at all. They let me try to get things going naturally for 12 hours and after that I was induced. She was born 33 hours after ROM.
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#16 of 23 Old 09-04-2008, 12:23 AM
 
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I was originally told by my midwife that she would want to induce if I didn't start cx within 12 hours of PROM; but when I pushed her about how short that was, she agreed that she could be open to 24 hours. I wasn't too happy with that answer either... all my research suggested the risk of infection was low if you avoided vaginal exams. My own sister (like other posters here) took 48 hours after water breaking before labor really began, and she gave birth with no problems in a birth center. For this reason, when I felt something I thought might be a leak in my waters, I chose NOT to call my midwives and start that clock ticking. I felt the first cx about 24 hours later and was very glad to still be in my own home, where I could rest through the night, and labor in my own space in the early morning when contractions started to get serious, and go to the hospital only when I was ready to push my baby out. I would never have had my wonderful intervention-free birth if I hadn't trusted my instincts to lay low.

Jojo, Do ask exactly how much time he allows after PROM, it is a fair question and most OBs/CNMs/hospitals these days do have a specific policy. One option if you think he is being inflexible is to switch care providers. If you want to stay with him, you may want to think about when to share the news about water breaking. In fact, some OBs actually have timetables about how long they think labor should take (based on an "average" curve they read in their med school textbook) and if a woman hasen't given birth 12 hours after starting labor, or showing up at the hospital, she'll be pressured into a c-section even without any other evidence of medical need. If this sounds like your guy (another good thing to ask about!), then you might not even want him to know you are in labor until you are really active.
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#17 of 23 Old 09-04-2008, 01:42 AM
 
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Just wanted to share my experience. I think that every momma should listen to her instincts when it comes to intervening and getting labor going.

DS's water broke a full week before I went into labor. Instincts told me to be relaxed and do nothing to force labor. I stayed at home and we were strict about hygiene. I cut out all sugar, and white foods (bread, rice, crackers). Drank a lot of water, ate really well, took lots of Vit C. I did not wear panties and actually encouraged a little leaking by walking and rocking a bit if it had been awhile. I figured fluid trickling down was keeping things moving in the right direction rather than letting germs travel up.

My midwife started to get nervous about me getting an infection and having to go to a hospital after 3 days. On the third day I tried some acupuncture and nipple stimulation after having steady rushes all night. (It was cool too. I get what people mean when they use the word rush now.) Nothing. I ordered some cotton root bark just in case.

On the seventh day I had another good night of rest and rushes. I started taking cotton root bark and using a double breast pump. That did it. 10 hours later, after a straight forward labor, DS was here.

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#18 of 23 Old 09-04-2008, 02:04 AM
 
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...and here's my experience.

My water broke on a Friday afternoon at about 5 PM, I went until Monday morning at about 3 AM before labor started, and that was with Cervadil put in. Just counting that is about 50 hours from my water breaking that labor started, and Hannah was born at 2 PM that Monday. So, that's about 70 or so hours after my water broke that I gave birth.

As PP said, I went on how I felt and what I thought baby felt. My MW did take me to a nearby hospital to do a NST on Sunday afternoon, after 48 hours of waiting with no end in sight, and as I suspected, baby was doing just fine.
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#19 of 23 Old 09-04-2008, 12:01 PM
 
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Unfortunately hospitals and ob's have set an arbitrary timeschedule that doesn't have a heck of a lot to do with what the body can really do. That whole 12 hr/24 hr thing is an example of that. Talk to your care provider, but you can go a heck of a lot longer - safely - than the traditional hospital schedule. Just 1 more reason for hospitals to start their cascading interventions. It happened to a cousin of mine; her water broke and at exactly 12 hrs (how ridiculous!) with no risk factors they started her on pitocin, then the epi, then the c-section.

My water was broken with my last for over 24 hrs before labor started, and my mw was cool with it. So there's a big difference between "what's safe" and "what does a traditional ob/hospital allow" unfortunately. And they often have nothing to do with each other.
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#20 of 23 Old 09-04-2008, 03:39 PM
 
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Quote:
Originally Posted by Jojo F. View Post
I'm sure I have read the answer somewhere before but do you laides know what is the safe amount of time to wait after the water breaks to give birth? How long can I go after the water breaks?

I *may* have to give birth with an OB- I sure hope not- but in this case I want to be ready and well informed.

TIA!!!
Haven't read the responses yet, but to the OP -

It all depends on who you tell. Most OBs will panic if you don't look like you're going to deliver before 24 hours. So myself, if my waters break and I don't have labour yet, my approach would be to not mention it - along with not allowing anything into my vagina, and keeping an eye on myself for fever and clarity of fluid.

If your waters were to break at 33 weeks, say, they'd leave you alone indefinitely as long as everything else was copacetic, because of the prematurity of the baby. So IMO, if they'll leave a premie alone despite waters breaking - and logically a premie would be MORE vulnerable to an infection were it to happen - then they can leave my term baby alone, too.
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#21 of 23 Old 09-04-2008, 03:46 PM
 
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Quote:
Originally Posted by meganmarie View Post
In fact, some OBs actually have timetables about how long they think labor should take (based on an "average" curve they read in their med school textbook) and if a woman hasen't given birth 12 hours after starting labor, or showing up at the hospital, she'll be pressured into a c-section even without any other evidence of medical need. If this sounds like your guy (another good thing to ask about!), then you might not even want him to know you are in labor until you are really active.
This is known as the Dublin protocol - I think there's good info about it on Henci Goer's site, she has the chapter from TWG about slow labour published online. hencigoer.com
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#22 of 23 Old 09-05-2008, 03:50 PM
 
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What is interesting to note is that according to research approximately 93% of women will go into labor spontaneously after their water breaks within 24 hours. (Average time for your BOW to break is 8 cm dilation).

I have watched the typical hospital protocol go from 48 hours to 24 to 12 and even 6 at some hospitals (from rupture to induction). This is obviously setting a large number of women up for induction (and the cascade of interventions that typically follows)
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#23 of 23 Old 09-06-2008, 09:48 PM
 
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I sat on bedrest for 15 DAYS after my water broke! Once it breaks usually you deliver in 24 hours but not always. They monitored me closely at the hospital until she came on her own...they couldn't stop labor..just shy of 34 weeks...so she was 6 weeks premature. So you can go for quite awhile!
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