What if waters break and contractions don't start? How to avoid pitocin?

RachelDanaeJ

I am 31 weeks with my first (a boy names Noah:)) and for some reason my biggest concern is my water breaking and contractions not starting. I'd like to wait at home for 12 hours before heading to the hospital, but I am afraid of a prolapsed cord or other complication. I REALLY want to avoid pitocin and after speaking with my birthing class instructor, it doesn't sound like the hospital supports any natural methods of getting contractions to start once the water breaks. Any thoughts or ideas? Could I head in for acupuncture if my contractions don't start? Should I head into the hospital right after my water breaks and just stand firm in not accepting pitocin? Anyone else fixated on one "what if" of pregnancy and it driving themselves crazy?

barnwife

This happened to me with S. (LO3). My MW told me that most babies are born within 24 hours after waters breaking (when looking at those without intervention). She instructed me to stay at home (didn't want to pick up any germs to increase chance of infection), put nothing in my vagina, and no baths. U took my temperature every couple hours to monitor for infection. She also did no cervical checks.

24 hours later I still didn't have timeable contractions. (I had had 4 of 5 sporadic ones.) She said I could go to the hospital to be induced. I couldn't figure out how that would help. I mean, if baby were ready, I'd have been having contractions. And the risk of infection is low as long as you take common sense precautions. 

36 hours after my water broke we were discussing possible natural induction methods. I wanted to hold out longer (because practically all babies are born within 48 hours) and she was fine with that. 48 hours was late at night, so we decided natural induction would have to wait until the morning. (I wanted a decent nights sleep if possible.)

49 hours after my water broke I woke to timeable, consistent contractions. LO was born 3 hours after that at home. (We plan HB.)

So, long story short, I wouldn't go for acupuncture after my water broke. I would however try things like nipple stimulation or castor oil if contractions really weren't starting.

A question for you @RachelDanaeJ...why head to the hospital if you aren't having contractions and don't want pit? Exactly what would you be doing there? Laying in bed? Walking the halls? Wouldn't you be more comfortable at home?

waittilltomorrow

My midwife does not recommend castor oil. She suggests raspberry leaf tea/tablets and nipple stimulation as natural ways to induce labor.

She also said lots of sex, but obviously this would not be appropriate if your waters have broken.

MississippiCatfish

I understand thinking about the what ifs - so normal. I do it too.

When my first was born, my water broke and contractions started BOOM about 30 minutes later, really intense right away, no build up. Just to give you an example of a different sort of scenario:)

jennybean80

If your water breaks and you are GBS negative and want to stay home you can try nipple stimulation to help trigger labour. It will help release natural Oxytocin, which is basically what pitocin is. Try 20 min on one side then wait another 20 min, switch sides and repeat. You can use manual stim, or a breast pump.

If you are GBS positive you should go see your care provider to have antibiotics started. They might be willing to do a saline lock and just have you come back every 4 hours for your doses.

RachelDanaeJ

Thanks all! My fear with staying at home and waiting for contractions to start (which is what I'd like to do) is what if I have a prolapsed cord? How would I know if the baby is in distress? @Barnwife was your MW concerned with the cord? How did she know the baby was still getting oxygen? (Totally not doubting your MW,  just wondering!) Thanks, again!

DebateThis

My water broke ay 9:30 am on a Wednesday. My MW confirmed it but my contractions were only 10-20 min apart and not strong at all so she sent me home to walk a lot with instructions to be back at the hospital at 9pm if nothing had happened so pit could be started. Nothing happened, but I dawdled a lot and got to the hospital at 11pm. The pit was really not bad at all for me and I delivered in pretty much a whirlwind hour and 11 minutes. It was intense but I never felt that I couldn't manage it.

Good luck!

barnwife

@RachelDanaeJ
Well, if she was concerned with the cord, I don't remember her mentioning it to me. I do remember her asking many times if I was still feeling baby move. And S. was as active as ever after my water broke. 

huntjul

Someone smarter than me can correct this if I'm wrong, but if LO's head in engaged in the pelvis (as is common with most FTMs), I'd imagine the risk of a cord prolapse would be almost nil since the head is occupying the entire orifice.

jennybean80

Cord prolapse is most common if baby is breech or transverse. If the head is well engaged, prolapse is unlikely.

That being said, if you do have a prolapse you will probably be able to see or feel the loop of cord hanging out of the vagina. If this happens, call 9-1-1 as this is a HUGE emergency situation. Then get on your hands and knees with your bum up in the air to try and keep LO off of the cord. Hopefully nobody actually has to deal with this!!

emmyfreeman27

Yep- just stay home until you are ready to have that baby (ie, contractions, etc.).  You would definitely know if the cord was hanging out! 

I've also heard that with most natural labors, the water doesn't break until later on anyway. Mine didn't break until I was in transition with LO #2. 

shiway

Well first the odds are In your favor. Something like 80% of mamas will go into natural labor within 12 hrs. Those that don't will likely goito labor within 24. Definitely don't got in right away. Make sure your provider is supportive of your choices to sty home adm wait it out. I am with a birth center and they give you 24-36 hrs to go into labor and then another set of hours to achieve a birth. Hospitals are not so patient. They put you on the clock as soon as you walk I the door. They might give you 2-4 hrs. Then try like to push pitocin. And then you are I a slippery slope. This is why choosing your provider wisely is so important.

Empireceo

Jenstwins said:

Cord prolapse is most common if baby is breech or transverse. 

Yes, this was me.  Baby was breech and my water broke  without any contractions.  My OB told me to get to the hospital immediately.  

TrendyTina

As PPs have mentioned, for MOST people labor will start within a day of your waters rupturing. For me, although, this did not happen. We gave it 26 hours, took herbs, used the breast pump, but nothing worked. I had mild contractions, but nothing to get be dilated past 1.5 cm. At hour 26 I started pitocin and 2 hours later, I was pushing. 1 hour of pushing and my son was born. 

wintersong

@TrendyTina, you bring up a good point...Pitocin isn't always bad, just like sections aren't always unnecessary. Sometimes its so easy to get caught up in the natural birth mindset that we can forget medicine isn't evil! Sometimes interventions are necessary. If that really happens to you, if you really are one of the women for whom labor does not start, its nice to know that eventually obs can help if necessary.

my question is, how long until its necessary? How long is walking around with broken waters safe? Is there a chance of infection? Other risks besides prolapsed cord? (LOL, I'm really asking, I don't know the answers

alliejoe

I could be wrong, but if you stay hydrated I thin waters continue to generate, so if your water broke and is just a steady leak, you still have water.

My water broke and was a consistent trickle till I had ctx. Then it was more gushy.  It took about 2-2.5 hours for my ctx to start, but they were hard and fast when they did. MW had me come in before ctx started b/c there was muconium in the fluid and I was gbs+ though.

Summer889

huntjul said:

Someone smarter than me can correct this if I'm wrong, but if LO's head in engaged in the pelvis (as is common with most FTMs), I'd imagine the risk of a cord prolapse would be almost nil since the head is occupying the entire orifice.

This is exactly what my MW told me when I asked about the risk of cord prolapse.  

I was told I can safely stay home for 24 hours (18 if GBS+) after water brakes waiting for labor to begin.  She said the vast majority of women go into labor within 24 hours of water breaking.  So it's not something I'd spend a lot of time stressing over.  

HNRomance

from what I've READ biggest thing to avoid is having vaginal exams, sex or baths while you are waiting for contractions to start if water breaks early. You don't want anyone introducing additional bacteria up there and giving it time to cause infection. I would probably start worrying if there was a gush and no progress but a slow trickle can be ok if you stay hydrated since you will continue to replenish amniotic fluid until your baby is born. In any case, if your provider is pretty open to options then just call them if it happens and you can balance your decision against their advice. Then they can be "on-call" for you too if labor starts in a hurry. Make a plan for yourself so you don't have to worry.