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Natural Birth
Risks after water breaks - question
Ob appt today and just going over some potential scenarios for D-day. For the record the entire practice has been very supportive of my natural birth preferences and requests thus far.
So today she says that once my water breaks (even if its just a leak), I have to go into the hospital since there becomes a risk for infection. Is this true?
I live less than 5 minutes from hospital and was planning on laboring at home as long as possible. So a leaky water wasnt exactly on my list of reasons to rush in.
Thoughts? Experiences? Opinions? References?
TIA!
__Hope everyone has a great weekend! (and Happy Easter & Passover too!)
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Re: Risks after water breaks - question
If everyone keeps their hands to themselves there is very little risk in the first 24 hours..and even beyond. The problem is that at a hospital they tend to want to check you a LOT, so you are a lot more likely to have bacteria introduced.
FWIW, my labor was 40 hours long and started with my water breaking.
I would NOT rush off to the hospital when your water breaks. It is just going to start a time clock and give them more ammunition to push pit and other interventions.
Are you sure your OB is supportive of natural birth? The whole "OMG! water breaking = infection" would throw up a red flag for me.
I agree- there is a risk that you can get an infection. However- they put you on a time clock as soon as you get to the hospital. Decline vaginal exams as much as possible. Even a gloved hand is unsterile (the glove is for their protection, not yours). I would try to wait it out until you feel like you are in active labor before going to the hospital or calling your OB's. You will get pressured to have labor augmentation if you get into a hospital setting. Obviously if you start developing a fever, don't wait, call.
"Are you sure your OB is supportive of natural birth? The whole "OMG! water breaking = infection" would throw up a red flag for me. " Ditto.
There are definitely reasons for going in right away. One of them is if the water is discolored by meconium. This could indicate that the baby is in distress and could cause other problems and would need to be monitored.
Other than that, I agree with the other posters! I was advised by my doula to keep checking my temperature every hour if my waters break at home. This is to make sure that an infection doesn't develop. I'd stay home as long as possible and might lie (shhh) when asked about what time my water broke when I get to the hospital, so I could buy a little more time on their timetable for delivery after rupture of membranes.
This was a discussion at this early in your gestation? Weird. Also, did your water break on it's own with your first?
I would think that the ONLY reason you'd have a greater risk would be that you had a fast labor the first time around & are GBS +. They like for two doses of antibiotics (over an eight hour period) to reduce the likelihood of the baby getting GBS.
I agree that for an OB being onboard w/natural delivery, this is a red flag for me. If you don't have GBS, or didn't w/the first (many don't retest for second or subsequent babies), I would give yourself at least 6-8 hours to see if regular/painful, timeable ctxs before going in--if your water breaks first. Once you go in, you are (most likely) on a time table, but not always. HTH.
Trevor Calvin 12.10.07 7:26pm 7lbs2.5oz 19.75in
Emerson Claire 07.07.11 11:34am 7lbs7oz 20.5 in
That would be a bit of a red flag for me, too.
With DS, my water broke & we called the midwives pretty much right away. They encouraged us to get some rest and stay home as long as possible. My water broke at 1am and we arrived at the hospital around 8:30am. The only times I would go in right away are reasons pp mentioned - meconium in fluid or GBS+ (or if labor had progressed extremely fast with first LO, I guess)
Tough one.... different situation for us because we were planning a HB.
Bottom line for me was that I spent a ton of time working to start labor (i.e., days) after I got a slow, hind leak. (I know this isn't recommended though... if I'd fully ruptured, I would have handled the situation differently.) We started the clock for real when she did an internal exam and stripped my membranes.
Recommendation, get yourself some pH paper (from your MW) so that you can test for yourself what you're leaking when the time comes. That helped us with the guessing game.
Sure, there is a risk of infection, but many doctors tend to blow things out of proportion. The main thing thing that ups the risk of infection is internal exams! I gave birth at a very natural birth friendly hospital. The first sign of labor was my water breaking with a huge gush and then I had no contractions...for three days. They had me come in every 24 hours (I think this might have been for a NST although they never used that term) so they could monitor me and the baby for an hour and then I could go home. They gave me a list of instructions of what to do and not to do, i.e., no baths, sex, basically nothing in the vagina at all. I had to take my temperature every three hours. They did not do exams on me because they said that if I was not contracting, then one can assume I'm not dilating, therefore no need to do an exam that could possibly introduce infection. They had a rule of allowing me to wait for up to 72 hours before starting induction. Even at that point I could have signed a waiver and continued to wait if I wanted. Around 60 hours after my water broke with not so much as a twinge of contraction (I beat all the odds!), I reluctantly agreed to get things started with cytotec. I was terrified of pitocin and was hoping that the cytotec would get things going and no pit would be needed. About six hours after my first dose of cytotec (I had two doses four hours apart), labor started quickly, and my son was born about five hours after the first contraction. Neither one of us developed an infection.
As a side note, the whole issue of cytotec is something I did not know about beforehand and with everything I have learned since I don't know that I would have accepted this drug had I known about all of the risks involved. Thank goodness I did not experience any of the more serious side effects associated with this drug, but once my labor started, it was fast and furious often with very little relief in between contractions. Knowing what I know now, I can't help but wonder if my labor progressed the way it did because of the cytotec.
Agreed!!!
The discussion sort of evolved from a question about internal exams... and Im a bit neurotic so I guess I started coming up with all these "what if" scenarios... This is my first pregnancy (no terminations, or miscarriages or any other procedures that involved dialation)
So I just listened to what she said and I figured I would read up some on this topic and bring it up again at my next appointment and this way, now I can have an educated conversation about it and know what I am talking about and what/why I may refuse, decline, ignore certain rountines... kwim
Thanks for your input!