Broken water?

Peedy · July 2014

Hi, I'm new to this board, I'm mostly active on the august 14 board. My water hasn't broken. However, my best friend's did last night and she is currently on a pitocin IV and only 2cm dilated.

My question is... (Because I'd like to have a natural birth) is it ok in this type of situation to refuse induction until you're further along? Or is this one of those cases where you need to just let the doctors do their thing?

*LrCg* · July 2014

I think it depends on your provider and place of birth. My understanding is at a hospital the clock starts when your water breaks. With my first my water broke and I had no contractions for over 14 hours. My midwife monitored me and because I never had internals there was no concern of infection. I ended up with a beautiful home birth but had I been in a hospital it would have been an automatic c-section.

barnwife · July 2014

With S. (third labor/delivery), my water broke and I had only sporadic contractions (about 15 over the next 48 hours). My MW performed no internals. I took my temperature every couple hours (to monitor for infection). And 48 hours after my water broke, I finally started consistent contractions. I had about 3 hours of contractions 30 seconds long and 10 minutes apart.

Then I pushed twice and was holding S. Thank goodness we were planning a HB, as I had no idea I was that close to delivery.

For me, I wouldn't be inducing solely because water was broken.

Peedy · July 2014

Thanks for the reply!

cherylanddoug · July 2014

They tried to put me on pitocin right away when I came in after my water broke because the clock was ticking (5hours, contractions not regular, on 2cm dilated) and because I was a first time mom. I refused and chose to walk around for a bit. J was born by the 14th hour.

francined01 · July 2014

they will prob put pressure on you to do an induction- but you can absolutely refuse

vvvvvfee · July 2014

yes, you can always say, "i do not consent," and refuse any intervention. if you refuse internal checks, there is less chance of bacteria being introduced. (just so long as there is no meconium in the fluid-- if there is, there is a danger of infection and induction may be warranted.)

my water broke at home, but i had a very fast labor (water broke at about 1 AM, DS was born at about 5 AM). the majority of people do not have their water break before active labor starts.

Jmorgan971 · July 2014

Yes to what all the PP have said. You can refuse inductions or other interventions, but it may be difficult for you, your SO, or whoever else is with you to make those decisions in the middle of labor. It might be good to go through some mock scenarios and be prepared to ask questions if and when an intervention is recommended. (Birthing From Within covers this to some degree.) My DH said it would be hard for him not to do whatever the medical staff recommended. So we talked a lot about that before the big day. My labor ended up being precipitous (water broke at 10 pm, arrived at the hospital pushing, DS was born at midnight) so we didn't have to put our plan into action. But I'm glad we prepared just in case.

DebateThis · July 2014

I'm a big believer in using accurate terminology. Once your water has broken on its own, the correct term is augmentation of labor, not induction.

To answer OP's question, you absolutely do not have to go to the hospital or consent to pitocin immediately upon your water breaking. (And to respond to PP's comment - 14 hrs of no contractions is not inherently an "automatic c-section" in a hospital, either).

I went into labor at 35w4d, and labor sort of stalled out but I remained at 6cm and contracting every 10-20min for three weeks. My water broke at 8am at 38w4d, confirmed by my midwife at 9:30am, but ironically enough my contractions were almost completely gone for the first time in weeks. My MW sent me home to walk and bounce on my ball (even still at 6cm) with instructions to head back to the hospital at 9:30pm if ctx hadn't picked up. I walked and bounced and did lunges and stair climbers and did everything but borrow a neighbor's trampoline but my contractions didn't ever really pick up. I dragged my feet and didn't pack up to head to the hospital til ~10:30pm, arriving somewhere between 11:30 and midnight. My MW ordered a very low dose of pitocin to get things finally going at that point. Approaching 15 hrs with ruptured membranes and already at 6cm, we all felt it best that I was in the hospital at this point and not an hour away at home - I had an almost primal urge to get to the place where I knew I'd be delivering and hunker down at that point. DH thought it was odd that the switch in my head flipped from not wanting to go to the hospital to NEED TO GO NOW even though physically nothing had changed re: contractions.

I slept through what the nurses told me were strong and regular contractions thanks to some Benadryl and then woke up in transition at 8:30am, exactly 24hrs after my water broke. LO was out at 9:41am. My midwives skipped cervical checks due to membrane rupture and just relied on my comments/noises to tell them where I was in the process. Even with the pit IV I was still able to labor in any position I wanted, including in the tub, and deliver w/o pain meds of any sort.

I absolute attribute my birth going well to my midwives having a very hands off attitude. They trusted me and my body and were very conservative with pitocin to get my contractions into a rhythm and productive.

If your water happened to break at home, I would call your provider and keep them abreast of the situation, but plan on laboring at home for at least a few hours before you go to the hospital, and then be prepared to make the pitocin decision as needed. As long as you're contracting regularly and labor is progressing over several hours on its own, there's no reason to immediately head to the hospital or immediately augment labor the second your water breaks. Good luck!

jenn43 · July 2014

DebateThis said:

I'm a big believer in using accurate terminology. Once your water has broken on its own, the correct term is augmentation of labor, not induction.

Actually, labor is defined by the onset of contractions (check it out at the ACOG website: https://www.acog.org/~/media/Departments/Patient Safety and Quality Improvement/201213IssuesandRationale-Labor.pdf?dmc=1&ts=20131002T0144357028).

So you can still be induced after rupture of the membranes.

In my case, my water broke at home. My midwife was fine with me staying home until the following morning (18 hours), and LO was born 34 hours afterward. I was induced with two doses of cytotech. I think many OBs would be pushing for induction sooner than that, so this is a great question for your provider. Ask how long he/she is comfortable waiting to induce after rupture of the membranes if mom and baby are doing okay.

If you are in a hospital, however, be aware that LO may get additional blood work (CBC and blood cultures), and may have to stay an extra day for observation if you have prolonged rupture of the membranes, meaning 18 or 24 hours have passed (depending on who you ask) from the time your water breaks to the time the baby is born.

Broken water?

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