What to do when water breaks — The Bump
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What to do when water breaks

For those who are going for a med/intervention free birth what's the protocol on when your water breaks and when you need to go to the hospital? Specifically if the water breaks at term but you don't have early/active labor contractions yet.  I know birth centers and hospitals deal with things differently. Many midwives say you are at less risk of infection in your own home than a hospital with people checking your cervix. But hospitals want you to come right away. I know this is a bit of a what if, but I've read different things on this and would like to hear from others! 

My OB is supportive of med-free but really wants me to come in if water is to break. However, I know the longer I'm there the more likely that inductions will be discussed. So in this scenario, would I go right away and get checked, and then just walk around the hospital hoping to get things moving, or wait at home an hour or two to see if contractions start?

Re: What to do when water breaks

  • I honestly don't know (how's that for helpful?) but maybe you can go to get checked but not stay there? Maybe discuss these concerns with OB and ask for any issues you should look out for or be aware of. I do know that if your water gushes and the umbilical cord comes out, it is a huge emergency and you need to get to doc immediately. You should at least be calling to tell them it has broken.
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  • peregrinefalconx thank you :) I do know their can be complications with the cord. But I was curios what those who go to birth-centers or have had home births do.
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  • If the waters are clear with no presence of meconium I would feel comfortable waiting 6-12 hours before going in. I would however be trying to get contractions going naturally if they hadn't started yet through walking bouncing on a birth ball and nipple stimulation. Cord prolapse is pretty rare with spontaneous rupture of membranes and I would imagine is pretty obvious if it happens.

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  • I delivered with a birth center last time. Their policy was to alert them but obviously stay home if the waters was clear, and watch for signs of a fever. This time Im with a large hospital, and traditional midwife. 

     Regardless of what their policy is, I'll be staying home if my water breaks to see if I can get contractions into full labor and won't be planning on leaving until contractions are either regular and under 5 mins apart, or other signs that I am nearing transition. I stayed home till 7cm last time so I feel confident in this. As long as everything else is ok. Not sure on how long I would stay home but an hour or two seems short?

     It is about what you're comfortable with, though. Read up on emotional signposts of labor too, to help judge when to go in. If you feel safer being at the hospital, go in. If you're worried about going in too early, you can leave if you find you're not where you want to be. 
  • I echo the other comments about noting the color of the water.  I had more success laboring at home. I was laboring through the morning and my office was open, so they let me come in and my doctor checked me, was dilated to a 6, then I returned home for a bit.  For me there was no doubt when I needed to head to the hospital.  If you head to the hospital, be prepared to support yourself. With my first birth I made the mistake of heading in imagining that the nurses would be prepared to support me with a variety of techniques and equipment- the hospital website brags about their wide variety of support materials available.  However, just because they have them doesn't mean that the staff you're working with will volunteer them or know how to suggest you utilize some of them for effective pain management.  Build a team of support people prepared to keep coming with ideas for getting you through no matter where you are. 
  • This happened to me with my first. My water broke at 37 weeks, and no contractions in sight. I delivered at a hospital with midwives. I walked and tried to get contractions going on my own for about 7 hours before going in.  Then the midwife there had me keep working on getting things going for another 10 hours. We tried everything, but at that point I really had almost nothing and I was getting very tired, so I did end up having to have pitocin.  I was still able to go without epidural, but the pitocin was definitely rough.  Looking back, I am perfectly fine with how things turned out. I know some more hardcore natural birthers will push for days with water broken, but I really did not want to take that risk and I trusted my midwife when she finally suggested the pitocin.  I felt comfortable that there was no set time limit, but at the same time, they obviously wanted to be careful not to risk infection.  I went on to have a completely natural 4 hour labor/birth with my second. Both were great and I ended up with healthy baby at the end with both!
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  • My understanding is that it's very, very rare for water to break without contractions starting first. In my reading, 5% of women experienced this. Usually, contractions start and the water doesn't break until full effacement during active labor.

    What I've been told in our Bradley class is that, as long as the waters aren't discolored or odorous (and of course, a cord prolapse doesn't exist), it's fine to stay home and wait for contractions to begin or shorten. They didn't say exactly how long, however. That seems to be up to you, personally.

    We don't plan on telling our OB if the waters break first. We'll let them know when contractions are either 5 minutes apart and regular, or it's been a significant length of time without contractions (I'm thinking maybe 8-10 hours).

                                                                                                           
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  • just like the mamas above mentioned, as long as the condition,of the fluid is fine, there is not rush. Do not let anything enter your vagina when your membranes have ruptured...no sex and no cervical exams! Watch for a fever and stay home up to 24 hours
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