Monday, November 8, 2010

when your water breaks

If by chance you are full term and experience a "gush of water" (verses a slow leak, which would mean your bag of waters is still intact) and contractions have not yet started, you will likely feel excited and terrified and rush off to the hospital as quickly as possible.  Most women have been deeply rooted to the fear of infection. 

But before you head to the hosptial, you need to consider a few things.  Were you wanting a more natural birth, or medial?  What kinds of interventions were you hoping for, or wishing to avoid?  Most hospitals will require an induced labor if you come to them with a ruptured bag of waters.  Most hospital policies require the birth of the baby within 24 hours after the waters have ruptured.  Unless you have discussed this with your doctor beforehand, that is more than likely what you can expect.

Hospitals do this because the ruptured bag of waters has been associated with a prolapsed cord (where the umbilical cord comes out before the head, can get pinched, and block oxygen from the baby), and infection.  A recent medical article states, however, that while fewer infants were admitted to the NICU when labor was induced -- verses starting spontaneously -- there was no significant difference in whether or not the infant developed an infection.  It does not give any details as to why the infants were being admitted to the NICU, but later on it does say that babies born with a premature rupture of the membranes and spontaneous labor will be classified by most hospital policies as "high risk" and therefore go straight to the NICU, with or without any obvious emergency. 

In all cases, whether labor was induced or started on its own, an infection occured in 2-3% of the babies born.  So then, if your waters break and you are not wishing to be induced, it would be a good idea to stay home for a while.  Typically contractions will start withing 24 hours after your water has broken, but sometimes it can take up to a week.

Personally, I wouldn't wait around for an entire week.  The longer you wait, the greater the chance that your baby or you will develop some sort of infection and need to be pumped with antibiotics.  However I would give myself about a day to see where it went.  Of course you should be cautious; no sex, no baths -- unless the tub has been thoroughly scrubbed -- and generally keeping yourself clean. 

Nothing happens immediately; not infections, contractions, or especially the birth of your baby -- so if you are looking to avoid being induced, give yourself some time at home and see what your body does.  If, however, you have been begging your doctor to induce you, you are in luck.  A ruptured bag of waters will undoubtedly get the doctor moving.

There is a fantastic article with more information here:

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