URGENT: Water broke, no contractions.. is induction her only option?

[papal]

Hey everyone,
I need some quick help. My sister's water broke at midnight last night. She was not sure it was her waters because it has been trickling out all day, but they checked into the hospital and they confirmed that it was indeed her water. So it has been 18 hours or so since when she THINKS her water broke (there was bloody show at midnight too). She is feeling NO contractions. Is her only option an induction at this point since nothing is happening??? What is the usual protocol? She is waiting for her doctor to show up at the hospital but I just wanted to know what options she has at this point in time?

HELP!

[papal]

Hey everyone,
I need some quick help. My sister's water broke at midnight last night. She was not sure it was her waters because it has been trickling out all day, but they checked into the hospital and they confirmed that it was indeed her water. So it has been 18 hours or so since when she THINKS her water broke (there was bloody show at midnight too). She is feeling NO contractions. Is her only option an induction at this point since nothing is happening??? What is the usual protocol? She is waiting for her doctor to show up at the hospital but I just wanted to know what options she has at this point in time?

HELP!

[jayali]

Not an expert by any means (DS was a scheduled C), however, when my SIL was pregnant they said that she could only go 24 hours after her water broke. I believe the called it a "dry birth" and were worried about infection. All of this was a while ago, so I may have it wrong and things may have changed.

I will send strong labor vibes her way!!!

[jayali]

Not an expert by any means (DS was a scheduled C), however, when my SIL was pregnant they said that she could only go 24 hours after her water broke. I believe the called it a "dry birth" and were worried about infection. All of this was a while ago, so I may have it wrong and things may have changed.

I will send strong labor vibes her way!!!

[o_mom]

It depends on her caregiver - some will say birth within 24 hrs of water breaking, others will monitor but wait. Most things I have read say 24 hrs from 1st internal exam w/rtuptured membranes, but there is alot of variation. I was over 24 hrs from water breaking with DS1, but less than 24 from 1st exam. If she is full term they will probably push induction if she is still leaking.

sorry for typos... nak

[o_mom]

It depends on her caregiver - some will say birth within 24 hrs of water breaking, others will monitor but wait. Most things I have read say 24 hrs from 1st internal exam w/rtuptured membranes, but there is alot of variation. I was over 24 hrs from water breaking with DS1, but less than 24 from 1st exam. If she is full term they will probably push induction if she is still leaking.

sorry for typos... nak

[papal]

I am just worried about the slippery slope that an induction might lead to a C-section. The doctors know best here but I just want her to have the birth experience she wants.. :(
Would walking around or nipple stimulation be too late in the game to start labour on its own?

[papal]

I am just worried about the slippery slope that an induction might lead to a C-section. The doctors know best here but I just want her to have the birth experience she wants.. :(
Would walking around or nipple stimulation be too late in the game to start labour on its own?

[pampamz]

Hmm -- I was induced at 12 hrs post membrane-rupture. But, was begging for it anyways as I was overdue. That said, induction via drip was a bumpy road for me...

How exciting though -- good luck to her.

[pampamz]

Hmm -- I was induced at 12 hrs post membrane-rupture. But, was begging for it anyways as I was overdue. That said, induction via drip was a bumpy road for me...

How exciting though -- good luck to her.

[papal]

she is 38wks right now

nak

[papal]

she is 38wks right now

nak

[pampamz]

My sis was induced at 35 weeks after membranes rupturing and no C-section was required for her. I was 40+5 and no section either.

Walking might help -- it certainly did for my second but did nothing for my first DC. Nipple stim was irritating for me and did nothing also...despite DH's positive reinforcement!

[pampamz]

My sis was induced at 35 weeks after membranes rupturing and no C-section was required for her. I was 40+5 and no section either.

Walking might help -- it certainly did for my second but did nothing for my first DC. Nipple stim was irritating for me and did nothing also...despite DH's positive reinforcement!

[papal]

Not sure how she will be able to walk since they have the fetal monitor thingy attached to her. argh.

[papal]

Not sure how she will be able to walk since they have the fetal monitor thingy attached to her. argh.

[o_mom]

Tell her to unstrap the darn thing and walk. Nurses are notorious for saying they are going to monitor for 20 min and then they forget and three hours later you are still sitting there. Just tell her to get up, and go to the bathroom. :-)

[o_mom]

Tell her to unstrap the darn thing and walk. Nurses are notorious for saying they are going to monitor for 20 min and then they forget and three hours later you are still sitting there. Just tell her to get up, and go to the bathroom. :-)

[m448]

here's some info:

http://www.childbirthsolutions.com/articles/pregnancy/prom/index.php


Marielle


Ian - born 10/03
&
Ryan - born 01/06

[m448]

here's some info:

http://www.childbirthsolutions.com/articles/pregnancy/prom/index.php


Marielle


Ian - born 10/03
&
Ryan - born 01/06

[papal]

Thank you so very much Marielle! The article is exactly the kind of information I was looking for.

[Momof3Labs]

Rashmi, that's exactly what happened to me at 38 weeks with Colin, and I was basically induced (though got to 3cm without help, it was a long pitocin-ridden road to 10cm). He was ultimately a vaginal birth, but with forceps since all those hours in bed left him in a posterior position (so she should get up - even leaning over by the side of the bed - as much as possible).

With Logan, my water broke and labor was a little slow to start, so my CNM did the following things to help things along: soapsud enema (not as bad as it sounds, honestly), sent me walking around the floor with my doula, and breastpump. I don't think that I needed a lot of help this time, compared to with Colin (Logan was so much lower, and his water broke with a gush vs. a drip for Colin).

That said, my CNM said that when she used to do homebirths, probably 80% of their transports were for first time moms whose water broke but labor did not start on its own (or with the help that they could provide).

Unfortunately, your sis is probably limited in options based on what the hospital allows - they all have a certain time clock to follow once membranes rupture.

[dules]

This is how DD came. I did have contractions after water broke but they were non-productive for 12 hours (every 2 minutes and hurt like he** though!).

We finally did Pitocin and an epidural, got to 9, swelled back to 8, and DD was born via C 22 1/2 hours after my water broke. ETA they would not let me walk due to liability issues with my water leaking out - they were afraid I'd fall. DD reacted badly to me crouching, squatting or lying on my side so it was all back labor. :(

Congratulations on your new niece/nephew!

Best,
Mary

[papal]

Thanks so much for sharing your birth stories Lori!
I have not received an update from my BIL yet.. they were waiting for their doctor to arrive at the hospital. I hope that everything goes well for her.. I am so scared (i was not scared for me but even though she is older than me, I worry for her!)
I can't believe I am going to be an Auntie soon!! Yay!

[papal]

Thanks for sharing you birth story Mary!! Gosh that sounds like a long labour you had there. It is a good thing we get cute little babies out of all this!!! Mamas rock!

[Wife_and_mommy]

nak
R,

will say a prayer for her.




http://www.gynosaur.com/assets/ribbons/ribbon_gold_12m.gif[/img][/url]

[KrisM]

Mine with DS was similar, but my c/s was at 30 hours and due to a heartrate deceleration issue. My midwife would have let me go longer, if I could have. I got to 4cm on my own and then Pitocin. But, I had no fever and the water was clear.

But, for the water leaking and being slippery, they just gave me one of those huge pads to wear to catch it. No problem there.

Good luck to your sister!

[papal]

Congratulations Kris!!! Welcome baby Lucinda!! :)

[papal]

Update: Still no contractions.. induction has not been started yet but they are not letting her walk because that might accelerate the leakage and cause fetal distress.. ????? urgh. So hard to be so far away.

[m448]

Yikes. Is she striving for an intervention free birth? If so I might consider checking out of the hospital and then doing my own thing (walking, birth ball, etc.). Honestly, even in the hospital they can't NOT let her do anything. ;)

Also here's an excerpt from that very long article:

"The only time a prone position would seem advisable would be if the baby is less than 33 weeks gestation in order to prolong the latent period. In summary, cord prolapse is a serious, life-threatening complication which is most likely to occur with a sudden gush of fluid associated with PROM. HOWEVER, prolapse is extremely rare, and its threat should not be overestimated. Kitzinger says, "A prolapsed cord is very unlikely to occur during a home birth or in any birthplace where invasive procedures are not practiced. It is usually a consequence of intervention, in particular of rupturing the membranes artificially when the presenting part is very high" (140). To prevent a cord prolapse, then, perhaps the best thing a woman can do with PROM is to stay home as long as possible. In the hospital, there looms the much greater threat of a woman being restricted to bed after her water has already broken, since this position is known to contribute to the use of pitocin, fetal distress and unnecessary cesareans. If a woman's water breaks before she gets to the hospital (which is basically the definition of PROM), then the danger would seem to be mostly past, especially if the fetal head is engaged and blocking the cervical opening."

Marielle


Ian - born 10/03
&
Ryan - born 01/06

[papal]

Marielle, I did read that. I am going to ring her and get a feel of what is going on.. I don't want to confuse her further with all this.. the most important thing is that the baby (and mama) are safe.. I don't want my half-baked, half-assed information to affect the birth in a negative way.. ykwim? Anyway.. i will talk to her and ask her about walking around and such.

Thanks mama!

[papal]

Marielle, I did read that. I am going to ring her and get a feel of what is going on.. I don't want to confuse her further with all this.. the most important thing is that the baby (and mama) are safe.. I don't want my half-baked, half-assed information to affect the birth in a negative way.. ykwim? Anyway.. i will talk to her and ask her about walking around and such.

Thanks mama!

[m448]

Sorry, I quoted the article figuring you had other stuff to worry about and not too much time to read at this point.

Definitely good to counsel her over the phone. The next few hours are a crucial turning point in her labor and how it progresses. I asked if she was going for a NCB becaues if she is you can encourage her and help her refocus during this troubling time. If not, then you can lend a sympathetic ear and answer questions as she poses them to you.


Marielle


Ian - born 10/03
&
Ryan - born 01/06

[TaChapm]

No real important info here. I just wanted to say CONGRATULATIONS on becoming an Aunt!!! :)

It is good to see you around!

Tara
Mommy to Jackson 11-10-02
Tyler William 6-9-05
OMG!!! It's a GIRL!! Due September 5, 2006!

http://b4.lilypie.com/gzWfm8.png

http://b1.lilypie.com/kLMem8.png

http://bd.lilypie.com/UEZ3m8.png

[papal]

Thanks Tara! How are you doing???

[TaChapm]

We have been having a rough week to say the least but it could always be worse. In the grand scheme of things we are just happy that Jaci is staying put for now and looking at every day as a bonus. :)


Tara
Mommy to Jackson 11-10-02
Tyler William 6-9-05
OMG!!! It's a GIRL!! Due September 5, 2006!

http://b4.lilypie.com/gzWfm8.png

http://b1.lilypie.com/kLMem8.png

http://bd.lilypie.com/UEZ3m8.png

[papal]

(( Tara )) Sorry about the rough week!! We are not ready to meet you yet Miss Jaci! Stay PUT!!!

[pixelprincess]

A bit late here posting this. My water broke 3 weeks before my scheduled C-section date. It was a similar situation with an all night trickle, no contractions and I spent a night totally worried. I finally got online and realized that I was indeed leaking amniotic fluid (I thought it would be a big gush like the movies). Anyway, we went to the hospital in the am and they did a C-section right away. Good luck to your sis and best wishes for a healthy baby!

[megs4413]

another late post echoing the same situation...
i was 38 weeks and had been dilated to a 2 for a couple weeks when my water broke..mine was sudden gush and then a continuous leak....no contractions to speak of and they got me going on pitocin pretty quickly....i was delivered about 13 hours after the water broke....it was a rough ride but it was a vaginal delivery! What i had hoped for! And technically they call it an "augmentation" when you are ruptured and dilating without contractions when they give you pitocin to bring on contractions and speed up labor.....

[essnce629]

I know this is late and your sister has probably already had her baby but just thought I'd chime in.

All hospitals and care providers have their own protocols that they must follow. Some will only wait 12, 18, or 24 hours after your water has ruptured before using pitocin to get things going. Others will have you come in right away and get hooked up to pitocin (this is called active management of labor). But don't forget, once you are hooked up to pitocin you are considered high risk (pit can affect fetal heart rate by causing extremely long and hard contractions) so you must stay hooked up to the fetal monitor continuousely, which means you won't be able to walk around, and you will have to have an IV.

If you talk to a birthing center or homebirth midwife, however, you may get a whole other set of protocols. Technically, as long as your water is clear, mom doesn't have a fever, mom is group beta strep negative, there's no vaginal exams done (to prevent infection), and baby's heart rate is fine, your water breaking without contractions is not that big of a deal. Most moms will go into labor on their own (with no intervention) within 24 hours of their water breaking. I've heard of homebirth midwives letting moms go 72 hours or more with ruptured membranes as long as everything I mentioned above is followed (no vag exams being #1). And as long as mom is drinking fluids, her body will continue to make amniotic fluid. There is no such thing as a "dry birth." Here's more info on that:
http://parenting.ivillage.com/pregnancy/plabor/0,,midwife_3q15,00.html

However, in hospital births, they are more worried about infection and should be. Hospitals are breeding grounds for all types of bacteria and with multiple vag exams it's easy to introduce bacteria into the vagina which can lead to an infection. Prolonged rupture of membranes isn't a problem on it's own. But when you add multiple vag exams to the equation it's only a matter of time before infection sets in-- thus the time limit in hospitals before pitocin is started. At a homebirth in which prolonged rupture of membranes have occured, midwives will often have the mom take extra vitamin C, echinacea, and/or goldenseal in order to prevent infection. And unlike hospital births, homebirth midwives have no problem letting moms with ruptured membranes get in a birthing tub. All studies have shown that water does not go up into the vagina naturally-- it must be forced up (as in douching). If prolonged rupture of membranes start to become a problem (or if mom is just tired of waiting) most homebirth midwives will suggest measures such as castor oil, walking, acupuncture, nipple stimulation, and/or certain herbs (blue and black cohosh are the most common).

If I was having a hospital birth and my water broke without contractions, I'd wait 24 hours before going to the hospital. And I wouldn't call the hospital during that waiting period because they would just want to have me come in right away to "monitor" me (which would probably include a vag exam) and/or "get things started" (with pitocin). I'd take extra vitamin C, echinacea, and goldenseal, and take my temperature every couple of hours to make sure it was normal. During those 24 hours of waiting I'd walk my *ss off and later do my whole castor oil/nipple stimulation regimen if contractions hadn't started on their own. Then I'd call the acupuncturist. I'm sure things would get started by then and I'd head over to the hospital once I was in active labor (contractions 2-3 minutes apart for at least one hour). :) If all my natural techniques DIDN'T work for whatever reason, then I'd head over to the hospital after the 24+ hours and start on a low dose of pitocin (which I'd have turned off as soon as contractions got regular). Pitocin is a very strong drug and I'd try to avoid at all costs, BUT if it did become necessary at that point I'd take it in order to try and avoid a c-section.

***Latia
Birth and Postpartum Doula

Conner 8/19/03 (homebirthed water baby)
http://www.babiesonline.com/babies/a/aug2003angel
http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Self-weaned at 24 months!

[Globetrotter]

Something similar happened to me, resulting in a series of events that lead to a c/s. Pitocin induction on someone who isn't ready to labor isn't as effective as an augmentation (to push things along in someone who IS ready). Tell her not to labor in bed/on her back, even with those darned monitors. I wasn't assertive enough about it, and I also got several unneeded vaginal exams, which is quite idiotic considering they were so afraid of infection! My midwife said I could have gone longer, but the obs were pushing for a c/s at 36 hours, and I was too stressed to argue. I was also 38.5 weeks and strongly suspect that dd just wasn't ready to be born!! We had just moved into a house, and I think that had something to do with the PROM. Who knows?

I know it's hard to have control in India (I'm assuming she's there?). I hope mom and baby are well and you'll have some good news for us soon!!

Kris

[papal]

Thanks everyone for sharing your stories and perspectives (Kris, she is in NYC). Baby boy was born this morning at 5.00am. I don't know all the details and am waiting to hear more from my BIL. Hopefully the pitocin really kicked in and it was a short labour.. I won't stop worrying till I hear more!

[aliceinwonderland]

New auntie Rashmi!! Hope everyone is feeling great :)

[megs4413]

congrats on becoming an aunt!

[Momof3Labs]

Congratulations, Auntie Rashmi!! Now we can introduce you to the world of not-so-cute (and some very cute) boy clothes!!

[papal]

Thanks guys!!!
Apparently the pitocin really got things going super fast and the baby was born vaginally after a few hours of labour!
I am finally breathing easy, hearing my sister is doing well also!!
Yay!! Party On!

[JElaineB]

Yea, congrats on being an Auntie, Rashmi!

Jennifer
mom to Jacob 9/27/02

[Momof3Labs]

Oh, good! So her body was pretty close to ready; that's good.

Party on? Shop on!

[Globetrotter]

I'm thrilled to hear that it worked for her!!!
Congratulations :)

Kris

[kfcboston]

Yay!! Congratulations to all! Bring on the blue! ;)

[pb&j]

Wonderful! Congratulations!

-Ry,
mom to Emma, stillborn 11/04/04
and Max, 01/05/06

http://www.windsorpeak.com/dc/user_files/32812.gif
http://b1.lilypie.com/aKGqm5/.png[/img] ([img)

[laurena]

I had wanted to tell you earlier that I this happened to me with both DCs and both were born vaginally without any complications after only a few hours. But, I was too late (the adjustment to 2 kids is still a work in progress) and you already have your good news to stop your worrying.

Congratulations to you and your sister.

Lauren
DD 04/04
DS 05/06

[hez]

Congratulations to your sister! I'm so happy to hear good news :)

[brittone2]

Congrats Rashmi!

I'm so glad things went okay for her and her little one!!!

[Corie]

Congratulations!! :)

[essnce629]

Congrats on becoming an auntie!

***Latia
Birth and Postpartum Doula

Conner 8/19/03 (homebirthed water baby)
http://www.babiesonline.com/babies/a/aug2003angel
http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Self-weaned at 24 months!