In most cases, water breaking is associated with labour. However, there are rare times too where the water can break before labour begins. This scenario is called premature or pre-labour rupture of membranes or PROM which actually happens one out of five pregnancies according to statistics. Aside from this, when the water breaks before 37 weeks of pregnancy, it is then called preterm premature rupture of membranes or PPROM.
When the water breaks before the contractions begin, there are few choices on what to do basing on other symptoms felt and the medical history of the patient and these are offered by the doctor assigned or the midwife. With their advice, one can then decide on what is best for their upcoming labour. As said, options vary from patient to patient with accordance to their medical records thus some options maybe not safe for everyone. Another discussion that patients may have with their doctors is if they wanted to have the child birth at home with the doctor, of course, or wanting it to do in a hospital.
As your water breaks before the contraction, waiting for a while and assuming that the mother, as well as the baby, is doing well might be the appropriate thing to do. Since this might be for a few hours, the patient must be mindful of the things they will do. First is no bathing, no sex, and there should be nothing that goes into the vagina. With regards to medication, antibiotics are not recommended for patients who are experiencing PROM most especially if there is no infection to the patient, antibiotics will have no benefits in using them and there are also potential risks that may arise in the use of these medicines. So if the water broke but without contractions, it is best to stay home if there are no infections such as having a fever, absence of foul odour, and the fluid discharged is not discoloured.
The patient’s contractions should start within 24 hours after the water has broken but there are rare chances too where the contractions will start after 48 hours. Thus introducing a way to start the labour will be advised by a doctor after this period. However, if the patient is tested positive for Group B Streptococcus or GBS during pregnancy, induction will be offered as soon as possible as well as the intravenous antibiotics. The antibiotic will help the baby to be protected against possible contraction a GBS infection since this infection is rare for newborns but harmful if it happens.
The choice whether to perform an induction or not depends on the patient and if one refuses to have induced, there are things that she must do. First is to have the baby’s heart rate as well as its movements checked by a doctor for every 24 hours until labour, or when induction has been decided. Aside from the heart rate and movements, the temperature should be checked every four hours. Next is check or monitor if there is any change in the colour and smell of the amniotic fluid or waters.
Though the option of not getting induced even after 48 hours is presented, there are risks corresponding to not doing so. When it is over 48 hours after the water has broken and labour hasn’t started yet, induction should be preferred largely, since the main risk of this is that infection could be self developed once the waters have broken. With this infection, there will be then an increased risk of infection in the baby even with a very minute chance. If not induced, the baby may need to spend time in a special care unit as soon as he or she is born. This may be not a guaranteed risk on the baby, but still, the life of the little one should never be compromised.
Being induced after the water has broken won’t necessarily increase the risk of a caesarean operation but there could be chances of doing the procedure too. However, most studies showed that the rate of women underwent caesarean is large compared to those who have waited for labour after the breaking of their waters. With this, the risk of infection to arise will be weighed in accordance with the likelihood of going into labour naturally. Thus, a discussion between the doctor and the patient is always a must do.