The amniotic sac (bag of waters) is what keeps your baby thriving safe inside of your womb along side your Placenta
A trickle or gush is known as the waters leaking or breaking.
Premature rupture of membranes (PROM) is a rupture (breaking open) of the membranes (amniotic sac) before labor begins. If PROM occurs before 37 weeks of pregnancy, it is called preterm premature rupture of membranes (PPROM).
This is NOT an immediate need for emergency assistance, just like active contractions are not an immediate need for emergency assitance- this can be a variation of normal.
All pregnancies and births are unique and should be supported/respected with equal competent full spectrum care & evidence based autonomous options.
PROM occurs in about 8 to 10 percent of all pregnancies. PPROM (before 37 weeks) accounts for one fourth to one third of all preterm births.
How long a baby can thrive once your water breaks depends on a number of factors:
• In cases where your baby would be premature, they may survive just fine for weeks with proper monitoring and treatment, usually in a hospital setting.
• In cases where your baby is at least 37 weeks, current research suggests that it may be safe to wait 48 hours (and sometimes longer) for labor to start on its own. (But your caregiver may have a different protocol, like 24 hours.)
Evidence based Study:
"Fetal and/or maternal morbidity in PROM women may not increase if there is a strict analysis of maternal and or fetal risk factors added to a careful clinical management. Moreover, it may be useful to wait for spontaneous labor in order to enhance the patient's chance of vaginal delivery."
Source:
What should you do if this happens in your labor experience?
Take a deep breath and RELAX, jot down the time your water releases and monitor/support your body for the next 24-72hrs while collaborating a competent plan with your provider.
If you notify your provider right away you will be put on their clock determining the management of care you receive, in some cases this may remove options and body automony.
You have plenty of time and lots of options: in most low risk healthy pregnancies you do NOT need to be induced right away as tho it is an emergency.
Your body is wise and babies soul has a plan.
You do not generally risk onset infection with your waters broken like this, many endure broken waters for days at a time before baby arrives.
It is a sacred part of the process.
Though the standard care system encourages women be on antibiotics and induced at the 24hr mark in many facilities- research shows based on global experience, pre-rupture membranes are a variation of normal that should not pose immediate assistance.
Many women are often sent home with specific instructions.
You could risk infection if you are inserting foreign objects/cervical checks introducing bacteria or ignoring warning signs your body gives- listen to your body and use competent collaborative care with your team.
Once water breaks Before contractions begin
-Check your temp every 1-2hrs.
-Check babies heartrate every 1-2hrs.
-Check your pad when you go to the bathroom or feel a gush to monitor color/smell.
-Check maternal heartrate/blood pressure every 4-8hrs
-Take Vitamin C
Keep a pad on to monitor for stained waters, do not insert anything vaginally.
COLORS TO WATCH FOR:
Normal
-Clear, bloody, light yellow tinged
Potential stained waters to keep a close eye on incase of infection or meconium:
-dark tinged yellow, Dark brown, light or dark green, mixed brown/red/green.
Potential smells that pose concern of infection of stained meconium waters:
-Fowl
-Infectious
-intuitively concerning
Your bag of waters continues to replenish, your baby has plenty of amniotic fluid- continue to drink water + electrolytes to support your body.
Reasons contractions may not have begun & your waters are trickling or gushing:
•Natural or western induction methods especially in first time pregnancy may cause pre-ruptured membranes-Such as evening primrose oil, castor oil, membrane sweep.
•Fetal malpositioning
•Variation of normal
•Intervention interference with the physiological hormonal process.
Herbs that you can take to encourage favorable labor:
Organic Black Cohosh, Blue Cohosh, Lobelia and Ginger Root
Homeopathics you can take:
Caulophyllum 30c x 1 daily until labour starts. This remedy ripens the cervix.
If you are overdue and feel that labour is delayed due to fear or anxiety consider a single dose of the following remedies:
Aconite 200c – marked fear, including fear of dying during labour.
Gelsemium 200c – It is almost as if the woman is holding back the process with her emotional state of anxiety about how she will manage ie. Waters may have broken and then labour may have started but then stopped.
Techniques you can do:
Support fetal position because THIS is what makes the cervix dilate and supports beneficial contractions:
-Prenatal massage
-Chiro adjustment
-Acupuncture
-Flotation therapy in water
-Yoga hammock hanging
-Nipple/clitoral stimulation
-Relaxxxxxx
-Hydrate, Nourish and get Ready
Avoid:
-Intercourse
-Continuous cervical checks
-Panicking and inducing stress
Professional Recommendations & Guidelines
In 2016, ACOG changed its recommendation again. Although they still recommended induction of labor at term for people who experience PROM (Level B evidence), they also state “However, a course of expectant management may be acceptable for a patient who declines induction… as long as clinical and fetal conditions are reassuring and she is adequately counseled regarding the risks of prolonged PROM.”
The American College of Nurse Midwives (ACNM 2012) states that women with term PROM should be informed about the risks and benefits of expectant management versus induction, and that if women meet certain criteria, they should be supported in choosing expectant management as a safe option. These criteria for safe expectant management include:
-Term, uncomplicated, singleton pregnancy
-Clear amniotic fluid
-No infections, including GBS
-No fever
-Normal fetal heart rate
-No vaginal exam at baseline; keep vaginal exams to a minimum
The NICE guidelines from the United Kingdom state that women should be offered a choice between induction or expectant management, and that induction is appropriate at 24 after water breaks.
Pre-enroll to The Wombsister Childbirth Ed Masterclass Online now to prepare for your labor, birth and postpartum.