Going to hospital as soon as waters break??

[maveta]

I´m in Spain and have been told that protocol here is that you must go to the hospital as soon as your waters break and they then keep you in until you have the baby. I am a bit worried about this in case I don´t start to labour naturally and they start to pressure me for induction within a relatively short time frame. (yes this is my first baby, can you tell?!)
What do you reckon? DO I have to go in straight away or could I wait a bit longer?

[Frascati]

I think the reason being is that you need to be monitored. More prone to infections once waters have broken.

[MKG]

I would wait it out a little bit. If they give you a hard time say it may have happened in the shower and you didn't notice or something like that.

[MKG]

That being said I wouldn't wait a day or so, but a few hours to see if you get started on your own wouldn't hurt anything.

[nuttygirl]

Hey Maveta! Can you find some information on here (or elsewhere on the web) about what the risks are and print it out so that if they start to pressure you, you're armed with some stats to help argue your side of things?

[fannyannie]

NICE (National Institute for Clinical Excellence) says that you can have up to 96hrs before induction, there's no evidence that the risk of infection is any greater at home than in hospital.

With DS1 (here in the UK) my waters broke and they kept me in and were going to induce 24hrs later (ended up with a CS - but that's another thread lol)

DS2 my waters broken Sunday morning, I went to hospital briefly in the afternoon and they let me go home until the Wednesday - when I was induced.

If the same happens again (spontaneou rupture of waters) I intend to make sure I get the full 96hrs - and that I spend it at home.

[maveta]

Frascati, yes that´s what they say but seeing as I know in the UK they don´t necessarily make you go in, and stay in, I just wanted to know what the reasoning might be.

MKG - well that´s what I thought too.. I could always say I never noticed or something, they´re hardly going to be able to call me a liar and anyway - think I might be beyond caring if they did!

Nutty - good idea, I think that would help dh aswell cos it´s most likely going to be him freaking out and making me go in earlier than I want.

Fannyannie - yeah, I don´t know if being my first I´d be brave enough to wait so so long but even waiting a few hours more at home would be better than all that extra time in hospital...

[Olihan]

My friend's waters went and they gave her 96 hours but she had to take her temperature every 4 hours after the first 24 hours. If it started to go up then she was told to go in to hospital as it was an early sign of infection. It didn't and I think she started contractions after about 36 hours. Someone on here may know the ins and outs of monitoring your temperature.

It may not happen though, my waters were broken at 9cm in my first 2 labours and broke naturally 13 mins before I delivered in my 3rd. So don't worry unduly .

[maveta]

Thanks Olihan - not panicking (yet), I know it might not even happen spontaneously but thought I´d better check now instead of trying to log on to MN for advice while dh is pulling me down the stairs and into the car!!

[Cocobear]

Also of course make sure the waters aren't green and there's no blood. If all looks perfectly normal (clear or pinkish), and you're not having regular, painful contractions, there's really no need to rush to hospital. You might still get a good night's sleep (or even two) at home before labour really kicks in. I did!

[JimJammum]

My waters broke at 8am and about 2pm my dh called the hospital as I was not having any contractions. They asked me to go in to be monitored to check baby OK, and then sent me home with some anti-biotics. I think I could have had these for 48 hours before further action taken. As it was, contractions kicked in, and after 2 and half hours at home I was back in hospital and pushing!!

As far as I know, they don't induce you unless it has been a long time since waters broke - it' all about possible infections.

[Klaw]

I hope that Babedia sees this thread as she's Spanish and might have some insight into the protocols. I'll email her and ask her to reply to you.

[thirtysomething]

I don't get this whole risk of infection thing - my hind waters broke with DD (2nd labour) - and I was told to get to the hospital within an hour. Once there I knew I was in labour (feckin strong contractions) they said I wasn't, told me to have a bath in their not particularly clean hospital ward bathroom, and then finally accepted baby's arrivla was imminent. I questioned the bath as I thought it would increase the chances of infection and was told not to worry!

[fishie]

i had similar experience to fannieannie. i believe that up and down the stairs sideways is the way to get things going, but i was so clueless i lazed around leaking gently, inactivity not best idea.

are you spanish? are you worried about the birth generally? sounds as though you could do with some reassurance and advice from someone who knows how things happen there, cooee spanish people....?

[BetsyBoop]

Has the head engaged fully in the pelvis? With my first the head hadn't engaged & my m/w told me to go straight to hospital to be checked out if my waters went as there was a risk of cord prolapse (cord coming out into vagina once cervix started to dilate) as the head wasn't "in the way" to stop it.

They would have sent me home again after shecking me over if my BP hadn't have rocketed & DD's trace not fantastic, but that's a whole new thread.....

[babedia]

Hi Maveta, I'm Spanish and had my second baby there. I'm now back in the UK. The protocols are different in different hospitals, like in the UK. In most of them they'll give you 12-24 hours to go into labour otherwise they'll induce you. My waters started leaking at 7pm one evening and I eventually got to the hospital at 2pm the next day. I was told off like a 3 year old for not going straight away (I was actually trying to have a homebirth, but I didn't tell them that ). Having read the NICE guidelines here in the UK, I'd stay at home checking my temperature every 4 hours. I think I read somewhere that 60% of women will go into labour within 24 hours of their waters breaking and 95% within 72 hours. The best way to avoid infection is by staying at home, not having baths (have showers instead), not having sex and avoiding internals. I can guarantee that you'll be given an internal as soon as you set foot in a Spanish hospital, so I'd say, please please please try and wait at home as long as you can. Make a nice 'nest' in some dark corner in your house, listen to some relaxing music, dim the lights, and have nice positive birthing thoughts. I know this sounds a bit hippy, but it's worth a shot! Best of luck. Which hospital are you going to, by the way?

Also, even if your waters hadn't broken, I'd really recommend staying at home as long as possible when you're in labour. As soon as you go into the hospital they'll make you lie down flat on your back with a monitor, they won't allow you to drink or eat, etc - you're better off in your own home, moving in any way your body asks you to, eating or going to the loo, or having a nice hot shower to help with the pain, then go in at the last minute. If this is your first labour it's likely to be long (sorry!). And once you get to hospital, please don't let them bully you! Ask what they're doing at each stage and don't hesitate to say a big fat NO if you're not happy with it. Let us know how you get on.

[babedia]

Some more info about the protocols here . And also different statistics from the ones I posted about what percentage of women will go into labour within a given time (sorry I got them wrong):
86% of women will labour within 12-23 hours
91% will labour within 24-47 hours
94% will labour within 48-95 hours
6% of women will not be in spontaneous labour within 96 hours of PROM.

[maveta]

Thanks for all the advice.. thanks Klaw for pointing babedia this way in particular..fishie, I´m not spanish but dh is which makes for something of a culture clash at times when I am arguing points based on UK friends´ experiences/ MN experiences and he is coming from his own family´s POV. I was very worried and scared about the apparent differences in care when I was about 4 months pregnant and since then have kind of realised I am going to have to chill out or it will just make it a more stressful experience for me.

Babedia - thanks so much for your post, it is reassuring to speak to someone who has been through the system here and understands just how bossy and bullying the medical people can be here. I have just read your post to dh and I said "see! and she´s spanish!" I am in Mallorca and will be going to Son Llatzer which is a pretty new hospital and has a good reputation as one of the more ´humanitarian´ ones but I am worried about excessive internals/ monitoring etc. Luckily dh is 100% on my side (as long as HE doesn´t give in to the bullying!) and we´ve done a birth plan together so even though they might not look at it, WE know what we want and he will help me try to get it esp. re. moving around, eating, drinking etc.
Thanks

[chicca]

Hi there. I am in Spain too and managed to have a home birth. Sadly had to go to hospital afterwards as placenta refused to budge. Rather like babedia's experience both the ambulance guys and the doctors were disapproving to say the least and DH was kept well away. However I understand things are improving so good luck. They are still keen to keep you in one place though once you are admitted. But what can they do to stop you moving around? You sound like you are really well-informed and knowledge is power so I'm sure it will go well.

[maveta]

Thanks Chicca - dh wouldn´t even HEAR of a homebirth, it´s still a pretty freaky thing to do out here.. I am very much going with the ´how can they stop me´ train of thought, hope it works!!

[babedia]

maveta, you go girl! Just pretend you don't understand a word if they tell you to do something you don't want to. They're not going to manhandle you onto a bed, are they?

Chicca, congratulations on managing a homebirth in Spain I tried, but the only midwife I could find who was willing to do it gave up on me after 12 hours of contractions and no progress. I was trying for a homebirth after CS, so she was a bit nervous. So I ended up with another CS (sob). I was really worried about how I'd be treated in hospital and I have to say the care afterwards was fantastic and I needn't have worried about all the horror stories of them taking your baby away for hours afterwards, etc.

Maveta, put your foot down. I hate confrontation and I agreed to everything like a good girl. Just think they'll forget about you the minute you leave the hospital while you'll remember the birth forever. I really resent now all the unpleasant internals and regret not daring say no at the time.

[babedia]

Morning Maveta. I suddenly felt guilty this morning that I was sounding so negative about Spanish hospitals, when what you need now is to feel as positive and calm as possible. Just to give you a different story - my sister's waters went completely at 35 weeks and she just rushed to hospital immediately (also in Spain). They induced her as soon as she got there, got an epidural, fell asleep and woke up feeling like she needed to push. My nephew came out in one push and she almost didn't notice. And that was her first labour too. I would still wait for labour to kick off naturally if I were you, but I just wanted to give you a positive story.

[maveta]

Oh no, not at all! You´ve not said anything worse than I have heard already! I am being calm about it but it´s good to be prepared and know what things I can argue and which I can´t.. your advice has been really appreciated