Planned homebirth - waters broken what happens with antibiotics?

[anchovies]

My sisters waters broke (gushed) last night at 2am and she is booked for a homebirth. She started having irregular contractions this morning so I would assume she's got a way to go? Apparently they want her to go in this evening at 9pm to start IV antibiotics, is that it for the homebirth then? Induction booked for the 25th but it doesn't look like she will need it. They have given her a leaflet on choosing when to start the antibiotics and the risks but it is a info sheet for doctors so not very clear. She is monitoring her temperature. If anyone can advise that would be great!

Anyone? She is worried sick as has a massive hospital phobia!

different hospitals have different protocols about how long to wait after waters have broken.

The antibiotics are because there is a risk of infection. So your sister needs to keep an eye on her temperature. She has the choice of whether or not to have the antibiotics, but she would be wise to monitor her temperature.

If contractions have started then it should be okay. Hopefully the contractions will have picked up nicely and she remains on course for her homebirth.

Thanks so much for the reply, so you would think if everything carries on today, her temp stays ok and she has progressed well by this evening that she could stay at home?

Oh and do you know if 18 hrs before antibiotics is on the high or low side time-wise?

That's a decision that she would have to make.

She should talk to her caregiver/community mw.

I'm trying to look up some info for you as it's all about informed choice.

But if she's contracting then she should let her mw know and it should all be fine.

I am googling frantically and can only find info on PROM and induction, have hardly found anything on antibiotics. MW is insisting hospital at 18 hrs. Thanks again!

You can try the WHO guidelines.

i don't know about guidelines, but my friend's waters broke on monday morning, she still had a home birth, her baby boy was born at 6pm last night, 40 hours after her waters broke. so it is possible!

She needs to do everything possible to get her labour started properly - walking round fondling my nipples did it for me!

I had a homebirth and loved it but if she needs IV antibiotics then she will need to be in hospital - it isn't worth the risk of anything going wrong.

With dd1 my waters broke on the sunday eve and I didn't give birth until the early hours of Tuesdayu morning without any need for IV's.

Most hospitals will want to give IVABs in labour if waters have been broken for more than 24 hours.

Nice guidelines basically recommend waiting for up to 96 hours, if no labour then IOL plus IVABS.

As MarsLady says, keep checking temp 4-6 hourly (anything over 37.5 she should phone her m/w for advice), if liquor is clear, baby moving, no pv bleeding except show, she should be ok to have expectant management. If they wont give IVABs at home, then your sister has the choice of going in to hospital for IOL / IVABs or having a hb with none. If no temp and no history of GBS, the chance of having an infection is really quite small.

Keep the nipple stim going, walk about and it sounds like labour might be starting anyway, so hopefully she will get going herself. I suggest no baths until in good labour and no sex, as anything going into the vagina can increase the infection risk, showers ok though.

anchovies - Get your sister to insist on a home birth and have injections of antibiotics at home. I did it!!! She will have to have a 10ml injection about every 2 hours which is a BIG injection but isn't too bad, you have to get them done between contractions! I guess I had about 8 of them during my labour and after each one you just sink back into the pool and the stinging stops.

A doctor had to give the prescription and the liquid to the midwife but the midwife was fine giving it. If you need any more info I am happy to help.

i was just about to give the NICE guidlines, but mintpurple already has she should quite those to the hospital if they try and make her go in before then.

all the other advice that mint has given is spot on, good luck to your sister xxxxxx

see that mintpurple and mars have said it already ! all the best to your sister, anchovies, and i hope she has a great homebirth!