Waters broke 24 hours ago, no contractions and don't want to be induced

[Blissfulignorance]

Has anyone experienced their waters breaking and going into labour naturally after 24 hours?

I'm a planned home birth and everything is going well so far in terms of movements, temperature and clear waters. This is my 2nd and I want to avoid induction as I had an awful time with my first.

Looking for some other experiences to help me keep positive that I can have an uninterrupted birth?

Have you contacted triage? What did they say? What do you want happen (because of the ROM)? When do you want it to happen?

I'm sorry but you really need to contact your maternity unit or go in - waters breaking leaves you at high risk of infection (it happened to me, we got sepsis)

Hi there,

My waters broke at 38 weeks and they let me wait 24 hours for labour to start naturally.....it didn't....so I had to be induced because of infection! How far gone are you? Good luck x

This was me. I had water births previously, so I was unable to do that, but I did manage to avoid an induction. I was in the hospital for monitoring though (which I would strongly advise you to do).

The labour was very straightforward.

But please do get yourself to hospital for monitoring.

(Sorry I should say, I went over 24 hours, but I had no vaginal examinations so my infection risk was lowered. I did have to transfer to consultant led (which in practice really made no difference), but my consultant was fully supportive of my choice.)

I walked and walked, bounced on the ball, and watched some Peter Kay to get the endorphins going.

For what it's worth OP, while it wasn't the birth I wanted, my second induction was way easier than the first one

This happened to me, I really didn't want an induction, but I wanted an infection less. I had a leak, so they induced me by popping my waters 24 hours later and DD was born an hour and a half later, just gas and air, no complications. Inductions are not always awful! Good luck.

I’d really phone to go in if still nothing is happening.

This happened with my first. Waters broke, only the odd irregular contraction followed, and after nearly 48 hours of stop start labour, I was finally induced via drip but ended up with an Emcs. My baby spent a week in special care due to infection from having no waters around her for more than 24 hours.

I had this and it was fine. They won’t do all the slow stuff like pessaries, it’s straight to the drip. 5hours from drip to baby

You need to contact triage ASAP

I know you don’t want inducing but sometimes it has to happen. A friend of mine had a child born with cerebral palsy because the midwife unit refused to induce her until it was too late.

Yes me, I laboured naturally two days later. We both needed antibiotics, I was very poorly. You need to speak to your maternity unit.

You need to speak to triage. It's not worth risking infections.

Can you speak to your homebirth team @Blissfulignorance? They will be realistic but also know if there is any way to still have a safe home birth.

The risk of infection is very real. It may not be the labour that you want but please go to the hospital so you can have the outcome that you want. Go in and take the medical advice

My waters broke and labour didn't start until 36 hours later.

Both me and my daughter developed sepsis.

I'm furious that the hospital left me waiting for so longer. I certainly wouldn't choose to wait with the risks involved.

@kitkatsky

For what it's worth OP, while it wasn't the birth I wanted, my second induction was way easier than the first one

This ..

My first was a cocktail of drug and drug and a long old slog

Second induction was perfect and no stitches required

I never went into labour with my first, my waters leaked for over a week whilst I was being induced... ended up having a c section.

Baby was very closely monitored and I was given antibiotics too. I really recommend you call maternity, you'd feel awful if something happened to baby. You could always request a section instead of being induced.

Yes my DS, both her and DN developed sepsis and DN had a stay in NICU. I’d ring the labour ward if I was in your position ASAP

My waters broke and labour didn't start. I was given pre-emptive antibiotics but then threw a temperature and nded up with a bad infection that developed into sepsis. I'd follow medical advice on this one, even if it means you don't get the home birth you want.

@Blissfulignorance you ask for help having positive thoughts…but you need realistic thoughts. Your waters broke 24 hours ago, there is a risk of infection to the baby. What’s the point of getting your planned home birth if at the end of it your baby is very ill? Sorry to be blunt, but you need to go to hospital.

You don't have to do anything, but it would be very much worth having a conversation about the risks.

Some providers are happy to let you go up to 48 hours after waters breaking naturally. Or you might talk to them and make a decision yourself to be happy with 36 hours as a compromise or something like that.

OTOH there are aspects of home birth you can do in hospital. I transferred in from my planned home birth with my first and I was very happy with the hospital birth that I had. Spent a lot of time in the pool (didn't deliver in there). I found that the staff treated me very kindly and were pretty hands off because I'd originally planned a home birth.

It might not be that induction is necessary. And you can make your wishes heard and known. But I would definitely talk it through with someone, whether it's a community midwife you call out or phone triage or go in to discuss options.

The NICE guidelines state:

1.2.3 Prelabour rupture of membranes at term
1.2.3.1Women with prelabour rupture of membranes at term (at or over 37 weeks) should be offered a choice of induction of labour with vaginal PGE2[3] or expectant management.

According to the Homebirth reference page, the guidance pre-2008 was that up to 96 hours with rupture of membranes was appropriate, it was changed in 2008 to state that induction should be offered (not recommended) after 24 hours.

This is the more detailed NICE guidance:

1.11 Prelabour rupture of membranes at term
1.11.1 Do not carry out a speculum examination if it is certain that the membranes have ruptured. [2007]

1.11.2 If it is uncertain whether prelabour rupture of the membranes has occurred, offer the woman a speculum examination to determine whether the membranes have ruptured. Avoid digital vaginal examination in the absence of contractions. [2007]

1.11.3 Advise women presenting with prelabour rupture of the membranes at term that:

the risk of serious neonatal infection is 1%, rather than 0.5% for women with intact membranes

60% of women with prelabour rupture of the membranes will go into labour within 24 hours

induction of labour[4] is appropriate approximately 24 hours after rupture of the membranes. [2007]

1.11.4 Until the induction is started or if expectant management beyond 24 hours is chosen by the woman:

do not offer lower vaginal swabs and measurement of maternal C‑reactive protein

to detect any infection that may be developing, advise the woman to record her temperature every 4 hours during waking hours and to report immediately any change in the colour or smell of her vaginal loss

inform the woman that bathing or showering is not associated with an increase in infection, but that having sexual intercourse may be. [2007]

1.11.5 Assess fetal movement and heart rate at initial contact and then every 24 hours after rupture of the membranes while the woman is not in labour, and advise the woman to report immediately any decrease in fetal movements. [2007]

1.11.6 If labour has not started 24 hours after rupture of the membranes, advise the woman to give birth where there is access to neonatal services and to stay in hospital for at least 12 hours after the birth. [2007]

Sorry meant to add - the homebirth reference page is quite out of date now, so I am not sure whether anything has changed since 2008. But with all the references in that guidance to a 2007 study, I am guessing that it has not changed.

I was left for just over 24 hours and both me and baby got sepsis.

Yes, also got sepsis and baby was unwell for 10 days too..