Water breaks before labor - risk of infection... what infection?

[Nikki_d72]

you would have a fever before any infection got too far off. so if your checking your temp every 4 hours you would have a heads up before it got bad.and the answer to your question, if your keeping everything out of there, including sterlie gloves, the risk of infection is verrrry low.
the USA is highly medicalized. they are more concerned w liability. im not saying infections dont happen, but they certainly do not occur at the rate the US OBs lead you to believe.

While I agree with most of what you are saying, this isn't strictly true. When I was in hospital after premature rupture of membranes with my twins, my temp was being checked 2-3 times a day as they were concerned about infection due to the prolonged rupture. In the end I did develop chorioamnionitis (the fancy medical term for infection of the membranes) so my body went into labour to rid itself of the infection but I still showed no elevated temperature and only a very slight elevation on my White cell count (which usually happens in labour anyway) - they said it was a subclinical infection, so basically an infection with no fever or other signs in me.

Hystology showed Strep B all through the placenta as well as the membranes, so infection was most definitely well underway in my case. If it had developed into sepsis I could have lost my uterus or even my life, they made this very clear, which is why they wouldn't attempt to halt labour.

Obviously this was preterm so things may be a little different at term and it was 6 days after rupture but the fact remains that monitoring for fever is not that reliable an indicator for infection. I had one sterile speculum exam on admission and that was all. I drank gallons of water every day and took high doses of vitamin C to try to mitigate against infection and was also on oral antibiotics so my risks were kept to a minimum. My Obstetrician told me "it's not a case of if infection will set in, but when. I know in the case preterm rupture of membranes, many OB's and hospital's policy will be immediate induction, the fear of sepsis is so great so my Ob was pretty grounded and evidence-based, he also gave me a copy of the peer-reviewed evidence they were making their decisions based on, so he was not at all medically heavy-handed or driven by fear of litigation, thus I trust the information I was given.

In a fullterm baby the risk is primarily to the baby first but also the mother and although it is small, it is there and if you are that one in so many hundred, it doesn't feel any better, believe me.

I do agree that a lot of intervention is driven by fear of litigation though and your choices should always be explained to you properly - the chioce has to be the woman's and you do have the right to question and refuse anything. The other option than early induction can be IV antibiotics in labour, so that may be a better option for some than early induction, if you choose to wait and see. I know a lot of US hospitals can get a bit heavy-handed if you refuse induction for early release of membranes and may try to "threaten" you with taking the baby into Nicu and such if you refuse - I would read up on your rights prior to going in but in the end of the day it may not happen anyway - membranes usually only release prior to onset of labour in about 25% of labours, despite the images in the movies...

Good luck all, I hope it doesn't even become an issue for you, or me, I'm 36+3 at the moment and hoping my membranes stay intact well into labour this time, they released prior to labour with my DD as well which led to lots of intervention in hospital instead of a possibly calm birth-centre birth but I'm a lot more educated now and have an independant MW who will be with me this time to hopefully keep the interveners at bay lol. Having said that, as long as he's alive an healthy I'll be happy, but I still would like as gentle an entrance to the world for him as I can get. xx

 

[justhoping]

My waters broke at home and then they kept me in hospital. I had a speculum exam to confirm when i went in. I had a pessary and a sweep 36 hours later (hospital was too busy to induce before and then i was induced 2 and a half days after my water went! I was only checked twice during labour and my temp had started to rise towards the end but i had been left a long time but there was no effect on baby whatsoever. She was born 3 days after my waters broke!

I did develop an infection 12days pp but that was due to retained uterine products and nothing to do with how long my waters were broke for x

one infection started during labor and my temp did not rise and they broke my water so i wasnt exposed long

personally i think if it can help protect you and the baby then try and do it....btw that is just mho....

i understand the people who are put off by it though

 

[DittyByrd]

My water broke before labor began as well. They checked me a minimum number of times they had to to see how I was progressing. I was induced and ended up on IV antibiotics as a preventative. My membranes were ruptured for 52 hours prior to a vaginal delivery so the 24 hr timeline is not necessarily something every hospital adheres to - I was at a BIG NAME hospital in the USA. The docs told me as long as my water was clear and I had no fever and continued to progress they'd stay the course. And we did!

I don't think the concern is so much the natural bacteria of the vagina but more ascending bacteria from the outside (Staph, etc) that can be introduced via introduction of foreign objects/fingers/penises. Once the protection of the amniotic sac is removed, baby and uterus are now exposed to these pathogens. In non-pregnancy, the cervix is closed and protects the uterus from infection.

 

[Bay]

With my first, i started leaking amniotic fluid at the start of 36 week. It was confirmed in hospital and they only inserted a speculum (no further internals) to see the position ofmy cervix. I was told that elevated body temperature means infection has already occurred and it could be too late. I was under alot of pressure by hospital staff to induce and fed horror stories every day i went in for fetal monitoring. I held out for a week and went into labour naturally right on week 37, and my baby boy was clear of infection and so was i.

I'm not advicating for or against induction, but in this particular instance it was the right choice for us to not go with induction. to be honest if i went through it all with another pregnancy i'm not sure what i would do.