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24 hour limit on labor after water breaks


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  #1  
May 18th, 2010, 03:29 PM
Jule'sMomInOR's Avatar Mega Super Mommy
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I had lunch with someone today who wanted, and had, a natural childbirth about a year ago. She seems to have done a lot of research and was very educated on the subject before her birth, and we're on the same page about a lot of things. However, she told me about her friend, who also wanted a natural birth but her water broke before she started having contractions. 18 hours later, her friend wasn't having contractions and went to the hospital, asked to be given pitocin so she could be induced and have a natural birth "because she knew she had to get the baby out within 24 hours of her water breaking". I told her I thought the 24 hour rule was BS and the reason we're likely to get an infection after this much time is because of the vaginal exams, which are only done once we go in to the hospital! So I said if that happens to me, I'll just stay home and not tell them, when I finally do go in, when my water actually broke. She said if I do that, I'm gambling with my baby's life. I normally ignore comments like this, but she seems to be actually educated on the subject. (She was also 41 when she had her first child, so maybe she was more sensitive to these things due to being high risk?) Anyway, I'm just wondering if you ladies have any thoughts on this 24 hour rule.
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  #2  
May 18th, 2010, 04:00 PM
Isaeph's Avatar Jennifer the Momma
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Only from a victim's point of view. My water broke with my first and after 4 hours of no contractions they induced me with cervical gel. I didn't know enough back then to refuse...otherwise I would have done just what you said and stayed home and waited it out.
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  #3  
May 18th, 2010, 04:13 PM
mgm78's Avatar Zoe's mom Meredith
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my water broke before labor started. (ie, no contractions until after the water broke). My midwives want you to be in "active labor" by 24 hours, to them, this means, dialated at least 5-6cm, and if so, you are good to keep going. My midwives, however, did have me take two bottles of castor oil (small bottles) to encourage the labor since the water broke first.
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  #4  
May 18th, 2010, 04:15 PM
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She is wrong. Yes, there is an increase in infection, but like you said that increase is mostly because of vaginal exams. If I went 24 hours with ruptured membranes and was concerned I would go in and tell them I didn't know when they broke. As long as I showed no signs of infection I would wait.

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  #5  
May 18th, 2010, 05:59 PM
moon~maiden's Avatar Cheryl~ birth truster
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I think the way that Mere's BC handled it is more appropriate - you do want to see some signs of labor maybe 24 hours or so after, but you don't need to have had the baby by then. Infection isn't something that WILL happen, but it can. You do want to avoid bathing with perfumes, oils, bubble baths, etc and even avoid soap in your vaginal area, and of course the fewer internal checks the better. You can sit in water though. I'm not totally sure at what point you really need to worry. I wonder what my midwife's protocol on this is.

If my water broke but I was having no signs I would do lots of walking, stair climbing, foot rubs, nipple stimulation etc.

She is well versed but maybe she just didn't feel comfortable personally with waiting too long.
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  #6  
May 18th, 2010, 06:00 PM
UrbanMomma's Avatar Platinum Supermommy
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I also would assume risk of infection going up due to exams. I had a homebirth with my second dd and my water was broke for 27 hours before labor started, she was born with no issues.
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  #7  
May 18th, 2010, 07:02 PM
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The midwife that taught our class said she would be comfortable waiting a max of 48 hours, but not much past that due to risk of infection.

(I don't have a M/W because you can't use them for hospital birth here And I was not ready for a home birth )
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  #8  
May 18th, 2010, 08:06 PM
oriel13's Avatar Tishauna
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My water was broken for 32 hours before I had DS. I'd been having some contractions for a while before that happened and waited at the house for them to pick up (doing lots of walking, nipple stim, lunges, etc in the meantime). I went to the hospital after about 12 hours and when they asked how long it had been I fudged it by a few hours. In retrospect I really wish I'd stayed home the full 24 hours before going in as I did end up on Pitocin pretty soon after they talked to the OB. On the upside I refused all but 2 of the vaginal exams until I felt ready to push because I knew that would up the chance of infection.
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  #9  
May 18th, 2010, 08:11 PM
lunarmagic's Avatar Platinum Supermommy
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I think the hospitals in this area what to see you in active labor 24 hours after your water breaks, if everything's progressing and there's no sign of infection then they'll let you keep going without augmenting or anything. Of course that would depend on the caregiver, but I know my midwives are very hands-off. Minimize internal checks, frequent monitoring of the baby and you to check for infection, but otherwise fine to wait. I mean, I wouldn't want to wait too long, and if labor honestly hasn't started after 24 hours then I would get very nervous. But I don't think there needs to be any strict "you must have the baby before X hours" limit on it.... just watching closely to make sure it's all okay.
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  #10  
May 18th, 2010, 08:39 PM
laisydaisymama's Avatar Natural Birth Junkie
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I can tell you my answer comes from a VERY different experience than most women have.

Generally speaking, Dr's seem to stick with "born within 24 hours" or at least really close to it. I know people that were 8-9cm being wheeled in for a c-section because they had reached the 24 hour mark.

I can also tell you from experience, that if they deem the baby safer in than out, that rule goes out the window.

With DS2, my water broke at 31 weeks, I was 4cm dilated and contracting, but not progressing. I sat in the hospital for 25 days before they started pitocin. They did not perform cervical checks unless I requested them because of a change in pressure or sensation. I did not get an infection, and he did not get an infection. They watched me very carefully, and I was not allowed to have tylenol or anything that could hide a fever or other signs of infection, but the risk of prematurity outweighed the risk of infection.


so yeah....you can imagine how I feel when people end up with pit or a c-section because they didn't progress fast enough and they were ruptured.
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  #11  
May 19th, 2010, 06:38 AM
mgm78's Avatar Zoe's mom Meredith
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Quote:
Originally Posted by laisydaisymama View Post
I can tell you my answer comes from a VERY different experience than most women have.

Generally speaking, Dr's seem to stick with "born within 24 hours" or at least really close to it. I know people that were 8-9cm being wheeled in for a c-section because they had reached the 24 hour mark..
one of my friends had her baby 2 days after me at a local hospital. She was at 9cm at 24 hours and they gave her a c-section because she was at 24 hours.
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  #12  
May 19th, 2010, 06:52 AM
lunarmagic's Avatar Platinum Supermommy
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Quote:
Originally Posted by mgm78 View Post
one of my friends had her baby 2 days after me at a local hospital. She was at 9cm at 24 hours and they gave her a c-section because she was at 24 hours.
Now that just seems utterly ridiculous!!
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  #13  
May 19th, 2010, 07:39 AM
Isaeph's Avatar Jennifer the Momma
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I think the hospital I had ds1 in would have been one of those hospitals that wheeled me in for a c-section at 24 hours if I was pushing! They gave me TWICE the recommended dose of the cervical gel softener in HALF the time directed, and then said they'd start pitocin at 4am if I wasn't further along. I gave birth at 4:04 and had fully planned on refusing the pitocin. I told them the first time they suggested it "over my dead body". But yeah, when ds was born my water had been broken for 14 hours. They were only going to wait 8 hours after my second dose of the cervical gel to give me pitocin and that's like 4 hours early if I remember right. It's like they were trying to rupture my uterus or kill the baby, sheesh.
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  #14  
May 19th, 2010, 10:20 AM
Jule'sMomInOR's Avatar Mega Super Mommy
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Quote:
Originally Posted by lunarmagic View Post
Now that just seems utterly ridiculous!!


That is exactly when I plan to go to the hospital at the last minute, and if I have to, I'll develop amnesia on how long I've been in labor and when my water broke!
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  #15  
May 19th, 2010, 10:25 AM
Kathode's Avatar Mega Super Mommy
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Quote:
Originally Posted by Isaeph View Post
It's like they were trying to rupture my uterus or kill the baby, sheesh.
Sheesh! They act like there are absolutely no side effects to this stuff, aren't these people supposed to be professionals?

I'm so glad Cheryl pointed me in the direction of this board, talk about eye-opening! A c-section at 9cm!
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  #16  
May 19th, 2010, 10:33 AM
MaggieLizer's Avatar Platinum Supermommy
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Quote:
Originally Posted by ExpectingFirstinOR View Post
That is exactly when I plan to go to the hospital at the last minute, and if I have to, I'll develop amnesia on how long I've been in labor and when my water broke!


This thread has me a little freaked out, so this is what I'm planning on doing too if I'm in that situation.
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  #17  
May 19th, 2010, 06:17 PM
Hollybear's Avatar Mega Super Mommy
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Good idea. Is it safe to "fabricate" what time your water broke? I know this sounds stupid but is there a way they can check how long?

I would just go to the hospital and be like, "I guess about an hour or so ago?"
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  #18  
May 19th, 2010, 07:20 PM
moon~maiden's Avatar Cheryl~ birth truster
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not everyone has to even worry about this- my water broke halfway through my labor with Cadie.
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  #19  
May 19th, 2010, 08:06 PM
lunarmagic's Avatar Platinum Supermommy
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Quote:
Originally Posted by moon~maiden View Post
not everyone has to even worry about this- my water broke halfway through my labor with Cadie.
Yeah, mine didn't break until I started pushing in pregnancy #1.
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  #20  
May 19th, 2010, 08:21 PM
laisydaisymama's Avatar Natural Birth Junkie
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mine only broke early with 1/3.

but no, they can't tell how long it's been broken. I would totally go in 6-12 hours later and say it had been a couple of hours.
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