Rupture of the Membranes is an excellent sign that baby is on the way. One usually starts labor immediately or if already in labor the labor will increase which is what causes the birth of your baby.
Premature rupture of membranes means the water broke and labor does not begin. The body is not ready for labor and therefore it does not get the clues to put itself in labor. This can happen many weeks before your due date or even around your due date yet labor does not begin.
If labor does not start, most likely the mother will need some means of induction. The baby is exposed to bacteria entering the uterus which can cause an infection in the uterus or the baby itself. The longer the time from rupture of membranes to the delivery increases the exposure of infection and therefore puts mom and baby at a higher risk for complications.
Standard hospital procedure includes intravenous antibiotics starting at 18 hours and continuing until the baby is born, and blood cultures being taken on the baby to watch for infection. Your baby needs extra observation if 24 hours has lapsed and may need NICU admission if the baby is symptomatic.
Knowing that these added risk occurs, we start giving all Moms advice and assistance to get her into labor once the water breaks. We are pushing the clock knowing that the sooner the baby delivers the less chance of needing antibiotics or hospitalization. While some patients want to just wait for labor, we know that some Moms will not start labor until we intervene. Waiting too long has resulted in mothers and babies having to be hospitalized.
Why would a mother not go into labor? Cervical ripeness and the application of the baby’s head on the cervix is the key factor for the body to be stimulated to go into labor. If the baby has not engaged or the cervix is firm and not ripe for labor, the body will not be stimulated. Labor does ensue if your cervix is ripe and the baby is moving into the birth canal, hence most women go into labor once the water breaks.
What can I do if my water breaks and labor does not begin? Call your health care provider so we can confirm that your water broke. If confirmed we usually start with things such as walking, nipple stimulation, assistance with the baby’s head applying to the cervix. During your exam we determine if your cervix if not ready and decide the best plan of management to ripen the cervix and to get contractions to begin.
If a mother gets a fever or the baby is born with one, hospitalization is critical to prevent severe infection. Our goal is to prevent prolonged rupture of membranes and a fever or infection starting.
We wish that PROM was never a problem, yet if it is we will work with you to go into labor so your baby does not become exposed to an infection or need hospitalization. CALL US IF YOU ARE LEAKING WATER EVEN IF YOU ARE NOT SURE.