Breaking of the waters
I meet many pregnant women in the birth accompaniment courses that I normally hold at the centers where I collaborate and there is a question, a question that is always very common: breaking of the waters. What do I do when it happens? I must run? If I don't notice it?
Things that happen in the delivery room (PHOTO STORY)
Very strange things can happen during labor, here are a few
Breaking of the waters without realizing it. It's possible?
I would really like to answer first of all the question of whether it is possible not to realize that we have broken the waters. To do this it is necessary to make a premise, there are two membrane rupture options (because in reality the water does not break but the membranes that contain the water or the amniotic fluid): a break low and a breakup high.
- The low break is the classic film break, the one to be clear where a sort of takes place flooding of the woman for whom it is absolutely impossible not to notice that it is happening.
- La high breaking instead it is the most difficult to recognize, in practice the membranes do not break at the bottom, near the cervix, but at the side or up inside the uterus. So not a large amount of liquid comes out but a continuum dripping. In this case it is possible that at first it is not noticed but the suspicion comes when this dripping is really persistent. It happens that mothers think "ok there are two cases, or the pregnancy losses have become more abundant or something is happening, in any case I'm going to get checked" and here we discover the high break with a small test to understand if whether or not those leaks are amniotic fluid. So there is actually a bit more breakup silent of the classic but the doubt comes the same.
What to do when the waters break
The second classic question I am asked is: what to do when the waters break. You must know that they exist different hospital protocols from region to region and not only from hospital to hospital to understand what to do when the waters break. However, the first discriminating factor common to all procedures is the when, that is, if we are a term of pregnancy or not.
- In the first case, it is not an emergency and you don't have to rush to the hospital, unless the liquid you see leaking has a green or red / brownish tint.
- In the second case, regardless of the color of the liquid, we must go to the hospital as soon as possible because we are facing the so-called premature rupture of membranes.
We consider at term of pregnancy all those mothers who give birth from the 38th week of pregnancy, some hospital protocols even at 37 weeks. Before that date we have to go to the hospital right away.
Premature rupture of water, what to do
We talked about the case in which there is a premature rupture of the membranes (I will call them membranes and not waters for reasons of scientific correctness of the language) and of the fact that we must go to the hospital immediately. We're just talking about the case where the waters break before the term of pregnancy. There is another wording which, however, is not "premature" regarding the rupture of the membranes or the use of the term "early".
An early rupture of the membranes is the event that occurs before the onset of labor. That is, when a full-term pregnant woman breaks water before the contractions of labor begin. I must admit that if the first case of premature rupture of the membranes is not very frequent, the second case of early rupture of the membranes is very common.
And it is in this case (that of early rupture) that a series of factors related to the clinical protocols of the various hospitals intervene, for which the advice is to inform you first with the hospital you have chosen to give birth on how they act in these cases.
I will give you some examples, some hospitals require that with the result of the positive late pregnancy swab go to the hospital immediately after the breaking of the waters others say within 3-4 hours. Still, in some hospitals when it happens to break the waters with a negative swab they require that the woman be in hospital within 6 hours, others instead immediately. As you can see there is no uniformity in this so for this reason I recommend asking how the chosen structures behave.Read also: How Labor Begins
From the breaking of the waters what is missing to childbirth
A good question is how long the birth is missing from the breaking of the waters in the sense that there is no answer always identical. It depends, first of all, on many factors whether the rupture occurred before or during labor. If all in all we can during labor calculate it based on when it happens, for example if they break at one expansion of 4 cm on average it could take another 4 hours. In the event that it occurs out of labor, however, we cannot know.
That is, we cannot know if the first sign that labor is starting is precisely the breaking of the water or it has occurred for other reasons, for example the lot of tension in the bag due to a lot of liquid, infections, etc. etc.
So all in all we cannot predict how long after the birth will take place. Even in this case, however, the protocols of the various hospitals intervene, in the sense that once upon a time ruptured amniotic sac we never leave the baby indefinitely inside the womb with less and less fluid.
There are different protocols in which, however, the sole purpose is: if more than a certain amount of time (12-24 hours) passes from the breaking of the waters to the beginning of labor, we intervene with induction. This is because the sac and amniotic fluid still act as a protection for example for the child against physical trauma and infections and leaving a child without fluid is not a safe procedure.
How to stimulate the breaking of the waters
The question is not how to stimulate the breaking of the waters but why do it. That is, there is no scientific evidence that tells us that waters must necessarily break during labor and delivery (except for some cases in which it is decided to break them for clinical reasons). Indeed, the more the amniotic sac remains intact, the more the child's well-being is preserved and, in any case, should it break it would be a physiological process dictated by labor. There are so-called children "Born with shirt”, And that is exactly what it means, babies born quietly inside their intact pouch with all their amniotic fluid.
So I strongly advise against any scientific (unless specifically indicated by the clinician) or traditional practice that has as its final purpose the rupture of the amniotic sac.
Induced water breakdown
There are some cases, which should be carefully selected, in which the water breaking is practiced by the obstetrician or gynecologist voluntarily. This procedure is called amnioressi o amniorexi. Basically it happens that with a plastic hook she makes a small hole in the tight bag containing the child and amniotic fluid. It is not a painful procedure for the baby, but it could be a little annoying for the mother.
Why do you do it? In some cases of very very long labor or in which the welfare of the baby begins to give signs of failure can actually be useful to unblock labor and make it go away permanently. But I repeat they must be cases carefully selected, it is not a procedure that shortens the time of labor and should not be used as such. To understand how the hospitals you have chosen use induced rupture, you can certainly ask in the delivery room or at the birth accompaniment course if you do it in the same structure.
The world of water breaking is very fascinating because if on the one hand it is a signal that something is happening, the fact that it is not absolutely mandatory for it to happen envelops this event in an aura of mystery. Let's take it this way, when it happens that your waters break in public, in general terror you know that you have time to get in your car and go to the hospital. The only exception that I reiterate because it is very important is this: if it happens that you are not at term of pregnancy or that you are completed but the liquid is not clear go to the hospital right away to check your and baby's well-being.