Advice for when your waters have broken after 37 weeks of pregnancy (Membranes have ruptured)
We have confirmed that your waters have broken (ruptured membranes) and that you and your baby are well.
Waters break at term (37-42 weeks) in 8-10% of pregnancies; in a few women they break earlier, and in most cases they break later during labour.
When the waters have broken about 75% of women will go into natural labour within 24 hours and a further 10% by 48 hours. If your labour does not start within 24 hours of your waters breaking, it is recommended that your labour is induced as this reduces the risk of infection for you and your baby from 1% to 0.5%.
You have the choice to either:
- Begin your induction as soon as possible. The midwife or doctor will discuss this with you as the timing is dependent on activity in the maternity unit.
Or
- Go home for 24 hours or until your labour starts. This is called expectant management. (Our usual recommendation is to come in for Induction of Labour (IOL) after 24 hours).
Possible Induction of Labour (IOL) outcomes:
Less than two thirds of women who are induced will give birth without further intervention, about 15% will have an instrumental birth and 22% an emergency cesarean section. Induction of labour fails in about 15% of cases.
Expectant Management
If you decide to wait, induction of labour is advisable approximately 24 hours after your waters have broken, this is because the risk of infection to you or your baby increases the longer your waters have been broken. Risk rises from 1:200 membrane intact to 1:100 membrane broken).
If labour has not started within 24 hours of your waters breaking you are advised to give birth in hospital, where there is access to neonatal services should they be needed. We recommend that you and your baby should stay in hospital for at least 12 hours following the birth so that we can monitor for any signs of possible infection.
Provided there are no signs of an infection, antibiotics will not need to be given to you or your baby, even if the membranes have been ruptured for over 24 hours.
While waiting for your labour to start, if you experience any of the following symptoms you should contact maternity Triage on 01582 329574 for Luton site or 01234 795805 for Bedford site:
- you are having regular, strong contractions every 3-5 minutes that last for more than a minute and have been like this for an hour or so.
- your temperature is raised greater than 37.5°C. on two occasions (Take your temperature every four hours while you are awake),
- you feel unwell, hot or feverish.
- you notice a change in the colour or smell of your waters.
- your baby’s movement pattern has changed or baby is not moving as much as usual.
- you are worried or concerned for any reason.
If you are booked for home assessment in labour or home delivery inform Delivery Suite of this arrangement when you ring and they will contact your midwife or a member of the team for you.
Your date and time of admission to the maternity unit, if you have decided to wait for labour to start naturally.
We have advised you to come back to the hospital to Ward 32 if your labour has not started within 24 hours.
Details are as follows –
Date:
Time:
Concerns
If you have any concerns contact maternity Triage on 01582 329574 for Luton site or 01234 795805 for Bedford site.
Ref:
NICE, National Institute for Health and Clinical Excellence
CG70 Inducing labour (July 2008)