Waters broken - should SIL be induced?

[Tracie]

Can anyone point me in the direction of some good online articles about
the necessity (or not!) for induction if your waters have broken and labour hasn't yet started.

My SIL is due in 2 days time - her waters broke last night. Hospital wants
to induce her tomorrow and she is in two minds. I really hope she says no, but
the decision of course, is hers. I would love to be able to get some up to date info to her which will help her to make up her mind.

Can anyone help?

[Melissa1983]

I was induced with both my mine children. I think way they want to induce her is so she doesn't get infection, which can happen if your waters break and anything happens, and the baby can get in distress.

Sorry i don't know any articiles to help you. But good luck to your SIL.

[Biene]

I don't want to scare you, but I know someone who's waters broke, she was asked if she wanted to be induced and she refused, she finally gave birth 4 days later but her baby was stillborn, it turns out she had contracted an infection and the baby had died 2 days earlier. The hospital basically told her if she had been induced when they asked her, her baby would have lived :(

Sorry I can't give you any articles.

[OM]

Tracie can I ask why you think your SIL should say no to being induced? I am just curious that is all.

[Goosie22]

As you said the decision is up to you SIL. It is only recently that induction was encouraged after SROM with no Labour and the reason was because of the small increase in the risk of infection. Up untill 2002 (i think???) most Public Hospitals had the policy of 24hrs or more before induction with antibiotics(edited to add that the Antibiotics were for cover not induction:o ) after a certain ammount of time. As you see with the last link the %'s women who establish nicely if left alone. She may have reduced options if there are any other risk factors and the Drs should discuss all of the options with her.


http://www.maternitywise.org/pdfs/gecpc3ch23.pdf

http://www.radmid.demon.co.uk/prom.htm

[~beckkles~]

I agree with the other girls, once your membranes have ruptured the risk of infection travelling up to bubs is extremley high. Especially if she was to go into natural labour and have to endure internals.
Bec

[Kaileysmum]

I agree with the others, she should get induced in by 24 hour after her water breaks if she doesnt go into labour. Just so she doesnt get an infection. i know someone who's waters broke and she left it, to wait for natural labour to come and she got a infection, and the fluid she had left went green and her baby was covered in green stuff when he was born. Sounds Yukky I know. The baby was fine though. Hope this helps!!! Sorry if Ive scared you. I think sometimes induction needs to be used sometimes, to help the mumma and the bub meet.

Sorry I can't give you any articles, and good luck to your sil, hope everything goes well for her whatever she decides.

[Tracie]

The reason I was keen for her to say no was that I felt sure I had read that statistics showed that the risk of infection was extremely small and that for mums who had pre-labour rupture of membranes (PROM) most went into labour spontaneously.

As it turns out, I was right in my suspicions ..... see below .......

" If a mother's amniotic sac ruptures before labor begins and she does not soon begin having productive contractions, most physicians say that she must be induced and have the baby within 12-24 hours, citing the risk of infection. However, it appears to be vaginal exams which are most likely to introduce bacteria into the mother. If a woman avoids any exams, does not insert anything into the vagina, and is not exposed to the pathogens in a hospital environment, she is not as likely to contract an infection. If she chooses a more expectant approach, she can monitor her temperature to verify that there is no infection.

The rate of infant mortality and morbidity do not appear to increase if the mother waits for labor to start on its own, although she may be in the hospital longer. There is no significant difference in rates of infection or cesarean section whether she waits 24 hours or up to three days. Some studies have shown an increased rate of operative delivery (cesarean or instrumental delivery) with induction, and no benefit to the fetus. Researchers in 1996 concluded that:
With expectant (“wait and see”) care about 70% of women will give birth within 24 hours and 85% within 48 hours. The majority of these women will derive little, if any, benefit from induction and a routine policy of induction of labor after PROM cannot be justified on the basis of the data that are available."

Of course there are cases where PROM does cause problems and I feel so terribly sad for Biene's friend who lost her baby, but the fact of the matter is, as sad as it is, that this is a very rare occurence. Provided all the necessary precautions are taken, that mum monitors her own condition regularly and that baby is monitored regularly to ensure he/she is in good health then the outcome should be fine for the majority.

Being induced brings with it many risks of it's own and these appear to be more detrimental to mother and baby than simply adopting a "wait and see" approach.

All that said, my SIL refused induction for this morning. She went to hospital today and did all the necessary checks and everything is absolutely fine. In fact the midwives were not entirely convinced that her waters had indeed broken!
So it's back to the patient wait for baby to decide she is ready to come out.

Thanks ladies for all your thoughts and advice!

Cheers
Tracie

[Ffrenchknickers]

I am sure that bub'll come out when "it's" good and ready:) The body knows what it is doing:) Good luck to her and good on her (and you:)) for asking questions!

[~beckkles~]

Tracey,
I had PROM at 20 weeks and held on for 1 and a half weeks waiting for labour.
In that time I developed a nasty infection. In saying that though I also had PROM in a prior pregnancy at 16 weeks and delieved within 24hrs.
Bec

[Cheekychops]

I think there is prob more risk of not being induced than of being induced. personally i couldn't live with myself if i said no to being induced and something went wrong.....

[Tracie]

Yep, would be heartbreaking but you could also say that you couldn't live
with yourself if you said yes to an induction and something went wrong
as a result of that intervention?

I guess what it all comes down to is getting the correct information about
the risks for either option and then making the decision that is best for
you...

I really believe that it is all about asking questions (not just saying yes to whatever the doctor orders) and Informed Choice and that the only person who can make the choice is the mother herself.

[Angelmist♥]

My waters actually broke 16 days before the arrival of my little girl (via induction). I did go to our hospital when it happened, and they couldn't find any "evidence" to prove they had broken...Although they refused point blank to perform an ultrasound to check my liquor levels.

Anyway they told me to go home, have sex (maybe a bit tmi)if I wanted to try and bring the baby on or have a warm bath!!!!!!!Oh my gosh...... all the things they tell you will cause infections.:mad: After about 3 or 4 days I actually started thinking I must have been mistaken but when she was born there was no liquor present at all.So needless to say they apologised profusely to me!

Apart from her weight, she was born perfectly healthy and I had no infections...

I honestly believe the actual induction was more severe than no fluid.. in my case anyway.

Good luck to your SIL!!!

[DIANNEKB]

My baby was due on the 14th feb but my waters broke on the 19th Jan and I was induced straight away ... I myself dont see the problem with inducing labour as it made the process alot quicker... plus I would not have wanted to risk an infection... I didnt actually have a choice in the matter the hospital just induced me...
Hope everything turns out well...

Di..xx