"My water broke!"...Guess what...it's NOT an Emergency!

Bismillah al-Rahman al-Rahim



Art by:  Amy Swagman
http://themandalajourney.com/

Important amendment to this article:  I inadvertantly left off some very good points which were made in the comments section by a reader.  Please take the time to read the entire article AND comments to get a more complete view of this topic.

I recently had two separate occasions to work with women that had amniotic leaks prior to the onset of labor.  Both wanted natural birth without medical induction, augmentation, or cesarean surgery.  But both were worried if they didn't rush to the hospital that their babies would be in jeapordy.

Fortunately, I was able to provide them information that gave them the confidence to allow nature to take its course.  I pray that sharing this here will help others in the same circumstance. 

Please contact me if you would like to share a topic idea.  Now on to the article..."My water broke!"...Guess what...it's NOT an Emergency!

Unfortunately we are so conditioned by the media's portrayal of birth as an emergency that we often put ourselves in compromising situations, when all that is called for is patience and common sense monitoring.  Doctors may add to this drama by rushing to intervene. 


I'll begin by categorizing my eight labors in relation to the "water breaking." My personal case study serves to demonstrate that water breaking isn't always indicative of immediate birth.


Water Broke in Active Labor


With babies one, two, three, seven, and eight my water broke late in labor.  With the exception of my first, these babies were born very quickly once my water broke.  The first baby took about 45 minutes, but the rest were in my arms within fifteen minutes or less.  With the exception of the last, I was at my planned birth location when this happened.  With the last I was at home in my bathroom, although we planned to birth her in another room, we decided the bathroom turned out great for ease of clean up, subhanAllah. 


Water Broke During Early Labor


With baby four my water broke during the light contractions of early first stage. We rushed to the hospital expecting our baby to arrive quickly, only to find ourselves passing the next several hours confined to our drab labor room.  Had I known it would be six hours before his birth, I surely would have stayed home longer! 


Water Broke Before the Onset of Labor..Doctor "Helped"


With babies five my water broke before the onset of labor. 


With baby five I followed the conditioning of media and my physician and rushed into the hospital.  After approximately twenty hours with barely noticable contractions and insufficient "progress," I finally gave in to the doctor's insistence to "help me."

I reluctantly agreed to a Pitocin drip (intravenous medication which causes the uterus to contract abnormally hard and fast).  Within seconds I was in extreme pain and regretting the decision.  Fortunatley, my baby was born within fifteen minutes of the drip, but let me tell you, that was fifteen minutes too long! 


Alhamdulelah, I was able to tolerate the artifical labor long enough to birth my baby without any other medical interventions.  But many women receive this drug very early on and are quickly spent of all energy and tolerance and thus begins the domino effect of further medications for pain and many times ending with esarean surgery.

Water Broke Before the Onset of Labor..I Patiently Waited



Case One...Thirty-One Hours

Getting back to my two recent cases.  The first one was full term and noticed leaking.  She called me ready to head to the hopsital.  After a brief inquiry I determined that she had no other noticible signs of labor. 


I reminded her that I am not a doctor and cannot provide medical advice.  I encouraged her to do her own research and make her own decision, but based on my experience and research, I would wait it out, so long as the following conditions existed:

With baby six my water broke with no other noticible signs of labor.  I took my time.  I didn't head to the clinic for birth until labor was well established and I knew it was "time."  I delivered without any intervention within half an hour of arriving.

1. No signs of infection (fever, foul smelling discharge, etc.)
2. Clear amniotic fluid (no signs of meconium staining)
3. Regular fetal movement felt by mother
4. Mother feeling well
5. Genital area kept clean
6. Nothing entered into the birth canal (no intercourse, no tampons, no exams)
7. Mother stays well hydrated (the body continually produces amniotic fluid and water intake is important)

She got a bit nervous as the time passed and I provided her the following website:  When Your Water Breaks Before Labor Begins.  It was enough to ease her mind.


After about twenty-nine hours her labor was well established and she was ready to go.  Alhamdulelah, she had her baby without interventions thirty-one hours after her water had broken. 

I am pretty sure that if she had rushed in, she would have had Pitosin to induce her labor, at the very least, and possibly ended up with an unnecessary cesarean.


Case Two...Five Weeks


The mother was 35 weeks.  She called me with a concern that her fluid was leaking.  I gave her the same response as the prior case and also suggested she consult her doctor since she was not full term.

When she visited the doctor, she was advised to have a Chortisone (steroid) shot and schedule a Cesarean.   I did some research on the steroid and found that it is given to help boost the baby's lung development but that it is of no use after the thirty-fourth week.  It is also a very painful injection.

The mother opted to avoid the shot and the doctor for a while.  She did not schedule the surgery and just waited it out.  I encouraged her to get a second opinion and stressed the importance of drinking a lot, watching for infection, and taking note of fetal movements.  She felt confident with her baby's fetal activity and opted not to get a second opinon.

Several weeks passed and her due date came and went.  Her doctor was again suggesting a cesarean as she was now "over due."  I reminded her that the due date is nothing more than an educated guess and not an exact science.  I suggested she get a second opinon to be sure that baby was thriving.  Again she avoided the doctor and just waited it out.

A few days later she went into spontaneous labor.  After three hours she had her healthy, full term baby, vaginally, with a different doctor, masha'allah.  She was thrilled with her birth experience and grateful that she hadn't over reacted to the leaking.

Conclusion

If the mother were extremely preterm, the doctor would most likely monitor her for infection and wait it out, in hopes the pregnancy would continue long enough for the baby to be more developed before birth.  However, if the mother is full term (or close enough to it) doctors tend to rush to get the baby out.  This makes no sense to me at all.  If we can monitor and wait for natural labor in the case of an early baby...why rush the full term baby just because it's developed enough to thrive? 

The water breaking is only one of many signs of labor.  Some women have a leak or breaking of water several hours, days, or even weeks before the onset of labor.  The body continuously produces amniotic fluid.  In a healthy, well nourished, hydrated mother there is little risk of a problem associated with leaking amniotic fluid besides infection.  This risk is only compounded by a doctor's fingers inserted in the vagina to do an unnecessary exam.

Patience, hands-off (or out), and common sense monitoring is the theme I'd follow, regardless of gestational age.  But in all cases, it's your body, your birth, and your baby.  No one else lives with the consequences of rushing (which could include induction or cesarean and all the risks associated with major abdominal surgery) or waiting (possible infection).  Both avenues have risks.  But realize, birth is a risk and there's no way around that. 

My Final Advice

1. Pray Istikarah, ask for guidance, and trust Allah
2. Get educated, do your own research
3. Consult your doctor
4. Get a second (or third or fourth, etc.) opinion if you have doubts
5. Ask questions to make an informed decision
6. Remeber the final goal is healthy mother/healthy baby, regardless of how/when it's born

May Allah provide the best guidance to every expectant mother and protect each from any harm....Ameen!