Membrane release before birth sensations begin, what to do?

1. Drink plenty of fluids. Minimum: 8 glasses spaced throughout the day. Purified water with lemon squeezed in it is good.

2. Allow nothing in vagina. No fingers, no tampons, no oral-genital contact, no bath water, no swimming pool water, no speculum, no penis, nothing whatsoever!

3. Wear something loose-fitting with no panties.

4. If you are leaking and need something for sitting, use clean towels fresh out of a hot dryer.

5. Take your temperature every 4 hours while you are awake. Normal range is 35.5 to 37.3 Degrees Centigrade or 96 to 99 Degrees Fahrenheit. If it goes above the upper ranges, drink some water, retake it and if your temperature remains up call your medical person. It could be a sign of infection.

6. Take 250mg Vitamin C every 3 hours while you are awake. Oranges, grapefruit, kiwi fruit, red peppers are all good sources.

7. No baths. Shower as much as you like.

8. Eat foods that are non-constipating and easy to digest. Especially avoid foods with MSG or nitrates, such as pizza, Chinese food, or deli meats. These foods can make you vomit in the birth process.

9. Be meticulous about toileting. Wipe from front to back, and wash hands carefully after.

l0. If the water is colored green or brown (meconium), or if it has a bad smell (sign of infection), let your medical person know.

If you want to know your baby is doing well, check the baby’s heart rate- have someone put his or her ear against your lower belly or listen through a toilet paper roll. The fetal heart rate should be 140-160 beats a minute. And to monitor the fetal movements in a day, start at 9 a.m. and count each time the baby kicks until 3 p.m. There should be l0 distinct movements (the Cardiff fetal movement test). Contact your medical person if you get less than 10 movements, or if you’re having problems assessing the fetal heart rate.

Question to Gloria: “How long can I go after my waters have broken before birth?”

“There is always more fluid being released to replace the amniotic waters. I once had a client with released membranes and water gushing out for 6 weeks. She gave birth on her due date to a healthy 7 1/2 pound girl. If the temperature of the Mom is normal and she is using the precautions above, there is no reason to treat the mother/baby any differently than if the membranes are intact. The woman usually wants to drink extra fluids and should be encouraged to salt her food liberally.”

Mary’s Expectant Management of SROM
“How do I ‘manage’ SROM [spontaneous rupture of the membranes- waters breaking] prelabour at term at home? If expectant ["wait and see"] management is chosen by the mother, I do NOTHING, no vaginal exams, and await events asking the woman to monitor her Temperature AND PULSE. I am perhaps a little obsessive about maternal pulses, but in my experience a rising pulse rate can often precede a rise in temp. If no signs of labour after 24 hours I would do a full blood count and C reactive protein and repeat this every 2 days. I would advise avoiding penetrative sex, and suggest showering rather than bathing.

“I have a current client whose membranes ruptured spontaneously with a twin pregnancy at 28 weeks; she, with truly amazing strength and fortitude, coped with leaking liquor [water] until labour started spontaneously at 35 weeks.” -Mary Cronk, Independent Midwife, United Kingdom

There’s a truly inspiring video of Teresa’s VBA3C birth. She gave birth after 10 days of released membranes.
By the way, I learned to call it “released membranes” rather than “broken waters” from my friend, Nancy Wainer. Nancy says there’s nothing broken about birth. The vast majority of women who release their membranes spontaneously will give birth within 24 hours, another large percentage will give birth within 48 hours, but there are always a few women who will go for a long time with released membranes (why do they always seem to be my clients?). It seems that the amniotic fluid has some prostaglandins in it that help to soften and ripen the cervix so the births tend to go smoothly once they begin.

About gloria

I live and work in Vancouver BC Canada. I've been in the childbirth business for 30 years. I teach midwifery and doula courses both online and in person.
This entry was posted in Holistic midwifery & doula education. Bookmark the permalink.

7 Responses to Membrane release before birth sensations begin, what to do?

  1. Kathy says:

    Gloria,

    I’m curious as to why no bathing, when water-birth is a perfectly valid option. Is it just to be “on the safe side”? Also, do the recommendations change when there is known GBS+ status?

    And here’s a freebie for you — how to insert a link so that clicking on it will take you to the webpage. It’s a bit tricky to tell you how to do it, because if I just copy and paste the correct html, then it will convert it to a link when you see it. :-)

    All html goes inside the less than / greater than signs , so the first thing is ”

    Then you type the phrase that you want to be the actual link you want to be in blue and underlined (typically something like “click here”), and follow that up by closing the html (take out all the spaces).

    Here’s how the tinyurl link above would look embedded:

    There’s a truly inspiring video of Teresa’s VBA3C birth.

    It’s complicated to explain, but once you get used to it, easy to do. I’ll embed my blog by linking my name in the signature — you may be able to see the exact html text by editing my comment, which will make it a lot clearer.

    Kathy

  2. gloria says:

    Kathy, thanks so much. It’s actually easy for me to imbed links because it’s automatic on wordpress but I disabled the rich text feature and then forgot to turn it back on –Duh.

    re the showers only. You’re right, water doesn’t go up the vagina unless you purposely hold your labia open so (really) tub baths are not a problem. We discourage tub bathing as an “over zealous” precaution and also so that, if there is a transport to hosp, the mother can truthfully say she hasn’t been sitting in a bath. The woman that I had with 6 weeks of released membranes had a waterbirth. G

    • Andrea says:

      I would still try to avoid baths/water immersion with PROM until I was in active labour. One doesn’t need to “hold their labia open” for water to get into their vagina; it’s not water-tight. ;) The fewer bacteria that get up there, the better.

  3. Lee-Ann Grenier says:

    I had SROM for five days prior to the birth of my HBAC daughter. The midwife advised the same precautions, but I chose to have a few baths in a tub scrubbed clean with baking soda and vinegar, and kept track of my temperature. I was surprised to learn that we could confirm that it was amnoitic fluid by smearing it on a slide and checking for a ferning pattern!

  4. Cricket says:

    i had SROM at 34 and 1 – unfortunately i was in the hospital with my daughter so i was admitted and monitored for almost 2 weeks before she came. they wanted to induce me several times for no reason other than i had broken water but i refused. all they did was check my temp, bp and used a doppler (not my first choice) several times a day and had a few U/S to check the fluid levels (also not my first choice). it’s totally possible to be in hospital with SROM, you just have to advocate for yourself and baby.

  5. Pingback: Gloria Lemay | Ripple Effect Yoga

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