Waters breaking before labour starts

What if your waters break before labour starts?

It is normal for the waters to break before labour starts in up to 1 in 5 pregnancies. When your water’s break you should contact the Maternity Advice Line/Triage as soon as possible. The number is at the end of this page. You will be advised on what you should do. It is likely that it will be arranged for you to go to the place where you are booked to have your baby. This is to check the wellbeing of you and your baby.

When waters break before labour starts about 6 out of 10 women will go into labour naturally within 24 hours. Providing your pregnancy is more than 37 weeks and your observations and your baby’s heartbeat are within normal limits, you will be offered the following options:

Option 1

Go home and wait to see if labour happens spontaneously (naturally) within 24 hours of your waters breaking. At home you need to be aware of circumstances for which you will need to contact the Maternity Advice Line/Triage for further advice: 

• If you begin to feel unwell or if your temperature is or rises above 37.5°C (please take your temperature every 4 hours while you are awake)
• If you are concerned about your baby’s movements
• If the colour or smell of the waters you are leaking changes, for example it becomes blood stained, greenish or brownish in colour
• You begin to experience contractions or pain.

If you were planning to give birth in a Birth Unit or Birth Centre you should still be able to, providing you go into labour within 24 hours of your waters breaking. The midwife will advise you. Before you leave hospital you will be given instructions on what to do if your labour has not started naturally within 24 hours of your waters breaking.

Option 2

To have labour induced either straight away or as soon as it can be in the Delivery Suite in the Women’s Centre at Gloucestershire Royal Hospital.

What is induction of labour?

Induction of labour is a process used to start labour.

How is labour induced?

The midwife or obstetrician caring for you will assess what is the best way of induction for you depending on your individual circumstances. This will be discussed with you. You will be offered either the prostaglandin or oxytocin method of induction

Prostaglandins

Prostaglandins are a group of drugs which help to induce labour by encouraging the cervix to soften and shorten. This allows the cervix to open and uterine contractions to start. Prostaglandins are given either in a pessary or small tampon form and inserted into the vagina.

Before being induced, the baby’s heart rate will be monitored for a minimum of 30 minutes using an electronic fetal monitor called a Cardiotocograph (CTG). This will be performed to make sure your baby’s heart rate pattern is within normal limits. Monitoring of your baby’s heart rate will be repeated at intervals throughout the induction process. There is no evidence to suggest that induced labour is more painful than natural labour, although prostaglandins may cause the vagina to be sore.

Oxytocin

Oxytocin is a drug which is given into your blood stream through a drip (thin tube) inserted into the back of your hand or arm. Your waters must have broken before oxytocin can be used. This encourages your uterus (womb) to contract. The rate of the drip is gradually increased until you are having regular contractions. The oxytocin drip will continue until you give birth and for a short while afterwards. While you are having the drip, your baby’s heart rate will be monitored continuously with an electronic CTG machine. You will be able to choose to stand up, bounce on a ball or sit in a chair while you are on the drip. Very occasionally the prostaglandins or oxytocin can make the uterus contract too often and affect the baby’s heart rate. If this happens, the oxytocin drip can be stopped. It may be necessary to give you an injection to help relax the uterus.

Where will I be induced?

All inductions of labour take place in The Women’s Centre, Gloucestershire Royal Hospital. Inductions of labour are not carried out in a Birth Unit setting as increased monitoring of you and your baby is needed. If you choose Option 2 the midwife and obstetrician caring for you will decide, with you, the most suitable method of induction and transfer you to the appropriate ward.

If the prostaglandin method of induction is chosen it is likely that you will be induced on the Maternity Ward. If the oxytocic drip method of induction is chosen, this will be started in the Delivery Suite.

Admission

If you go home and labour does not start naturally, within 24 hours, and you need to be induced you will be cared for at The Women’s Centre, Gloucestershire Royal Hospital. The maternity ward will contact you when you are scheduled to return for your induction.

If you have not heard from the Maternity ward by 3:00pm on the date you are expecting to be induced, please call one of the numbers below.

Tel: 0300 422 5519

Tel: 0300 422 5520

The Maternity Ward team will let you know whether there is a bed available. You may be asked to come in straight away or asked to ring back later in the day. On arrival at the Maternity Ward, you will be welcomed by a midwife who will assess you and your baby’s wellbeing before starting your induction of labour. With your consent, the midwife will perform a vaginal examination. This is to decide which method of induction is most suitable for you.

General information

Please bring with you everything that you will need for yourself and your baby. Once you have been admitted for labour to be induced, it is unlikely you will then go home again until after your baby is born. Your birth partner is welcome to stay with you during the induction process if you wish.

However, at night, if you are not in labour it may be advisable for your birth partner to go home. This will allow you both to get a good night’s sleep. If you then go into labour during the night your birth partner will be called in. Please be aware induction of labour can take 24 to 36 hours before labour starts.

During the course of your induction of labour, you will have a midwife allocated to your care. Your midwife will be happy to answer any questions you have. If there is any part of the procedure you do not understand please do not hesitate to ask. Please ask your friends and relatives to wait until they hear news from you or your partner.

If labour does not start until over 24 hours after your waters have broken, your baby may be at a slightly higher risk of getting an infection. You will be advised to stay in the hospital for at least 24 hours following the birth so observations can be performed on your baby to look out for signs of infection.

Please call the Maternity Ward at the Women’s Centre if you have not been contacted by 3:00pm on the day of your planned induction.

Maternity Ward

Gloucestershire Royal Hospital

Tel: 0300 422 5519 or Tel: 0300 422 5520

Open 24 hours Contact information Maternity Advice Line/Triage Gloucestershire Royal Hospital Tel: 0300 422 5541