The waters break, but there are no contractions: what to do in this case? Amniotic fluid during pregnancy and childbirth: how much and why

Selection amniotic fluid from the genital tract to later dates is one of the harbingers of the onset of childbirth. Let us consider this process in more detail, find out: how the waters of pregnant women leave before childbirth, when this happens, and what the expectant mother experiences.

What does "the waters break" mean?

amniotic fluid (approx. amniotic fluid) is a natural barrier, performs a protective function. It directly reduces pressure on the walls of the uterus, prevents infection of the baby inside the womb, and protects against external influences. The volume of amniotic fluid increases as the gestation period increases, and by the end reaches a volume of 1.5 liters. The fetal membranes, the placenta also prevents the penetration of pathogens inside, maintaining sterility until the moment of delivery.

In the later stages, before childbirth, the integrity of the fetal bladder is violated and water comes out through the vagina. In this case, obstetricians use the term - discharge of amniotic fluid. This sign is the harbinger of the beginning birth process, signaling to the woman that it is necessary to go to maternity hospital. In this case, it is necessary to fix the time when the discharge of water occurred.

When does a pregnant woman's water break?

The discharge of water is a physiological process, which is the end of the first stage of childbirth. Occurs after a breach amniotic sac, when the cervix opens a little by 4-5 cm. However, such an option is also possible when the outflow of amniotic fluid is noted before the start of the period of contractions. In this case, doctors use the concept of "prenatal rupture of amniotic fluid." If after that they do not begin within a few hours, doctors take actions to stimulate the process of childbirth.

How to understand that the waters have broken?

In order not to miss the onset of childbirth, expectant mothers often ask the gynecologist how to understand that the waters have broken during pregnancy. The main sign of this process is the outflow of fluid from the genital tract. In this case, the volume can be small - 100-200 ml. In this amount, the anterior waters are released, which were between the presenting part of the fetal body and internal pharynx uterus.

Young mothers, telling their pregnant friends about how the water breaks before childbirth, compare this process with involuntary urination - underwear and clothes suddenly become wet. More often the discharge occurs in the morning hours. In some cases, it may be noted - the gradual separation of the amniotic fluid due to a violation of the integrity of the fetal bladder. This condition requires the supervision of a doctor, as it can disrupt the further course of the delivery process.

Is it possible to skip the discharge of water?

Answering the question of pregnant women, is it possible not to notice the discharge of water, doctors give a negative answer. Even slight selection fluid from the vagina, always alarms the pregnant woman. In some cases, women bearing their first child may mistake the allocation for water. These two biological fluids have significant differences:

cork is always thick and slimy consistency;
its volume does not increase over time;
cork release occurs more often a few weeks before delivery.

The waters have broken - after how much to give birth?

The discharge of water before childbirth means that the cervix is already slightly open, softened and ready for the birth process. This period is favorable for the start of delivery. However, doctors cannot accurately answer how long childbirth will begin. Normally, contractions accompany the outpouring, but in practice another option is possible. More often this happens in primiparas, when the amniotic fluid first leaves, after a while the first contractions appear. On average, they are observed after 3-4 hours.

It is very important to monitor how the waters of pregnant women leave before childbirth and the duration waterless period- the time from the outpouring to the birth of the baby. Normally, it should not exceed 12 hours. In practice, doctors, after the outflow of water and the absence of contractions after a few hours, begin stimulating activities. A long anhydrous period adversely affects the process of delivery and the condition of the fetus.

How long does it take for contractions to start after water breaks?

Having figured out how the water breaks during pregnancy, women are trying to find out when their baby will be born. After the waters have broken, how long it takes for contractions to start depends on individual features organism. It has been established that in multiparous women, the anhydrous period lasts less, and contractions begin after 1-2 hours. There are cases when the first regular contractions cause a violation of the integrity of the fetal bladder. As they increase, the cervix opens, after which the second stage of labor begins - the expulsion of the fetus.

Can contractions start without water breaking?

Contractions without water breakage are possible. Such a phenomenon is a variant of the norm, which is fully consistent with the mechanism of childbirth. As a result of intense contractions of the uterine myometrium, the cervix opens. In this place, the integrity of the fetal bladder is violated due to the increasing intrauterine pressure. After the outflow of amniotic fluid and the full disclosure of the uterine cervix, the process of moving the fetus through the birth canal begins.

The waters have broken, but there are no contractions - what to do?

Often, primiparous women are faced with a situation before childbirth in which the waters have broken, and contractions are not observed. Doctors with such a development of events are advised not to wait for their appearance while at home, but to go to the maternity hospital. At the same time, it is important to record the time of amniotic fluid discharge, and inform the doctors upon arrival at the medical facility. In the maternity hospital, doctors examine the pregnant woman and, if necessary, begin stimulation of the birth process.

What to do if the water breaks?

The outpouring of amniotic fluid is a signal for mom that will happen soon long-awaited meeting with a baby. The pregnant woman should pay attention to the time when the outflow occurred in order to inform her doctors. It is necessary to carefully examine the waters: normally they are transparent, occasionally have a pinkish tint, there is no smell. Greenish, Brown color near fetal fluid points to intrauterine infection, which threatens the health of the baby. This can also be observed during oxygen starvation (hypoxia), requiring medical care.

After the water breaks in pregnant women before childbirth, expectant mothers can complete the final preparations for departure to the maternity home. Doctors recommend going to a medical facility no later than the start of regular contractions: the interval between two subsequent uterine contractions should be no more than 10 minutes. If there are no contractions, and the waters receded 2-3 hours ago, you should not wait for their independent appearance, but go to a medical facility.

Premature rupture of amniotic fluid

The early discharge of amniotic fluid, which occurs before the start of the delivery process in the absence of contractions, is commonly called premature discharge of amniotic fluid. Talking about how the water leaves in pregnant women before childbirth, doctors pay attention to the possibility of their premature release. According to observations, this phenomenon occurs in 10% of all pregnancies.

A sharp discharge of amniotic fluid requires urgent hospitalization: when there are no contractions, the interval between them does not decrease, the intensity of contractions is low, there is a risk of fetal death. The long anhydrous period itself is fraught with the development of complications, including infection of the fetus. Timely provision of medical assistance helps to avoid violations.

Childbirth is a complex and sometimes unpredictable process. Their course is difficult to predict. In some women, they pass quickly and begin suddenly, in others they proceed more slowly. But what to do when the water breaks, but there are no contractions? Is it dangerous?

Is it normal?

Many are interested in the following question: "What first: contractions or Everything is individual and depends on some features of the cervix, as well as on the location of the fetus in the womb. So, if the baby's head is too low, then the membranes can burst, and the amniotic fluid will pour out. And this is quite it's normal if contractions follow almost immediately.Then labor activity will be normal and active, the baby will appear in the very near future.But if the water breaks, and there are no contractions for two - four hours, then it is worth sounding the alarm, since a child without amniotic fluid in the womb can live for about 12-15 hours.

Causes

Why did this happen? If the waters break, but there are no contractions, then this could happen under the influence of several factors:

polyhydramnios;
intrauterine infections;
multiple pregnancy;
pathology or cervix.

Possible risks

Is there a threat to the child's life? Yes, if the waters break without contractions, then it can be dangerous. Here are some options for the outcome of events:

The uterus will decrease in size and move slightly. And this may affect normal course childbirth.
If the child for a long time will be without amniotic fluid (after all, there is oxygen in it, which the fetus breathes), then hypoxia may begin. And such a state is harmful to the brain and nervous system and can be life threatening.
In most cases, labor activity after the outflow of amniotic fluid slows down and may even die out completely.
When the integrity of the membranes is broken, bacteria and other pathogenic organisms from the external environment can freely penetrate the fetus. There is a risk of infection.
With the outflow, a violation of the process of feeding the fetus can occur, which can be dangerous.

What to do?

What to do if the water breaks, but there are no contractions? You must definitely go to And even better, call a doctor and report your condition by phone so that the doctors take with them funds to stimulate contractions and labor activity.

When a pregnant woman enters the hospital, she will certainly have an ultrasound scan to assess the condition of the baby and the placenta. A decision will be made depending on the results and the gestation period. Here are some options:

If the period is short, then attempts will be made to maintain the pregnancy. In case of failure, the baby will be given drugs to accelerate the development and opening of the lungs.
If the period is normal, then doctors will try to induce contractions with the help of medications.
If uterine contractions have begun, then childbirth will proceed normally. But it is important that the waterless period does not exceed 12-15 hours.
If there is no uterine activity and the cervix is not open, then a caesarean section will be performed.

Let the birth be successful, and the baby will be born healthy!

Every woman who is in an “interesting” position understands perfectly well that with the approach of childbirth, the likelihood of sudden discharge of amniotic fluid.

Inexperienced future moms listen to the slightest change in their body, afraid to miss this one. important point.

They are even more concerned about the question of what to do when the water has broken during pregnancy.

Do broken waters always signal the onset of labor Or you can safely wait until the appointed time?

How do you know if the water has broken?

The baby throughout pregnancy grows and develops in a special shell filled with liquid. This fluid is called amniotic fluid. In fact, amniotic fluid is formed from maternal blood plasma and is constantly updated and replenished if necessary.

This substance is absolutely sterile, which ensures reliable protection developing organism from various infections. Content in liquid a large number immunoglobulin is an additional barrier against external influences.

The comfortable water environment allows the baby to turn freely and protects the bladder from uterine contractions. Regardless of conditions environment and the state of the mother in the amniotic fluid, a constant pressure is maintained and temperature indicators. Due to the presence of water, the baby is reliably protected from physical and noise external influences.

If you feel the release of warm fluid from the vagina (usually this happens when a woman lies and tries to get up), in an amount of more than 100 milliliters or more (it happens that a liter and a half is poured out at once), without specific smell urine is they, the waters have departed.

Why are the waters breaking?

As the child grows, the volume of the surrounding waters also increases. By the time of birth, their number can reach 1.5 liters. Excess amniotic fluid or low content is considered pathological conditions threatening normal development baby.

With the approach of labor hormonal background the expectant mother begins to change rapidly. Such processes contribute to the natural birth process. Under the influence of the hormone oxytocin, which also promotes uterine contractions, the fetal membrane becomes looser. And the pressure in the bubble increases significantly under the onslaught of the baby, seeking to leave the hostile pulsating uterus.

The fetal membranes do not withstand, and their rupture occurs. This moment is accompanied by the discharge of water during pregnancy. The woman may even hear the bubble burst. Unusual popping or clicking sounds confirm the violation of the integrity of the shell.

IN ideal the discharge of water occurs after the first stage of childbirth, when the cervix is open by more than 4 cm. This development of events is considered optimal for both the baby and the woman in labor.

But in life, processes do not always coincide with descriptions in reference books. This does not mean that other variants necessarily confirm the pathology. But woman must be prepared for premature discharge of water.

How does the water leave?

Some pregnant women on the eve of childbirth are even afraid to take a shower so as not to miss such an important moment.

There is also concern about involuntary urination, which often occurs over long periods. But the departure of the waters has its specific features, and it is difficult to confuse them with other physiological processes.

Water can flow in completely different ways. So, if the baby is prepared for childbirth and takes the correct position, his head rests against the womb and the amniotic fluid is divided by his body into two parts.

The anterior part of the amniotic fluid contains up to 250 ml of fluid. It is this liquid that is poured out when the fetal membrane bursts. Women have the feeling that a lot more fluid is pouring out of them. At the same time, this flow cannot be stopped by muscle tension or a change in body position.

So that a woman can imagine how the process will take place, in women's consultations in class, they are advised to experiment with their own perceptions in advance at home. To do this, it is recommended to pour a glass in the shower warm water to your feet. Such an experiment will allow you to remember the sensations.

In cases where the child takes the wrong position or did not have time to roll over, the volume of the outgoing fluid can be much larger. Sometimes all waters up to 1.5 or even up to 2 liters can be poured out at once. Such a "waterfall" is difficult to confuse with ordinary secretions. But even in this case, the waters can gush all at the same time, or they can flow out in a small trickle.

Another option for water discharge during pregnancy is leakage. Such situations arise if the fetal membrane has burst in the upper part or microcracks have appeared. Leakage is difficult to distinguish from urinary incontinence or increased vaginal discharge. It can last for hours or even weeks.

There are situations when water does not break even during childbirth. If the contractions drag on, and the fetal membrane remains intact, doctors resort to forced piercing.

This is not a medical whim. In this way, the uterus is saved from overvoltage, which can provoke its rupture during childbirth.

What waters are leaving?

Woman must record the time discharge of water, as well as their condition. By appearance the doctor will determine the presence of deviations and will be able to decide on next steps.

Normally, the water is absolutely transparent, may have an admixture of flakes or a slightly yellowish tint.

These waters do not have a specific odor., which allows them to be distinguished from urine. For amniotic fluid, a sweet smell reminiscent of fresh milk is considered natural.

If the waters are green, and even more so black, this indicates the presence of meconium in the waters.

Red waters confirm the presence of blood in them. This alarm signal. Blood appears with placental abruption.

Reliable self-diagnosis methods

If a woman doubts the correctness of her conclusions about the fluid that has appeared, you can resort to known ways self-diagnosis or consult a doctor. The need for additional diagnostics arises when the water leaves in an insignificant stream, but leaks in small portions.

Dry sheet test

It is quite common, informative and affordable way determine the discharge of amniotic fluid.

To carry it out, a pregnant woman must visit the toilet for emptying Bladder.

After that, the genitals are washed and wiped dry. The woman lays down on dry white cloth. You can use a diaper or sheet.

If after 15–20 minutes wet marks are found on the fabric, the discharge of water is confirmed.

test pad

At home, you can use more modern way determination of water discharge. Test pads can be purchased at a pharmacy. They allow you to confirm the type of discharge with high accuracy. Such a gasket is impregnated with a special substance that reacts to the acidity of secretions.

Normally, the flora of the vagina has a balance within pH 4.5. In amniotic fluid, the acidity reaches pH 7.0. The gasket begins to react to liquids in which this indicator exceeds 5.5.

For the test, the gasket is placed on underwear and do not remove until a fluid leak is felt. If there are no such sensations, the pad can be left on for up to 12 hours.

An indicator of the presence of fetal water is a change in the color of the gasket to blue or green tint.

If you don't trust home diagnostics you can contact the doctors. In gynecology, it is customary to determine the dubious discharge of water using:

Gynecological examination;

smear microscopy;

Aminotest with the use of a dye introduced into the amniotic fluid;

Cytoscopic examination

The waters have broken: when will the birth begin?

In most cases, the water breaks on the eve of childbirth. Contractions can begin literally immediately after the discharge of water, if the fetus is ready for birth and the cervix has time to prepare for labor. Some time may pass and labor activity will begin in 2-3 hours.

In pregnant women, the cervix opens more slowly. In an hour, the cervix can open only half a centimeter. Therefore, childbirth in such pregnant women begins no earlier than after 9-12 hours.

For women with childbirth experience, the process develops much more rapidly. Their cervix can open in 5-6 hours. In these cases, if there is no desire to give birth at home or on the road, you will have to hurry.

It's harder if the cervix is not ready for labor and the waters have already receded. In such cases, before the onset of contractions, both 12 and 72 hours can pass. What to do if labor does not begin, doctors decide in each specific case separately.

There is a widespread belief among pregnant women that a baby without water is not able to live more than 6 hours, since he can die from a lack of oxygen. Such rumors absolutely unfounded.

Despite the departed water, the nutrition and breathing of the baby continues to be provided by the mother's body through the placenta. The absence of water will in no way affect its oxygen needs.

In addition, the waters do not drain in full and they are constantly updated. Therefore, literally after 4 hours, if the fetal membrane has retained its integrity and only leakage is observed, their volume will be replenished with new fluid.

What is the real danger for the baby? In open access for infections. If earlier child was practically in sterile conditions, the resulting crack in fetal membrane provides direct access for the penetration of various pathogens.

The baby, still in the uterus, did not have time to develop protective mechanisms. Any infection is now fatal for him.

If the anhydrous period is delayed by more than 12 hours, doctors begin antimicrobial therapy with medicines that are safe for the child.

What to do if the water breaks?

What should a woman do if her water has broken? The answer is unequivocal: urgently go to the hospital. Do not wait for the next visit to the gynecologist, namely, collect the necessary things, documents and call ambulance.

Further development of events will depend on the timing at which the waters receded, their characteristics in terms of color and volume.

38–40 weeks

Most likely, the baby is already ready for the birth. If the waters have departed in a normal volume or are constantly leaking, besides, their color is absolutely transparent, there is no reason for concern. The natural process has begun, and prenatal contractions will soon begin.

Moms giving birth for the first time still have a couple of hours left to calmly get together, gain strength and even get some rest.

In no case after the waters have broken:

To take a bath;

Be subjected to physical stress;

Have sex;

use tampons or sanitary pads.

If there is a need to hygiene procedures, for example, to process or shave the genitals, you need to use the shower. Wash only from front to back to prevent germs from entering the vagina.

If the water is constantly leaking, instead of pads that are saturated with fragrances and are not always sterile, you need to use a cotton cloth.

Herbal teas made from chamomile, echinacea, mint will help to calm down. In addition, these drinks also have antimicrobial properties.

For mothers who give birth not for the first time, there is no time for tea drinking. Contractions and childbirth can begin at any time. For such women, the discharge of water is not an alarming, but an important signal. Therefore, they should immediately go to the hospital.

The reason for the immediate appeal for help is the abundant discharge of water. If the waters departed at once and in a large volume, then the entire fetal bladder was emptied. This confirms that the baby did not have time to take correct position.

In such situations, it is extremely rare, but it is possible for one of the baby's limbs or even part of the umbilical cord to fall into the neck or into the vagina. If you do not help such a woman in labor in time, childbirth will be complicated. In addition, the prolapsed umbilical cord can be pinched by the cervical muscles or the fetus, and the child will have problems with oxygen supply.

If the waters have an unnatural color or smell, you should not postpone a visit to the maternity hospital. The presence of blood in the waters is a wake-up call. The natural process should not be accompanied by bleeding.

35–38 weeks

By 35 weeks, the baby has already formed lungs and is able to breathe on its own at birth. Therefore, if the waters break at this time, doctors decide to stimulate the birth process according to vital signs.

If nothing threatens the baby and the expectant mother, it is advisable to prolong the pregnancy. Expectant tactics allow you to carry the baby and give birth in deadlines.

The woman is placed in the hospital for the waiting period. Physicians are monitoring changes in the state and indicators of tests. To prevent infection of the fetus, I use antibiotics.

If there is a suspicion of the presence of infections, they resort to forced birth or caesarean section.

20–34 weeks

To prevent birth premature baby and to ensure the safe continuation of pregnancy after the early discharge of the waters, doctors adhere in most cases expectant tactics. They try to prolong such a pregnancy as long as possible.

A woman will have to spend the remaining period before labor in a hospital under close observation. future mommy placed in a sterile ward, where she must stay in lying position.

To control the condition of the baby and mother:

Once every four hours, temperature and pulse are measured;

Every day they conduct a blood test for the level of leukocytes;

The volume and quality of amniotic fluid is constantly monitored, for which the diaper is regularly changed under the woman;

Every 5 days, sowing of materials taken from the vagina is carried out;

The condition of the baby is monitored using ultrasound and cardiotocography.

The decision on the timing and method of delivery is made in each case individually.

Up to 20 weeks

Water on early dates may leave due to:

Infection of the fetus;

Inflammatory processes;

careless sex;

Hormonal failures;

excessive physical activity.

There is no single tactic for the discharge of water in the early stages. The decision is made after a detailed examination. But in most cases, such a pregnancy cannot be saved.

The waters have broken, and there are no contractions

Only when ideal birth water breaks during contractions. Different "variations" are characterized by the discharge of water in the absence of contractions. Doctors recommend in any case to go to the hospital.

Not worth it long time wait in the hope that labor will begin. Contractions may not start for the next 48 hours. Women, fearing the stimulation of childbirth, postpone visiting the maternity hospital, which creates favorable conditions for the development of infectious processes.

In some maternity hospitals, the practice is still preserved to stimulate labor activity 4–6 hours after the amniotic fluid has passed. Such tactics absolutely do not correspond to modern medical views.

Doctors have proven that the next 12 hours the baby is not in danger. And even the absence of contractions for 48 or even 72 hours is not considered a pathology.

The decision on urgent delivery is justified:

With complete discharge of amniotic fluid;

With the threat of displacement or abruption of the placenta;

If the contractions were present, and with the discharge of the waters they began to fade away;

When unnatural smell or the color of the amniotic fluid;

When the state of either the mother or the baby changes.

When the baby is infected;

If comorbidities are present.

The method of delivery in the absence of contractions, the doctor chooses in accordance with the condition of the woman:

1. If there is an incorrect location of the fetus, the woman in labor has health problems or is too narrow pelvis, held C-section.

2. If the cervix is ripe, but labor activity slows down, labor induction is used. To do this, the hormone oxytocin is injected, which allows you to accelerate uterine contractions and cervical dilatation.

3. With an immature cervix, labor is stimulated by introducing a gel or suppositories into the uterus containing prostaglandin hormones into the cervix.

In any situation, when the waters break, regardless of the timing and presence of contractions, it is necessary not to postpone a visit to the maternity hospital. Trust the doctors. In a hospital, all conditions are created for successful delivery or prolongation of pregnancy.

2 Sep 0 2729

Natalya Tomilina, doula, psychologist, body therapist: First you need to delve a little into the anatomy. There is a uterus, there is a bladder in the uterus, in it there are a child, an umbilical cord, a placenta, as it were, on one side (and reverse side it is attached to the wall of the uterus) and amniotic fluid. There is usually quite a lot of water, and the baby on the eve of childbirth is large and occupies almost the entire space of the uterus. His head (or butt) is below and inserted into the pelvis.

Further, about two situations of water discharge, the difference between discharge and leakage, what risks are there from the point of view of doctors, are they justified, what raises and lowers them, what you need to pay attention to, what factors to monitor, what protocols are adopted in Russian maternity hospitals, in maternity hospitals other countries, in home births.

So. Bubble burst can happen in different ways

1. The integrity is broken below, where the cervix and the head of the child are, usually in this case about half a glass of water is poured out, because of this the head drops lower, and it can be compared with a cork that was plugged into a bath so that water does not leak. Let's call this option the discharge of the anterior (that is, located between the head of the child and the cervix of the woman) waters. You need to know that on top of the belly, where the belly and arms of the baby, there is a decent amount of water, the so-called back, that is, as a rule, they do not flow out all and completely, there are a lot of them. And you need to know that every three to four hours new portions of water are produced by the mother's body.
If a woman strongly changes the position of her body (she got up, lay down, turned over, got up again, sat down), then the water will flow out. If you take one position, then they can stop flowing completely, because the head is pressed tightly against the pelvis.

What risks does medicine tell us about?

I'll start with the worst. Yes, I'm not afraid to talk to pregnant women about death. I believe that it is better to call her by her name and say in what cases she can be at all than to remain silent, thereby fueling the illusion that "childbirth is safe if ...". Yes, you need to prepare, you need to know certain researched laws of the course of childbirth, you need to take care of safety, but not go to the extreme of overcontrol. Doctors know, and in fact they talk among themselves, that childbirth is a process that does not fit into absolutely precise schemes. There are directions, yes. But childbirth is unpredictable. Childbirth is a compressed in time, concentrated model of life itself, and no one has yet been able to put life into schemes.

So, most of all they are afraid of the sudden antenatal (before birth) death of a child. But it is not connected only with receding waters. It is even more associated with severe overgestation (after 43 weeks), and according to some reports, it is higher at 37 weeks than at 42-43, while at 37 weeks no one is stimulated. In general, this thing is very mysterious - antenatal death. There are always risks in childbirth, simply because there is death. And this is not a reason for everyone to have a planned cesarean. And this is not a reason to monitor the child's condition around the clock. Just as we live, despite the fact that we know about the suddenness and unpredictability of death, we also go into childbirth, knowing that sometimes, oh, very rarely, some children do not live to see their birth and this is how this world. Personally, in my practice I have encountered two such cases, in both the exact cause has not been established.

Well, I wrote about death, now let's return to the reverse pole, which is about life. In general, childbirth is about life, really. Childbirth is the birth of a new life. Therefore, you can exhale and remember that most births go well for mom and baby).

However, what can be done to reduce the risk described above?

♦️ with broken waters and / or a post-term pregnancy - monitor the baby's movements and heartbeat (you can do it right at home, I will write below how). If something is bothering you, then seek help.

Cord prolapse risk

With spontaneous discharge of water, it is quite tiny. In my doula opinion, the situation of amniotomy is much more dangerous - a puncture of the bladder in the maternity hospital, when it is done as a stimulation of the birth process, thereby interfering with the work of the body.

In what situation can fallout still occur?

♦️ When the baby's head is high and not inserted into the pelvis and the bladder breaks. In this case, the water may rush in a stream, and the umbilical cord may fall out, because the child's head has not yet had time to "plug" the pelvis.

But this is indeed a very rare complication and the article is not about it, so let's continue.

Inflammatory process, infection

This is a big myth, and alas, most of our doctors firmly believe in it.
In fact, the risk of inflammation is also very small. It increases if: you are in the maternity hospital (the environment is more aggressive in the hospital) if you have a lot of vaginal examinations if you have a complicated pregnancy, there are infections. But even if these three points are present, there will not necessarily be inflammation.
What reduces the risk of infection:
♦️ exclude vaginal examinations
♦️ don't go to public places where there are a lot of people
♦️ do not swim in public pools and reservoirs (otherwise you suddenly decide to swim)
♦️ do not have sex with your husband (here it’s real - don’t)
♦️ observe normal hygiene
♦️ track the factors listed below.

What are we paying attention to?

The color and smell of the waters. The norm is light, transparent, pinkish waters. The smell should also be pleasant, if it is unpleasant and / or if the waters are green, brown, any dark shade, then consult your midwife or doctor. If we are talking about childbirth in the hospital, then you will definitely be told to come and lie down. This does not mean that everything is bad (about what “green waters” means, I will write another article), it means that more careful observation is needed. If we are talking about home birth, then your midwife will most likely immediately come to you and monitor the situation.

Next, I write about the situation when the waters are clear

We pay attention to your general condition, temperature (should not rise), emotional background. Fear and fear are adrenaline that blocks oxytocin and childbirth, so it is important to calm down and create safety for yourself. Moreover, for some women it is safe to immediately go to the maternity hospital and go under observation, while for others it is to stay at home, do ordinary things and calmly wait until the contractions begin.

And, perhaps, the most important thing that we pay attention to is the condition of the child. Here, it seems to me, many women are unaware that in fact the only way to understand whether everything is in order with the child is to listen to his heartbeat. Yes, there are also ultrasounds, but ultrasounds cannot be done constantly, for many hours. It can show that the baby is in order, the placenta is working, the water is preserved (albeit decreased), the cervix is ripe. But that's all.

Then CTG or Doppler comes into play. These are devices that are applied to the stomach and they read the rhythm of the heartbeat. In maternity hospitals there is a large device that records readings and itself recognizes strong changes and deviations. And home midwives carry portable hand-held dopplers or wooden tubes with them, with which they listen to the heart in the same way, only the device does not record and does not recognize the signal itself, here the midwife's ear is already working.

I find something surprising for many women. If you are calm and confident enough, then you can (and let the doctors throw tomatoes at me) track your heartbeat yourself. It is enough to learn to determine in which place of the abdomen you need to listen, and find out about digital indicators. I don't encourage everyone to do this. For many it will be too dangerous. But I know for sure that there are those for whom it will be on the contrary important - to find out what you can do yourself.

So, the only way to determine whether everything is in order with the baby in the situation of receding waters and further throughout all births is the heartbeat. If it is normal, it means that the flight is normal.

Based on all of the above, in many countries a protocol has been established - after the discharge of the waters, wait 72 hours, during which, as a rule, the woman begins contractions and she goes into labor. That is, the discharge of water without contractions is not childbirth!

In Russia, the protocols are as follows:

In many maternity hospitals, a woman is given 6 hours. If contractions do not start, then stimulation begins by type: artificial oxytocin → epidural anesthesia → weak efforts → squeezing (Kristeller's maneuver, banned in many countries) → episiotomy. Or just a caesarean section.

Why? Because they are afraid of the first point, antenatal death, and do not want to mess with a woman (after all, this is a free birth and she is in the pipeline).

In addition, antibiotics are prescribed. Why? Because they are afraid of the point about infections:

- in some maternity hospitals they give 12 hours and then everything is the same
- in advanced maternity hospitals they give 24 hours
- in Moscow, literally in a couple of maternity hospitals (or maybe in a single one) a woman is given 72 hours

♦️ It is important to know that “they give in the hospital” I mention as a figure of speech, and not as a fact. You can always refuse stimulation, write refusals and continue to wait, even if the maternity hospital “has not heard” about 72 hours and considers it a fiction.

Doctors are not gods, they can be very wrong, many are stuck at the level of medical knowledge of the last century and are not interested in modern medical research and protocols. And yes, some kind of you ordinary woman, reading the Internet, may be more competent than a whole, huge DOCTOR.

In home births, they usually wait the same 72 hours, the midwife listens to the heart, Life is going in their turn, and as a rule, contractions begin and childbirth is launched during this period, solo-children wait as long as they decide for themselves, and monitor their condition themselves.

2. The second option for a bubble burst is when it bursts somewhere high. In this case, when manually inspecting, we find a whole bubble, but the water is leaking and then it is obvious that the gap is much higher. This option is called water leakage.

In this case, it's even more interesting:

♦️ below the bubble is intact, the head has not moved down so much, there is no pressure on the neck and thus there is no stimulation either, so there may not be contractions at all for a very long time
♦️ water leaks little by little, they are renewed even with limited mobility ( bed rest) on ultrasound, you can see that the water index is increasing, although initially it was falling
♦️ the practice of home obstetrics, and especially the practice of conscious solo birth, shows that a woman can pass from such a situation of leakage for longer than 72 hours. In my personal practice (this is when I saw it with my own eyes) there were 4, 5 and 8 days. In the cases I read and heard, it even reached a couple of weeks. Irina Martynova's book "Confessions of a midwife" describes a case when a woman lay at home like this for 6 or 7 weeks (water began to leak at 32 weeks, if I remember correctly). But this is an exceptional case, which I just mention to show that this happens. Usually we are still talking about a full-term pregnancy and childbirth begins spontaneously within a week
♦️ in the maternity hospital for this situation, the same maximum protocol is 72 hours, they will not let you walk for a week, perhaps nowhere.

What should be feared?

The same as in the first situation: worsening of the heartbeat (this is perhaps the main thing) green, brown, dark color of the water. ♦️ The norm is light, transparent, pink water. general condition infection development.

Summarizing

I'm a doula and I don't make recommendations. A recommendation is a verb in the imperative mood that calls for action. I give information. Information is provided using the phrases “there is such an experience”, “it happens this way and that”, “you can do this” (but you can not do it, you are free to choose). That is why I will now write the word “can” below, which implies that there is some possibility, but everyone decides for himself whether to take advantage of this opportunity or not.

♦️ You can stay at home and not go to the maternity hospital right after the discharge or leakage of water for at least 6 hours, and at most about 3 days

♦️ If you are already in the maternity hospital, then you can write a receipt and refuse stimulation if it is offered earlier than after 72 hours and the condition of the woman and child is good

♦️ You can stay at home with water breaking/leaking and call a midwife, with whom you can arrange for her to monitor you and your baby until the contractions start and you go to the hospital (this service is usually called escort to the hospital, or it is possible, if you have a contract for an individual midwife in childbirth)

♦️ You can buy a manual doppler, study the information yourself and monitor the baby's heartbeat until the contractions begin.

And the important thing is that these opportunities are based not only on experience, but also on data from evidence-based medicine. I don't want to overload the text with links to research. Who cares, a lot of information can be found on pubmed and in English sources.

See also online workshops on childbirth by a rehabilitation doctor Oleg Leonkin from the cycle Lecture by Marina Golubtsova

Photo by Natasha Hanks

The waters have broken - after how much to give birth? This question worries, probably, every woman who is soon expecting the birth of a long-awaited baby. However, no gynecologist can give an unambiguous answer to this question, since the process of labor activity is a purely individual process for each woman in labor. In order for everything to go smoothly, you need to know what to do when the amniotic fluid leaves, and when, after that, the first harbingers of the upcoming birth should be expected.

How to behave after the departure of the OB?

What to do after amniotic fluid breaks? First of all, there is no need to panic - this is a physiological process, which is one of the main ones. Now let's talk about what exactly needs to be done if the OVs move away.

If the water has broken, then it's time to go to the hospital

Remember, or rather write down in a notebook the exact time of the departure of the OM. Then be sure to tell your gynecologist or nurse about it.
Pay close attention on the color of the liquid. So that she does not change the shade, a week before the birth, give up the dark bottom and bed linen- such actions will help you accurately determine the color of the OB.
What should be the departed waters? Normally, they should not have any shade, that is, be completely transparent. If you notice an admixture of white flakes in the amniotic fluid - do not worry, this is normal.
The greenish color of the OB indicates that literally in 6 hours the patient will give birth to a long-awaited baby.
The amount of amniotic fluid is another important factor. According to it, you can determine after what period of time childbirth will begin. Waters can be "anterior", the volume of which does not exceed 300 ml, and real amniotic (1.5 - 2 liters).

Helpful advice. If you don’t know how to determine which waters have broken, then you can practice a little before the due date. You can do this in the following way: pour on inside hip glass of water. Remember your feelings, then pour one and a half to two liters of liquid on the same part of the body. By doing this for at least a week, you will soon learn to distinguish between "front" water and amniotic fluid.

After the outpouring of amniotic fluid, it is urgent to call an ambulance, especially if there was a lot of water. With a small number of them, you have a couple of hours left, but you should go to the hospital as soon as possible.

Is the discharge of the mucous plug a signal of the imminent onset of labor?

A mucus plug is a clot of mucus streaked with blood. It performs an important function - it protects the uterine cavity from infection. Thus, throughout the period prenatal development the fetus is completely safe.

It is far from always a harbinger of an approaching birth. Many women mistakenly believe that she does not leave them at all before the onset of labor. The fact is that it can depart gradually, in streaks, and not all at once in a lump. The process can begin long before the opening of the cervix and the discharge of the OB. For each pregnant woman, it depends on the characteristics of the body and the course of pregnancy.

Mucus plug during pregnancy

Important! If you have noticed in yourself frequent occurrence bloody or mucous discharge on underwear, consult a doctor immediately. This may be evidence not of the release of the protective plug, but of the attachment of an infection. This condition requires immediate medical attention!

What sensations arise when the cork leaves?

The discharge of the mucous clot can be accompanied by rather unpleasant and painful sensations. However, it all depends on how acutely the body of the expectant mother reacts to the pain syndrome.

In one woman, the process of cork discharge can be very painful and accompanied by discomfort in the lumbar region. For another mom, it may happen unnoticed, such as while taking a bath, shower, swimming in the pool, or going to the restroom.

After the discharge of the mucous plug, it begins to gradually soften. The same thing happens with the birth canal. Due to this, the fetus can freely, and with minimal risk to the health of the mother, move along them.

One of the most frequently asked questions about this is the question, is it true that after the release of the protective cork, the baby immediately appears? And can this process be accelerated?

In this case, doctors give helpful advice: do not try to bring the birth closer on your own - everything should happen gradually, and only naturally. Any intervention in the process of childbirth can lead to consequences that are dangerous for the health of life, both for the mother herself and for her unborn baby.

To understand when childbirth begins after the cork is released, you need to pay attention to some nuances:

color and consistency of mucus;
prolapse of the abdomen (if any);
the presence of contractions, and not false, but real;
increased urge to defecate.

All of these factors signal that you will meet your little miracle pretty soon, and by that time you should be ready.

Departure of OV - how does it happen, and what to do in this case?

If the expectant mother's amniotic fluid departs, this means that the time has come, and the baby is already ready to be born. But sometimes it happens that the outpouring of amniotic fluid occurs prematurely, when the term of labor activity does not come soon. Such an anomaly occurs in the presence of certain deviations, so medical intervention is required.

Any strange discharge during pregnancy should be reported to the doctor immediately.

The fact is that the discharge of fetal waters should always end in labor, since the baby cannot stay in a dry, unprotected environment for a long time. Also far from uncommon are cases when the fetal waters flow out little by little. This happens gradually, and can last for several weeks, and sometimes even months.

If the leakage of amniotic fluid began long before the planned date of delivery, then such an anomaly should be reported to the gynecologist. He will accept necessary measures, since a decrease in the volume of amniotic fluid can lead to quite serious and dangerous consequences, up to hypoxia or even death of the fetus.

Remember! Any, even meager ones that have caused you suspicions and concerns, must be reported to the doctor. Especially if they have a greenish, brownish or brown color.

What to do with the departure of OV?

So what to do if the amniotic fluid has poured out completely? First of all, you need to urgently go to the maternity hospital, and here's why:

the doctor must establish how wide the cervix has opened, and constantly record this process;
sometimes the outpouring of fetal fluid is not accompanied by contractions, so the expectant mother may not understand that the long-awaited moment "X" is already close;
in some situations, along with AF, loops of the umbilical cord may also fall out, and this is already serious threat for the life of a child.

As you can see, the sooner you go to the hospital after the water breaks, the safer your baby and you will be.

When to give birth if the water has broken?

So, when to give birth if the waters broke? First of all, you need to pay attention to the features of fights. Quite often, they begin when the bubble with the amniotic fluid has already burst, and it has completely poured out.

During the anhydrous period, discomfort for the fetus inside the genital organ begins to increase, so the process of childbirth should occur no more than half a day after the amniotic fluid has passed. If it becomes obvious that labor will not begin so soon, the doctor will be forced to resort to at least - artificial stimulation delivery.

Important! If you, while at home at the time of spontaneous opening of the bladder with water, notice blood impurities in the fluid, call an ambulance immediately! Just make sure it was really blood and not a mucus plug first.

The danger of the situation in early pregnancy

It happens that the OM is poured out for a period of 22 weeks. This condition is extremely dangerous and requires immediate medical attention. Otherwise, the woman may have a miscarriage.

If the waters poured out after 22 weeks, then the expectant mother has every chance to keep the pregnancy, or give birth, but completely healthy baby. Of course, such babies are born prematurely, and very weak, but modern doctors can leave such a baby, giving him a chance for a healthy life.

Water discharge without contractions - is this normal?

An examination by a doctor will determine the time of onset of childbirth after the water has broken.

If your fetal waters have broken, and contractions have not yet begun, this is not a reason to panic. The body of each expectant mother is individual, therefore it is impossible to say exactly how the birth will take place in each specific case.

A gradual outpouring of amniotic fluid may also occur. In this case, it will proceed for several days, and the maximum safe length of the waterless period is only 6 hours. Its deviation upwards is allowed, but it should last no more than a day. If during this time the baby was not born, this can lead to serious complications and adverse consequences for the health of the crumbs.

In such a situation, the patient is also shown drug stimulation of labor. Often, for this purpose, special tablets are used that soften the cervix. After their use, childbirth should begin within half a day, a maximum of 24 hours.

With no effect from medications causing contractions, expectant mother an emergency caesarean section is performed. Only in this way it will be possible to avoid adverse consequences for the child, which threaten a long anhydrous period.

Interesting fact. In women who are going to give birth for the first time, the interval between periods of water discharge and the onset of labor is from 12 to 20 hours. With the repeated process of labor activity, this gap is reduced several times.

In order not to miss an important moment, you should monitor your condition even before the OB bubble bursts. should bring you to full “combat readiness” and force you to pack a bag for the hospital, because just a little bit - and you will meet your long-awaited and so beloved baby!