What is the Evidence for Inducing Labor if Your Water Breaks at Term?

What is the Evidence for Inducing Labor if Your Water Breaks at Term?
By Alicia A. Breakey, MA, PhD Candidate, Angela Reidner, MS, CNM, and Rebecca Dekker, PhD, RN, APRN

Another amazing article from Evidence Based Birth!

“Many people are under the impression that once a woman’s water breaks, she only has 24 hours to give birth or she will automatically need a C-section. Where did this opinion come from? Is it evidence-based?”

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What is PROM?

Prelabor or “premature” rupture of membranes (PROM), happens when your water breaks before the start of labor.

Term PROM is when your water breaks before labor at ≥37 weeks of pregnancy.

Preterm PROM, or PPROM, happens when your water breaks before 37 weeks.

The evidence on induction versus waiting for labor with term PROM is hard to interpret. This is because each research study set its own standards for how labor was induced, how long people waited for labor to begin before being induced, and what conditions required a Cesarean. These differences can lead to very different findings among studies that are supposed to be answering the same question.

The American College of Nurse Midwives (ACNM 2012) states that women with term PROM should be informed about the risks and benefits of expectant management versus induction, and that if women meet certain criteria, they should be supported in choosing expectant management as a safe option. These criteria for safe expectant management include:

• • Term, uncomplicated, singleton pregnancy
  • Clear amniotic fluid
  • No infections, including GBS
  • No fever
  • Normal fetal heart rate
  • No vaginal exam at baseline; keep vaginal exams to a minimum

Inducing labor for term PROM is a valid, evidence-based option for most people. At the same time, waiting for labor to start is also a valid, evidence-based option for most people. The person’s values, preferences, goals, and unique medical situation should always be taken into account when discussing their treatment options.

Read the entire article HERE.