Most women can have a natural childbirth even if labor doesn’t begin soon after their water breaks, according to a new study.
This situation occurs in about 11% of pregnant women who carry to term. Labor is typically induced in such cases.
But University of Michigan researchers found there is no significant increased risk to mother or infant in waiting awhile for labor to begin on its own — an approach called expectant management.
The study included more than 2,300 U.S. women cared for by a midwestern midwifery service between January 2016 and December 2018.
In 12% of those women, the amniotic sac ruptured early — commonly referred to as water breaking. Of those, 53% decided to wait at home for labor to begin; 36% were expectantly managed in the hospital; 7.5% were admitted for immediate induction of labor; and 3% were admitted for immediate cesarean birth.
Of the women who chose to wait, 65% went into labor on their own and did not need to be induced.
Labor is typically induced in these cases because it’s believed that the risk of infection for both mother and infant increases the more time elapses between rupture of the amniotic sac and the start of labor.
But infection rates did not differ between the different groups of women whose water broke early, the researchers said.
The findings showed that both inducing labor and using expectant management should be considered when water breaks early, and the decision should be guided by the mother’s wishes and health, according to study co-author Ruth Zielinski, a nurse midwife and clinical professor in nursing.
“Twenty-six years ago when I graduated from midwifery school, I assumed everyone wanted to avoid induction, but this is definitely not the case,” she said in a university news release. “Often, patients want to get things going and are fine with induction. However, with healthy, term pregnancies, waiting for a period of time for labor to start is reasonable and should be offered.”
It’s important for pregnant women to discuss their options with their care provider, Zielinski said.
The findings were published online recently in the Journal of Obstetric, Gynecologic & Neonatal Nursing.
The U.S. Office on Women’s Health has more about labor and birth.
SOURCE: University of Michigan, news release, March 9, 2021