Bath After Broken Water

I've heard the infection risk is minimal because of that and because the amniotic fluid is also trickling outward, but most hospitals I've been at don't allow bathing after water is broken anyway.

Personally I'd be comfortable bathing after my water was broken.

I am still a student by the way, but I don't think my opinion would change on this if I were already a nurse. From what I know water birth hasn't resulted in a lot of infections.

I'd be just the opposite. No bath for me. Any risk of infection to my baby is not worth it. Now, if I felt like I HAD to be washed for some reason, I'd hop into a shower for a quick rinse. But, everyone has their own opinion.. and I never had to deal with that, because my water never broke. I had an emergency C section the first time, and then followed that with C sections every time (total of 4).

I believe most studies cite the risk of infection is minimal. Obviously, we wouldn't perform water births if there was a risk of infection from sitting in a tub.

Not to mention, birth is not sterile. :)

Over and over I have seen studies in Midwifery journals, and OB articles that state the infection rates have been overrated in the past. That is, tub bathing is NOT a risk factor in causing infection in laboring women, but numerous lady partsl exams ARE. I can't remember WHERE I read it but something along the lines of 5 to 6 vag checks, and you raise a woman's chances of infection exponentially with each additional time you do this. I would sooner believe that than the idea that tub baths and birthing are infection risks by themselves.

I've heard two sides to this:

No bath after water is broken because of risk of infection

and

The risk of infection from taking a bath is minimal, because water is not usually FORCED up the lady parts

What are your thoughts on this and which do you agree with?

While I have no problem with a patient showering after her membranes have ruptured, I don't think bathing is a good idea. It is true that bath water is not forced into the lady parts, but it does enter and fill the lady partsl canal passively. That enables bacteria from the bath water to get into the lady parts, where they can begin an upward migration toward the baby. Without intact membranes for protection, the baby may potentially become infected, especially if labor is prolonged. This applies to all moms with ruptured membranes, not just those who are colonized with beta strep.

It would be interesting to see if there are any studies comparing neonatal infection rates in moms who bathe with ruptured membranes versus those who don't.

While I have no problem with a patient showering after her membranes have ruptured, I don't think bathing is a good idea.

So water births and/or hydrothearpy are not allowed at your facility?

I was in the tub with all 3 babies..after my membranes ruptured..

1st in hospital with CNM...went in the jacuzzi after 6 cms till pushing

2 and 3rd at home....labored almost totally in the water and 3rd was born in the water. i never had any complications at any time....

We let moms bathe with ruptured membranes...Of course, we wash our tubs a lot....Some MDS suggest no baths at home with ruptured membranes only because the hygienic habits of people are not neccessarily known...I say people can make up their own minds but we definitely encourage it on our unit..It is a wonderful way to have them relax and does wonders for back pain...

I fail to see how laying in a bed (or sitting on a chair, or labor ball) in a pool of amniontic fluid can POSSIBLE be "safer" than being in a tub?????

there is a risk of infection the minute a woman's water breaks (even before) but I think we need to think more about what the risks really are and practice accordingly.

So water births and/or hydrothearpy are not allowed at your facility?

No water births. Jacuzzi's used for patients with intact membranes, and for post-partum moms.

When you do water births, how long is the patient "submerged" prior to birth? I can see that it would probably not be an issue if the patient enters the water shortly before delivering (no time for the bacteria to migrate and infect the baby), but I'd definitely be afraid of infection with patients whose membranes are ruptured who soak in a tub, and then don't deliver for a prolonged period of time.

We let moms bathe with ruptured membranes...Of course, we wash our tubs a lot....Some MDS suggest no baths at home with ruptured membranes only because the hygienic habits of people are not neccessarily known...I say people can make up their own minds but we definitely encourage it on our unit..It is a wonderful way to have them relax and does wonders for back pain...

Do you have a special protocol for moms with beta strep? Hepatitis?

I guess like anything else, tradition tends to guide our practice more than it should. I'd be open-minded if research demonstrates its safety. Unfortunately, with the lawsuit-happy public these days, it would take only one case of "tub aquired" infection to ruin an OB's practice and put the tubs in mothballs.

The risks of infection are minimal. I chose to labor in the water with my 4th child, after my membranes broke. Certainly, the risks are far less than internals every hour! I would definitely support a woman who chose to labor in the tub. I hope to be a part of a hospital that allows that option for women. I wonder what the justification is for those hospitals that don't allow it? What is their scientific evidence to support such a policy, when the benefits to women can be so tremendous?

Lisa M.

Nursing Student