Does your hospital have a policy on no walking after ROM?

Canadian_Nurse · Oct 25, 2008

No...I've never heard of something so foolish! At my hospital, patients with ruptured membranes with no complications (no mec, no GBS+ status) and in no labor go home to await induction or labor, as long as they are cephalic.

Smurfette752, BSN · Oct 25, 2008

I am just a student...but where I delivered my son I was able to walk around after my SROM.

sunnysideup09 · Oct 25, 2008

If a fetus is not engaged, then no mother should be up after ROM due to risk of prolapsed cord. Is that what their policy is?

P_RN, ADN, RN · Oct 25, 2008

Yeah back in 68 and 70. I thought they'd learned a thing or two in the past 38 years. I kept saying I had to void......"no you don't that's just pressure" Well in a few minutes they wished they'd put a chux on the bed.

sample24 · Oct 25, 2008

Our facility has a strict bedrest policy after ROM. Not even to the bathroom. It's bedpan only, or foley if they have an epidural in place. This doesn't mean I completely agree with this policy under the right circumstances, but it's what we have in place now.

mama_d, BSN, RN · Oct 25, 2008

I know when I had my toddler at my facility they wouldn't let me out of the bed after they ruptured my membranes when checking dilation while triaging me. I was told b/c of risk of prolapsed cord.

Elvish, BSN, DNP, RN, NP · Oct 25, 2008

That is crazy. It's easy enough to check if head is engaged. I walked for hours and hours after I ROMed w/ my son. Our women walk all the time w/ ROM, as long as head is engaged.

Perhaps some of our UK/Aussie friends could shed some light on how things are done up/out/over there. I hear the rules are sometimes different...

hoppermom3 · Oct 25, 2008

We allow them to walk and even get in the tub as long as head is engaged.

lisamct · Oct 25, 2008

If their membranes rupture and they're not in labour, babies head is engaged and all is 'normal. our women are sent off home to do whatever they can to get themselves into labour and brought back 24-36 hours later for induction if nature doesnt kick in first.

If they rupture and are in labour and staying in the hospital then they're encourage to mobilise as much as possible, use the ball, the shower/tub or the birth pool pretty much the same as someone who's membranes are intact.

Only time it would really be different would be if there was another issue that made them more high risk. Saying that, the only time they wouldnt still be encouraged to mobilise would be if the babies head wasnt engaged otherwise they can mobilise as much as they want and as far as CTG cables allow!

Sandwitch883RN · Oct 25, 2008

Our policy is no amublation after ROM. Either bedpan or if epidural then it's a foley. I PRN in another facility that does allow for walking after ROM. They don't do epidurals, only intrathecals and very few women get a foley. However, both places discourage laboring in any position other than on the back in the bed. Being a labor nurse is so discouraging! I wish CNM's ruled the world....lol!

mom2michael, MSN, RN, NP · Oct 25, 2008

We have a group of docs that don't care at all. Whatever you want after ROM is fine with them. We have another group that doesn't let them move from the bed after ROM and 99.9% of the time as soon as soon as we have ROM, then it's off to IUPC's and FSE's anyway.

I wish we could send them home and let them stay at home but if a patient presents to our triage with ROM, they WILL have a baby in 18-24 hours period. If that means a C-section then so be it.

If we have a ROM >18 hours, the baby is started on ATB of the Peds choice, even if the CBC is normal and baby has a normal (and stable) temp. Preventive care measures they call it.