Just curious. One of the hospitals here mandates strict bedrest (not even up to the bathroom) after ROM. Is this a common practice?
Canadian_Nurse 59 Posts Specializes in Obs. Has 12 years experience. 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 133 Posts Oct 25, 2008 I am just a student...but where I delivered my son I was able to walk around after my SROM.
sunnysideup09 220 Posts 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 6,011 Posts Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89. Has 30 years experience. 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 41 Posts Specializes in PEDS/NSY/L&D/med-surg. Has 6 years experience. 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 1,187 Posts Specializes in tele, oncology. Has 10 years experience. 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 17 Articles; 5,259 Posts Specializes in Community, OB, Nursery. 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 203 Posts Specializes in OB, House Sup, ER, Med Surg. Has 5 years experience. Oct 25, 2008 We allow them to walk and even get in the tub as long as head is engaged.
lisamct 172 Posts Specializes in learning disabilities/midwifery. 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 165 Posts Specializes in Labor & Delivery. Has 10 years experience. 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 1,168 Posts Specializes in Rural Health. 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.
