scoobynutta555

Is there any experts in childbirth available to give me a second opinion?

A bit of brief backround:

My g/f was admtted to hospital with pains on Friday eve. She is apparently 35 weeks gone according by her approx due date.

She was kept in with pains and today she broke her waters. According to the consultants we have spoke to they are adopting a 'wait and see' approach until she gets to 37 weeks, a whole 2 weeks away!; will be discharged after 48 hours if she is pain free and asked to attend daily clinics to check for infection etc. She has been given steroids for the baby's lungs. She had a scan today where she was told the baby was large and approx 6 lbs, and few amionic fluids remain.

Now, from what I've seen and read it's recommended that after 4 days maximum if the baby isn't coming to induce the birth, (sometimes straight away) even though she is between 34-37 weeks. I've read that the risk of infection far outweighs the risk associated with a baby only 34 weeks in.

Added to this she is 100 miles or so from her 'home' hospital which is Luton. She's in Heartlands Birmingham at the moment. From what I understand both have rare preterm specialist units. They want to move her to Luton for observation.

Am I wrong in thinking I'm being given duff advice here? Naturally I don't think I know more than a consultant with years behind them, but it's at odds with what I've read myself. I'd prefer if they wait 48 hours after waters breaking before inducing straight away to prevent infection etc.

They seem very determined on getting her out and down to Luton, even telling her she 'had a low pain threshold' before her waters broke. Basically saying she was lying about her pains.

I'm getting pretty fed up of her treatment here. Any sensible advice from a professional or someone familiar with this?

Surely waiting over 2 weeks for labour without the fluids in place is madness, even if on antibiotics?

Lee247

I'm no expert other than having two kids. I always thought once the waters broke that birth could be within about 24 hours
Check out this link, I am inclined to agree with you and be concerned. Deep Singh might be able to advise you better

HON Mother & Child Glossary, The First Stage of Birth: Labour

Suresh

I'm also not an expert, but have an experience to share: Our boy was born 2 days after his mother's waters broke @ 37 weeks. She was on antibiotics all the while and I had to scrub her toilet daily to keep the risk of infection low. Such is the role of a dutiful hubby!

She should call her own midwife for advice ASAP i.e. talk to someone whose opinion she trusts.

Lee247

2 days

I gave birth 23 hours after my waters broke and I thought that was bad enough

Suresh

The Dutch are much more relaxed about such things and even encourage people to give birth at home if there are no medical indications.

They have a very low mortality rate, so they must be doing something right!

scoobynutta555

What concerns me is that if after 2 days the baby isn't born they're just going to discharge her and keep an eye on her. I've read a US article that says between 34-37 weeks they recommend that iducement takes place quite soon to prevent infection. At that term it says better to be born a few weeks early than to suffer infection. I just think we're getting palmed off here. Nowhere at all have I seen that you should wait 2 weeks after waters breaking, it seems ridiculous. And on top of that busing her 100 miles away.

There's very little information out there for preterm and waters breaking, most of it centres around 37 weeks. Still, there's nothing that i've read that says wait up to two weeks after waters breaking.

john banks

Whilst it is worth doing your own reading and discussing things, it is between your gf (& you) and her Consultant to decide on management. It is for her to make sure the issue has been discussed, and it is for the Consultant to reach an agreement with her having discussed the pros/cons of each option. The Consultant not only knows her history and present results, but has the training/experience and the legal responsibility for her care at this point - not her midwife, and not a paediatrician. Midwives are neither qualified or legally responsible for the decision to induce labour or not at this point.

Apparent commonsense or opinion can be misleading in cases like this. The evidence base from controlled trials can also be lacking to apply to a particular situation.

It is common to wait & see in this sort of case. It is commonly believed that the main infection risk is to the mother and is small. A large baby can still be immature. Infection can be either the cause or the result of rupture of membranes. There is about a 50% chance of spontaneous delivery in the next week I gather, and then a further 50% chance each week thereafter.

Lee247

You are obviously very concerned and rightly so. I would seek a second opinion. Hope it all goes well

scoobynutta555

Hi John, thanks for that.There has been no consultation with us from a consultant, they just keep on about moving out and away to Luton. It's very one dimensional thinking, and no discussion of pros and cons of infection versus premature delivery. From what we've experienced they don't even read the notes properly as they have to be retold facts other consultants were told. She has been also given conflicting reports from different people.

I fully appreciate that each case is different and no-one can offer exact advice not being in front of her files.

But, I simply cannot find anything that says two weeks after waters breaking you still adopt a wait and see approach. The very maximum I have seen anywhere is 4 days.

The 48 hours following waters breaking nearly 90% of labour starts. I'm just concerned that nothing is going to happen in 48 hours.

scoobynutta555

BTW I mentioned paediatrician as I'm sure that was the title of our last consultant. There's been 3 consultants to see her as far as i know.

Suresh

Watch out for GPs too! Ours opined that the waters hadn't broken and told the missus to just go home (actually she went shopping) despite the telltale odour of amniotic fluid. Luckily the midwife was available to override the GP and sent her to the hospital where her opinion was confirmed

Lee247

Just as a matter of interest, how is your partner feeling at the mo'

Stephb1986

i hope your missis is ok its a stressful time for both of you just do what you think is right

Manda_po

I was taken in early when my waters broke, but that was only three days early and they were letting me go nowhere. Perhaps the risk of infection is less the earlier in the pregnancy. In any event your major concern seems to be the risk of infection so you need to be asking direct questions about that to the relevant people. Good luck.

sarasquares

iTrader: (1)

i had one of mine at the L&D, he was 3 months prem, my waters had already broken, i went into labour but it tailed off, this happened for a few days. the body will continuously make the water that surrounds the baby. i was told about the risk of infection with the waters broken.
my son was born with an eye infection. he went on to die from Septecemia as his body was too small to cope. they didnt have much time to give the steroids, but his lungs were very good. with a baby that is nearer term, as yours, is at a much less risk, but the dangers are always there, especially with all the deadly bugs around now.
she would be better off at home where the chance of infection are less. the baby will probably come in a few days as the amniotic fluid contains a hormone that triggers labour. i dont imagine they will interfere too much as its intervention which is unnecessary to the baby.

good luck, hope it all goes well

a paediatrician is a person that looks after the baby when its born

scoobynutta555

She's on pethadine at the moment and getting back pains. No consultant has mentioned infection as such, just pressing on about antibiotics as if antibiotics are given no infection will occur.

Lee247

Back pains is a good sign of imminent labour. Fingers crossed 35 weeks and 6lbs is fine You could be a Daddy by the morning

sarasquares

iTrader: (1)

its worth her having them now as it takes a while for them to start working if she does get an infection. its just a precaution.

scoobynutta555

Hopefully soon! 35 weeks according to the notes. Could it not be 37 weeks as the due date is only an estimate anyway? There's been an issue with the due date from the off as being too far.

Manda_po

I agree, you haven't had a drink have you?

sarasquares

iTrader: (1)

when i was going into prem labour i was told about women that can often go for months with no waters. its prolly not ideal for such a long time but its the best place for the baby while it matures. at 35 weeks your baby has almost 100% survival rate. they may just be waiting for nature to take its course. its a really anxious time. i couldn't understand how a baby can survive with little amniotic fluid, but you would be surprised. try not to worry, but question everything to reassure yourself. just be prepared for the long haul

Lee247

I was told, and they were adamant, my baby would be born on 13th March. She came on 27th Feb. I was convinced I was two weeks ahead of what they said and I was right. They are always 2 weeks either way.
My Son, on the other hand, was exactly 40 weeks like they said
Sounds to me like it won't be too long
Please keep us informed.
I reiterate, if you are worried, I would still be inclined to seek a second opinion.

Lee247

Just poured myself a glass of wine

Manda_po

I meant him ,for getting to the hospital, as well you know.

sarasquares

iTrader: (1)

i might join you, still waiting

tronlc

This is a reply from the ball and chain......

I'm not a midwife but did do some midwife training, and my aunty is a midwife.....
As the guy said above midwives cannot give any orders for inducing, however it seems to me that the 'care' that your partner is recieving is nowhere near what it should be, you really should get a second opinnion, it is common for them to adopt the wait and see approach in these cases, yes, yet these cases are often mis-diagnosed, so I would demand some straight answers from the probably numerous consultants that you have allready seen.

It is likely that your partner will have a spontanious birth within the next 7-10 days, and yes, a large baby can be premature. As far as infection goes I wold not be too concerned about infection to the baby, but more so to your partner, they are doing the right thing putting her on antibiotics, and these will keep any infections at bay.

As far as moving her to a hospital that far away, that does not suprise me at all, as the sad truth is that there are not enough midwives, pre natal staff, so they often choose to palm patients off to someone else. If this is a case of 'we haven't got enough staff.....so let's put her on antibiotics and hope for the best...' then that wouldn't suprise me either.

Get your questions together and be ready to baombard the doctors...as you have the right to be concerned.

Hope this helps, hope you get some answers soon.

his ball and chain!!!

Stephb1986

* runs down to the fridge for the half bottle of vodka*

right i have vodka anyone want any???

Manda_po

<nods>

Lee247

Sorry, am in a reet one tonight