Labor: What to Do When Water Breaks but Baby Isn't Engaged

Q: Labor: What to Do When Water Breaks but Baby Isn't Engaged

Hello, the questioner： After the water breaks, if the fetal condition is stable and there is no infection, it is generally considered safe to deliver within 24 hours. <br>However, there are specific criteria for deciding whether a cesarean section is necessary, and many factors a

The amniotic sac has ruptured, but the fetus has not yet engaged in the birth canal?

Dear Doctor: I previously asked you about the signs of labor, and just as you said, the labor progressed very quickly! I started having contractions in the middle of the night, but they were not very noticeable, so I didn't pay much attention.
By 7 AM, the contractions were every five minutes, and by the time I got to the hospital, I was fully dilated.
My water hadn't broken, and there was no bloody show.
On the way, I felt the baby descending and had the urge to push, but I held back since I hadn't arrived at the hospital yet.
Once in the delivery room, the doctor said the baby hadn't descended yet, and I didn't feel the urge to push.
My water was broken, and after waiting an hour, if the baby hadn't descended, I would need a cesarean section! If I remember correctly, after the water breaks, isn't it possible to wait for 12 hours? Is it true that walking more after a cesarean section helps with recovery? Why does walking help the wound heal faster? Also, I had my first bowel movement four days after the cesarean, and it was dark and foul-smelling; is that normal? In Thailand, they remove stitches after a cesarean; do I need to clean the wound every day? How long until I can eat sesame oil and herbal dishes like "Four Herbs" and "Ten Complete Nourishments"?

Mao Mao, 30~39 year old female. Ask Date: 2012/08/14

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the questioner: After the water breaks, if the fetal condition is stable and there is no infection, it is generally considered safe to deliver within 24 hours.
However, there are specific criteria for deciding whether a cesarean section is necessary, and many factors are taken into account, not just the rupture of membranes; the attending physician will make the judgment.
After surgery, early mobilization can reduce adhesions and facilitate earlier bowel function recovery.
Additionally, resuming diet can help restore strength more quickly.
If the stool color is dark, it is important to consider whether iron supplements or other dark foods have been consumed; otherwise, a physician should evaluate whether there are other underlying causes.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2012/08/14

More Info

When it comes to labor and delivery, particularly in the scenario where the water has broken but the baby is not engaged, there are several important considerations and recommendations to keep in mind.
Firstly, it is essential to understand that when the amniotic sac ruptures (commonly referred to as "water breaking"), it can lead to a variety of outcomes depending on the timing and circumstances surrounding the rupture. In most cases, if the water breaks before labor begins, healthcare providers will monitor the situation closely. The general guideline is that if labor does not start within 12 to 24 hours after the water breaks, there may be an increased risk of infection for both the mother and the baby. Therefore, if the baby is not engaged and labor is not progressing, medical intervention may be necessary, which could include inducing labor or performing a cesarean section if the baby is not descending properly.

In your case, since you mentioned that the water broke and the baby was not engaged, the healthcare team may have opted for a cesarean section to ensure the safety of both you and your baby. It is crucial to communicate openly with your healthcare provider about your concerns and preferences during this process. They can provide you with the best options based on your specific situation.

Regarding your questions about recovery after a cesarean section, walking is indeed encouraged post-surgery. This activity helps promote circulation, reduces the risk of blood clots, and can aid in the healing process. It is important to start slowly and listen to your body, gradually increasing your activity level as you feel comfortable.

As for your bowel movements post-surgery, it is common for the first bowel movement to be delayed for several days after a cesarean section due to the effects of anesthesia, pain medications, and the physical stress of surgery. The stool may appear darker and have a stronger odor, which can be attributed to the presence of meconium, the first stool of a newborn, that may have been absorbed into your system during pregnancy.

Regarding wound care, it is essential to keep the incision site clean and dry. If your healthcare provider has advised you to clean the wound, follow their instructions carefully. In many cases, sutures or staples will be removed during a follow-up appointment, but it is vital to monitor for any signs of infection, such as increased redness, swelling, or discharge.

As for dietary considerations, including the consumption of traditional postpartum foods like sesame oil or herbal tonics, it is best to consult your healthcare provider. They can give you personalized advice based on your recovery progress and any dietary restrictions you may have.

In summary, when your water breaks but the baby is not engaged, close monitoring and communication with your healthcare provider are crucial. Post-cesarean recovery involves careful attention to activity levels, bowel health, wound care, and dietary choices. Always feel free to ask your healthcare provider any questions or express any concerns you may have during this time. Your health and the health of your baby are the top priorities.

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