Your Water Breaks First - A Date to PROM (Premature Rupture of Membranes) - The Risk of Infection

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Of most concern, to women who present with a spontaneous rupture of membranes before labor is established, is the risk of maternal and neonatal infection and indeed, infection is a concern, this risk should be treated with the respect and caution that it deserves, but there also exists room for putting things in their proper perspective.

Infection is the most modifiable of all these possible complications as it is both preventable and treatable.

According to the Merck Manual (2018) infection in American women occurs in:

1-3% of all normal vaginal births

5-15% of all scheduled Cesarean Sections

15-20% of all non-scheduled Cesarean Sections

You may develop an infection during pregnancy (pre-existing), be an un-symptomatic carrier (as is seen in Group B Strep), acquire an infection during labor (intrapartum) or after delivery (postpartum).

The most common way to develop an intrapartum infection especially after presenting with term PROM is through what is called an Ascending Infection (microorganisms are introduced up into your body for example: by the helping hands of others as they perform digital vaginal exams, blood work, attach central lines, etc.). Easily preventable by simply keeping clean, insisting that others keep clean as well, and vastly limiting invasive procedures.

Vaginas and birth canals are for the very most part “one way streets”, these body structures are designed to release substances such as menstrual fluids and creations such as babies down and out. While it is certainly possible to acquire vaginal tract infections such as STDS, yeast, and GBS, these are commonly introduced into your body through transmission from an outside source.  Normally your birth canal contains a varied assortment of your body’s healthy normal flora and as such is important to the health of your newborn baby, not to mention your own health.

Common sense dictates that you drastically limit what gets inserted into your body, ensuring that is genuinely needed for your health and the health of your baby. Here are some guidelines.

To help reduce your chance of infection regardless of membrane status (CDC 2018):

  • up to date vaccinations
  • always ask if there exists a non-invasive option
  • SAY NO TO DIGITAL VAGINAL EXAMS
  • everyone who touches you washes their hands (including you)
  • contact your health provider if PROM occurs
  • request option for vaginal birth if at all possible
  • contact your health professional if you suspect you have an infection of any kind
  • continue your health professional’s guidelines for cleanliness after birth

And WHO (World Health Organization) further advises that you should assure that you have access to quality care during your pregnancy and during birth and that your health care providers follow proper infection prevention and control methods by providing the right medication in a responsible and timely manner.