- You can wait.
Sometimes it will take a few hours for contractions to kick into gear. As long as you and your practitioner are fine with it, waiting for awhile may be appropriate assuming that you and baby are doing well. This generally means that nothing goes into your vagina, you don't get into a tub of water, you aren't running a fever, there is no foul odor and there is no discolored fluid. One study reported that waiting up to 24 hours, known as expectant management, didn't increase the risk of complications, as long as mom and baby didn't have an infection.
- You can try nipple stimulation.
Using your hands or a breast pump, you can stimulate your nipples. This helps produce oxytocin, which can help jump start contractions. If you don't have a breast pump, you can usually get one from a hospital lactation consultant.
- You can try activity.
Walking around can sometimes encourage labor to start. A walk around the house or even outside might help you.
- Acupressure may be helpful.
This involves using pressure on certain spots on your body to help try to stimulate labor. One such point is where the hard and soft palate meet in the roof of your mouth. Pressing here, much like thumb sucking, may help stimulate contractions.
- Some mothers require Pitocin.
Pitocin is a synthetic form of oxytocin, you natural labor causing hormone. It is given through an IV attached to a special pump to give just the right dose of Pitocin to you. This is given only in hospitals with good fetal monitoring because of the increased risks (fetal distress, too strong or long contractions, uterine rupture, etc.).
When your water breaks you should call your practitioner to discuss which options are safe for you and your baby. Not everyone will respond to all of these suggestions and some may not be safe for you or your baby given your medical history. You will also want to discuss with your practitioner when the best time is for you to either go to the hospital or their office, or if you are planning a home birth, when they would come to you to check on you and baby.
Duff, P: Premature rupture of the membranes at term. N Engl J Med 334:1053, 1996.
Obstetrics: Normal and Problem Pregnancies. Gabbe, S, Niebyl, J, Simpson, JL. Fifth Edition, 2007.