Experiencing premature rupture of membranes and premature labor is a frightening prospect for every pregnant woman. Appropriate medical action is needed to treat these two conditions, Mother.
So can pregnant women whose membranes rupture prematurely and are at risk of premature birth in a clinic, not in a hospital? What is the appropriate treatment for this condition?
Read the complete explanation below, Mother!
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Handling of pregnant women with premature rupture of membranes and the risk of prematurity
Premature rupture of membranes is a term that describes the membranes breaking before labor begins. Treatment for premature rupture of membranes will depend on when it occurs, whether before the end of 37 weeks of pregnancy or after.
Reported by the Cleveland Clinic, premature rupture of membranes that occurs after 37 weeks of pregnancy requires immediate action to deliver the baby. Meanwhile, if it occurs before 37 weeks, doctors will usually consider the risk of premature birth compared with the risk of complications, such as infection.
In conditions of premature rupture of membranes that pose a risk of premature birth, treatment must be carried out immediately to save the mother and baby. This treatment includes the right place of delivery.
Giving birth in a clinic vs hospital
Premature rupture of membranes which risks premature birth needs to be treated in hospital. Maternity clinics cannot be the main choice for giving birth to your little one, Mother. Mothers need to consider the risks if they choose to give birth at a clinic.
Quoting from The Mount Sinai Hospital page, if a pregnant woman experiences premature labor, she must be treated in hospital. Pregnant women may have to receive medicines to stop contractions and mature the baby’s lungs.
According to Sanford Health, two-fifths of women at 34 to 36 weeks of pregnancy will deliver their baby within a week. Many will also give birth within 48 hours. The delivery process can be carried out if the hospital has a neonate care room.
Premature labor can cause complications, requiring adequate medical treatment in the hospital. Some of these complications include postpartum bleeding in mothers who suffer from anemia and life-threatening infections.
Government regulations regarding childbirth in clinics and hospitals
The Indonesian government has made regulations regarding childbirth services for mothers who experience complications. If complications occur during pregnancy and childbirth, the mother can be referred to the hospital from the birth clinic.
The rules regarding this referral are regulated in article 17 paragraphs (1) and (2) in Minister of Health Regulation Number 21 of 2021 concerning the Implementation of Health Services for the Pre-Pregnancy, Pregnancy, Childbirth and Post-Birth Period, Contraception Services and Sexual Health Services.
“Mother and fetus with complications of pregnancy and childbirth, the delivery will be carried out in a hospital according to their competence,” reads article 17 paragraph (1).
“In the event that the mother and fetus experience complications or emergencies while at a first level Health Service Facility, the first level Health Service Facility must take pre-referral action and be immediately referred to a hospital,” states article 17 paragraph (2).
Illustration of a Mother Giving Birth/ Photo: Getty Images/iStockphoto
Referral from the clinic to the hospital to give birth
Clinics, maternity homes and community health centers are included in level 1 Health Facilities (Faskes). Irmawati, S.Si., Apt in the book Keep Smiling During Childbirth explains that maternity homes or birth clinics are places that can help with childbirth.
“This place can help with normal births without aids and normal births using forceps or vacuum tools if needed. If surgery is needed, the patient will be referred to a maternity hospital or general hospital,” he wrote.
“The supporting staff are midwives, but sometimes there are obstetricians who practice here.”
Referrals to the hospital can be made by the doctor or the clinic to the hospital if the mother experiences an emergency or complications from pregnancy and childbirth. This also includes the condition of premature rupture of membranes which leads to premature labor.
In the book Complete Guide to Pregnancy, Childbirth & Babies by Penny Simkin, PT, Janet Whalley, RN, BSN, Ann Keppler, RN, MN, mothers will be referred to the hospital if there are danger signs such as increased blood pressure, bleeding, blood sugar levels high levels, protein in the urine, problems with the fetus, or premature labor contractions.
“Even with careful prenatal care, 15 to 27 percent of women who want to give birth not in hospital are ultimately referred to hospital during labor or postpartum because of problems deemed to require obstetric intervention,” said the author team.
Emergency referrals are very rare for women who undergo careful examination and who have normal, problem-free pregnancies. Important conditions that can arise unexpectedly and dangerously during labor and require immediate medical attention, include uterine prolapse (if the cord comes out of the uterus before delivery), bleeding, and the fetus’ lack of oxygen supply during labor (due to bleeding, cord compression, and other factors) .
The importance of checking with a doctor and midwife
Checking with a doctor or midwife is very important during pregnancy. Especially for checking amniotic fluid via ultrasound, you can do it at the doctor. Several pregnancy clinics already have ultrasound examination services.
When checking your pregnancy, you can also explain your complaints to the doctor or midwife. Don’t forget to talk about the use of medicines during pregnancy and plans to give birth to your little one.
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