In case of premature rupture of membranes, it is recommended to remain calm. The woman does not have to lie down. A vaginal examination is not necessary in the absence of abnormalities. Speculum examination (plastic or metal device that can be inserted into the vagina) after a premature rupture of the membranes is not necessary.A low risk of infection for the baby of 1% is reported, but this would increase with vaginal examinations.
The woman can choose after a rupture of the membranes: Either she can still wait at home for 24 hours, bathing and showering would be possible. After 24 hours, induction of labor should be offered, or induction of labor with artificial labor meds, to which she must consent,
will follow timely. (7.1)(16)
Consultation with your doctor/ midwife should take place. We recommend that you contact your accompanying midwife or gynecologist after a rupture of the membranes to clarify the individual situation.
Iris Eichholz explains why caution is advised in the case of premature rupture of the membranes: "The vagina is a self-cleaning organ that knows only one direction of flow: from the inside to the outside. For physiological reasons, the external intimate area is heavily colonized with germs, especially due to its proximity to the anal region. Now it would cost these germs an enormous effort to work their way up the vagina "swimming against the current" under their own steam and cause an infection of the amniotic cavity, the membranes and the child. The vaginal examination, however, offers the germs a "favorable ride" directly to the baby's head.
Especially after successful rupture of the membranes, strict criteria are needed for the implementation of this intervention, which has many side effects." (15)
(15) Eichholz, Iris: Kinderrechtsverletzungen während Schwangerschaft, Geburt und in den ersten Lebenstagen, translated to english pages 5/6.
(16) These numbers refer to the location in the abbreviated version of the guideline "Vaginal Birth at Term".