It’s the moment every pregnant person anticipates and worries about at the same time – the breaking of your water.
You’ve probably heard stories of people’s water breaking in public places – like the middle of a grocery store. Or maybe you saw a person’s water breaking in a crazy flood-like gush in a movie or TV show and the craziness that ensued afterward.
Let’s first give you a bit of relief. Most often, your water won’t break until you’re well into labor. And it probably won’t be as dramatic as some clichéd pregnancy movies. It will most likely be a trickle than a storm surge.
“Only about 20% of pregnant people will experience their water breaking before labor starts,” said Jennifer Steir, a certified nurse midwife (CNM) with Banner Health. “Most people will experience this during labor or have their water broken by a health care provider. Babies can even be born ‘en caul’ when the baby is born while still in the double layer amniotic sac.”
So, how do you know if your water breaks, what should you do when it does and when should you be concerned? Read on as Steir helps answer all these questions and more to help you sail into childbirth.
What does “water breaking” really mean?
What you call water breaking, health care providers call ruptured membranes.
During pregnancy, your baby grows inside a person’s uterus in a sac filled with amniotic fluid. This fluid cushions your baby and protects them.
“At some point before delivery, the amniotic sac membranes will rupture or break, and the fluid will come out of the vagina,” Steir said. “This rupture of the membranes is what most people call ‘water breaking.’”
Your water breaking or ruptured membranes mean it’s time to call your provider.
How will I know my water has broken?
So, how do you know whether it’s your water breaking and not just discharge or pee?
Let’s face it. There’s a lot you don’t have control of these days. With your baby pushing on your bladder, you’re bound to tinkle occasionally when you sneeze or cough.
Here are some signs that your water broke and not something else:
- You hear a pop and feel pressure, then relief when the sac breaks.
- The fluid is clear and odorless, unlike urine.
- The fluid is thin and watery, unlike vaginal discharge.
- You can’t control, hold it in or stop the leaking from the vagina.
- The fluid continues to trickle out, requiring frequent changes of pads, underwear or underclothes.
What causes your water to break?
“We are not sure what causes the water to break, but most of the time, it breaks after labor starts,” Steir said.
If your water breaks before 37 weeks of pregnancy, this is known as premature rupture of membranes (PROM).
Experts don’t always know why PROM happens, but it may be caused by an infection, placental problems or a blood clot behind the placenta or membranes. Other things that can increase your risk include:
- Having had PROM during a previous pregnancy
- Having a short cervix
- Having had vaginal bleeding in pregnancy
Why would my provider break my water?
Sometimes, your provider may break your water, a process called amniotomy. It involves inserting a thin tool through the vagina to break the sac.
“Your provider may break your water to augment, or help along, your labor if contractions have spaced out or stopped,” Steir said. “Another reason is to place internal monitors to better detect the strength of contractions or the baby’s heartbeat if external monitors are not working adequately.”
What should I do once my water breaks?
Contact your health care provider immediately if you believe your water has broken. Most often, if contractions have not started or are still infrequent and mild, they may encourage you to rest at home until they progress.
However, you will probably need to head to the hospital in the following circumstances:
- Your water breaks before 37 weeks. Your provider may recommend an early delivery or medication to help delay the birth.
- Your amniotic fluid has a foul smell (bad odor) and has a greenish or dark tint. These are signs that your baby could be in trouble.
- You are group B streptococcus (GBS) positive. If you are GBS positive, you will need treatment with prophylactic antibiotics before birth to lower the risk of your baby being exposed to it during labor and delivery.
This will need to be started regardless of whether or not you are in labor and having contractions,” Steir said.
- You haven’t started contractions within 24 hours. Many people experience contractions within 12 to 24 hours after their water breaks. If it takes longer, your provider may induce labor to prevent infection.
Call 911 if you feel something in your vagina other than the fluid. Although rare, there are instances where the baby’s umbilical cord has been pushed into the vagina. An umbilical cord prolapse can be dangerous for you and the baby.
Knowing if your water has broken can be tricky, but it is a natural part of pregnancy. If you experience a dribble or rush of fluid, it’s important to pay attention to the color, odor and amount of liquid to ensure you and your baby are safe.
Don’t hesitate to call your health care provider if you’re unsure what to do when your water breaks. They can determine whether you need to come into the hospital or if it’s safe to wait.