“How will I know if my water breaks?” is a very common question I receive. Usually followed by, “What do I do if my water breaks?” Based on how often this comes up in class, I thought this would be a good topic to examine! The image most women have of one’s water breaking is usually derived from TV or movies in which a pregnant mama’s water breaks and all hell breaks loose. Let’s start off by saying that only about 10% of women will experience PROM – premature rupture of the membranes- meaning, the water breaks before the onset of labor. Most women- 90% to be specific- will either experience their membranes rupturing during labor or have them artificially ruptured by their care provider during labor, leaving little question as to what is happening. In rare cases, babies can even be born with the caul, which is when the amniotic sac is still intact after the baby is born.
How will you know if your water has broken?
Some women will experience a gush of fluid from their vagina, others will feel more of a trickle. It all depends on where the baby’s head is in relationship to the cervix. Think of the baby’s head like a wine cork: if the head is low, it will block the fluid rushing out, allowing for more of a trickle. If the head is high, there will likely be more of a gush. However, most women experience a fair amount of vaginal discharge during pregnancy or slight leaking of urine. A few ways to identify the difference between amniotic fluid and the other options just mentioned is, once the water breaks, the woman will continue to leak. Also, the amniotic fluid is mainly clear with no odor. Sometimes there are white specks or a slight blood tinge. If the baby has passed its first bowel movement, the fluid will be a greenish/black color. If you see this greenish/black fluid, you should let your care provider know immediately. This is called meconium and it can be a sign of fetal distress. If you are still not sure if your water broke, you care provider can do a quick, unobtrusive test. Your provider will swab the fluid with a nitrazine-based test for rapid and easy detection of the premature rupture of membranes during pregnancy (PROM).
Did you know there are two layers to your amniotic sac?
The amnion, the innermost bag also called the hind bag, is the sac in which the baby is directly contained. The chorion is the outer membrane or fore-bag. These two bags are in contact with one another and by the end of pregnancy fused together. It is because of these two layers of the amniotic sac that it is possible to have a leak or tear of the fore-bag which can repair itself and not be considered a “ruptured membrane”. Some women find that after a little while, they are no longer leaking amniotic fluid. It is not because there is no more fluid; your body will constantly be producing amniotic fluid. Again, you care provider can test to see if there is still amniotic fluid present. If the fore-bag resealed, then your provider will likely not be in a rush to induce or see that labor starts soon.
What happens once my water breaks?
If your membranes do rupture, again, just check out the color for meconium and then give your provider the heads up. If you are not experiencing contractions already, they will likely start within 12-24 hours of the membranes rupturing. Also, each care provider has his or her own protocol with dealing with ruptured membranes. Usually, unless there are outstanding circumstances, the care provider will allow for 12-24 hours to see if contractions begin naturally before intervening. It is really best to ask ahead of time how your provider handles PROM so that you are not surprised or disappointed with what is then suggested. It will also be important to be aware if a fever is starting, which is a sign of infection. While sex is a great way to induce labor, it is not advised once the water breaks. Keep everything out of the vagina and minimize vaginal exams. Every time a foreign object is introduced into the vagina, there is an increased risk of infection.
Be prepared for ruptured membranes at home!
Just a few suggestions for the weeks leading up to your due date. Have on hand some maxi pads, waterproof mattress cover and Wee Wee pads. Remember, once your water breaks, you will continue to leak. A little trick I learned through the years is to sleep with a waterproof mattress cover- nobody wants to have a ruined mattress covered with amniotic fluid! Or buy some Wee Wee pads from a local pet store. This will also absorb the fluid should your water break while you are sleeping and also come in handy if you are laboring at home for a bit and you are either sitting on a birth ball, chair or couch.
It is also important to continue to stay hydrated. Perhaps have a some coconut water or your favor juice (water it down a bit) on hand.
Hope this help demystify the questions around water breaking!