Along with pickles and ice cream, a pregnant woman whose water breaks suddenly before her contractions start is a cliché you may have seen many times on TV. In real life, about 10% of full-term labors start this way. Usually it’s more like a trickle than a geyser. Still, it’s important for you to know the signs that your membranes have ruptured.
Your Bag of Waters
When you’re pregnant, a sac of amniotic fluid holds your baby snug and safe in your belly. Also called a bag of waters, it makes room for your baby to grow, keeps her in a steady temperature, and cushions the umbilical cord so it won’t get squeezed.
When your body gets ready to deliver the baby, the water breaks and drains through your vagina. This can happen before or during your labor. That’s when you start feeling contractions and your cervix thins and widens so your baby can pass through. If your water breaks before contractions start, it’s called premature rupture of membranes (PROM).
It feels completely different for everyone. Some women notice just a slow drip that leaves their underpants wet. Others have a rapid gush that feels like they’ve peed in their pants. Sometimes you may hear a small pop.
What to Do
It can be hard to tell sometimes if your membrane has ruptured, especially if you don’t feel much moisture. You can try a quick sniff test. Amniotic fluid is usually clear or pale and doesn’t smell like pee. Urine may smell more like ammonia. If you think there’s any chance your water has broken, wear a pad (not a tampon) and call your doctor or midwife right away. They will usually tell you to come into their office or head straight to your hospital or birthing center. If it’s not obvious that your amniotic sac has ruptured, they can run a simple test on your fluid sample.
If you’re within 3 weeks of your due date, your doctor or midwife may have you wait for a few hours to see if you go into labor on your own. Or they might induce labor for you. Most women go into labor within 12 hours on their own.
Studies show that babies born to mothers who are induced right away are less likely to get infections, need less intensive care, and go home from the hospital sooner than infants whose moms who watched and waited. Talk to your obstetrician or midwife about what’s best for you.
If Your Water Breaks Too Early
About 3% of women have their water break before their 37th week of pregnancy. That’s called preterm premature rupture of membranes (PPROM). It’s more likely to happen if you:
- Are underweight
- Had a PPROM with an earlier pregnancy
- Have an untreated urinary tract infection
- Had vaginal bleeding at any time in pregnancy
- Had problems with your cervix during pregnancy
You need to go to their hospital right away for PPROM.
If you're at least 34 weeks pregnant, your doctor may want you to give birth to lower the odds that you or your baby will pick up a serious infection.
If you're 23-34 weeks pregnant, it’s usually best to delay delivery so your baby has more time to grow. You’ll get antibiotics to help prevent an infection and a course of steroids to help your baby's lung mature quicker. You may stay in the hospital until you give birth.
If your water breaks before 23 weeks, your doctor will talk to you about the dangers and benefits of continuing the pregnancy. Babies born after such an early water break are less likely to survive and more likely to have mental or physical disabilities.
If Your Water Doesn’t Break
If you’re already in labor but it’s going slowly, your doctor may manually break your water. They’ll insert a sterile plastic hook into your vagina and pull on your amniotic sac until it bursts. But research shows that for most women, it doesn’t speed up labor. You should do it only if baby’s head is already in your pelvis and low enough to cover your cervix. Otherwise, your body usually will continue with labor on its own until your little one arrives.