Water Breaking Before Labor: What You Need to Know
Pregnancy is a beautiful experience for all women; however, many precautions must be taken during the complete nine months that a mother carries their child. As a woman reaches her third trimester, it is important to be extra careful and look out for any signs of labor. The need for care only increases during the last few weeks of the due date. There are a lot of questions women have regarding their water breaking, including what it will feel like, what steps should be taken, and how to distinguish your water breaking from simply urinating. Therefore, it becomes important to identify the signs of water breaking and what it means for your delivery.
What Will Happen When Your Water Breaks?
Much like what is seen on television shows or movies, labor always starts suddenly and the heavily pregnant woman will notice a puddle of water accumulating at her feet. With this in mind, women tend to feel slightly anxious at the thought of leaving the house during the last few days or weeks prior to their delivery date. During the complete period of pregnancy, the baby is surrounded and cushioned by an amniotic sac or fluid filled membranous sac.
The water most commonly breaks either at the beginning of labor or during the labor process. The membranous sac will rupture, resulting in the gush or leaking of fluid that is common with water breakage. If the water breaks prior to experiencing labor, it would be known as “premature rupture of membranes” or PROM. When the water breaks, women often experience a sensation of wetness in the vagina or on the perineum. It feels like a constant leaking of watery fluid, in small amounts, coming from the vagina.
At times, it can be challenging to distinguish if the water has even truly broken. If there is only the presence of wetness and a slight trickle of fluid, it can often be mistaken for urine leakage. If you suspect that your water may have broken, ensure that you consult a doctor as soon as possible. The doctor will carry out a physical examination or lead you to the delivery facility. In some cases, they may also carry out an ultrasound to check the volume of amniotic fluid.
When Does Your Water Break?
The baby develops or grows in a sac that is surrounded by amniotic fluid. This fluid and sac helps protect the baby from infections, provides lubrication for movement and growth, and also provides a warm environment. As the birth day approaches, the baby usually shifts into a position wherein the head is facing down towards the mother’s pelvis. This is known as engaging. The fluid, which is located between the cervix and the baby’s head, is known as forewaters. The fluid that is located above the baby’s head is known as hindwaters. In most cases of pregnancy, the amniotic fluid ruptures just before the pushing stage when the cervix is completely dilated. This occurs due to the pressure of the baby being pushed downwards. When the baby is in the engaging position with its head downwards, only the forewaters can escape, which would be seen as a trickle or small gush. At this point, the hindwaters will also start to leak out. It can squeeze out in the form of a trickle or as a gush of water.
When contractions don’t start, even after the amniotic sac ruptures, then it is possible that the hindwaters leak could have been resealed or stopped leaking. This is a highly common scenario. When the water breaks and the baby is not in the engaging position, there is a risk of cord prolapse. A prolapsed cord occurs when the umbilical cord comes out before the baby’s head. Though this is a fairly uncommon scenario, a prolapsed cord can be serious. There is no specific date in which water breakage occurs; therefore, women should not feel the need to stay cooped up inside simply because they are nearing their estimated due date. If you are planning to leave the house, and you are nearing your due date, ensure that you keep some pads or towels handy.
Symptoms of Water Breaking
When the water breaks, some women may experience a “pop” sound. Some may also experience a gush of water or a light trickle. Every woman is different. Below are a few good indicators that your water has broken:
- There is no control over the flow of fluid.
- If you wear a pad, it may be getting wet constantly and require frequent replacement.
- A simple panty liner seems insufficient to absorb the fluid.
- The fluid that comes out is colorless and does not smell like urine.
If the water has broken, then it should be clear or have a slight pink tinge to it. However, contact the doctor if there is brown, green, or any other color present in the fluid. Some have experienced a semen-like smell in the fluid as well.
Post Water Breaking
Make a note of the time if you feel your water has broken. Additionally, it is also recommended to use a pad to absorb the fluid. Ensure that you inform your doctor of the water breakage immediately. Remember, water break does not result in immediate contractions. In fact, it may take some time before the actual labor contractions begin. The amniotic fluid will replenish on its own, so there is no need to worry. However, if the sac has been ruptured, there is a possibility that the baby may be exposed to bacteria. In such cases, avoid having sex or inserting anything inside the vagina in order to limit bacterial exposure.
When Will Labor Start?
15-20 percent of woman experience rupture to the membranes at the start of labor. Whether the fluid comes in the form of a slow leak or a large gush, it will often occur either overnight or early in the morning.
In most cases, labor will follow soon after the water breaks. However, in some cases there are delays in labor pains. If the woman experiences premature rupture of the membranous sac, the doctor may induce labor. It is important to remember that the longer it takes for labor to begin, after the sac has ruptured, the greater the risk that both the mother and child may develop an infection. Some women may have to wait for hours or even days after their water breaks before they begin to feel contractions. However, most women begin experiencing contractions within 24-48 hours after their water breaks.
What If My Water Breaks Early?
If the water breaks before the pregnancy reaches the 37th week, it is referred to as preterm PROM. Below are certain risk factors which can lead to early sac rupture:
- If there has been a history of preterm PROM in a previous pregnancy.
- The intra-amniotic infection.
- Length of the cervical is short
- Smoking or taking illicit drugs during pregnancy.
- Bleeding from the vagina during the second or third trimester.
- Being underweight due to poor nutrition.
Some potential complications that can be experienced during pregnancy include fetal infection, infection to the mother, and placental abruption wherein the placenta peels away from the inner wall of the uterus just before delivery. Babies that are born prematurely are at a far higher risk of complications. If a woman is 34 weeks pregnant and experiences preterm PROM, the doctor will likely opt for early delivery in order to prevent the risk of infection. If you are between 24-34 weeks pregnant, the doctor will usually delay the delivery so that the baby has time to completely develop before being born. In cases where the delivery is delayed, the mother will be given antibiotics so as to prevent any risk of infection. Additionally, she will also be given an injection of potent steroids, known as corticosteroids, to increase the baby’s lung development.
Doctors can also recommend steroids in the beginning of the 23rd week of pregnancy, especially if the mother is at risk of delivering the baby within seven days. The doctor can also recommend corticosteroids to women who are between their 34th and 36th week of pregnancy and seem to be at risk for delivering within 7 days. If a woman is less than 34 weeks pregnant, and she is at risk of delivering within 7 days, then the doctor may consider repeating the corticosteroid dose. If a woman is less than 24 weeks pregnant, the doctor will explain the risks and benefits of delaying the labor process and recommend the best course of action.
Water Breaking and Infection
Once the water has broken, there is no seal surrounding the baby; thus, there is no form of protection from unwanted infections. For this reason, any type of vaginal examinations is avoided after the water breaks. Even if the doctor is wearing gloves, there is still potential for bacteria to be pushed towards the cervix, leading to a risk of infection. If the water has been broken deliberately to induce labor, the woman may be started on a dose of antibiotics immediately or within a span of four hours. These antibiotics are used to prevent any potential infection. The doctor will also monitor you for any sign of infection.
When Water Doesn’t Break on Its Own
If the cervix is thinned, dilated, and the head of the baby is deep inside the pelvis during the process of labor, the doctor may use a technique which is called an amniotomy. This process is used for inducing contractions or intensifying them if they have already begun. During an amniotomy, the doctor will use a thin, plastic hook to make a small opening in the amniotic sac; thus, causing the water to break.
