During pregnancy, many women have questions about their water breaking. This event signals that the baby will be born soon.
The term “water breaking” refers to the breaking of the amniotic sac, which surrounds the fetus and contains amniotic fluid. When this sac breaks, the amniotic fluid is released.
Although many people associate the water breaking with a sudden and unmistakable gush of fluids, this is often not the case. For many, it is a much subtler event.
A woman’s water may break either before or during labor. In some cases, a medical professional may break the sac during induction or delivery, although this is rarely necessary.
This article explains how someone can tell if their water has broken and what they should do next. It also discusses why the water breaks and what happens when labor begins before the sac breaks.
The water breaking is a different experience for everyone.
Some women may notice a popping sensation before fluid gushes or trickles from the vagina. Others may notice excess dampness in their underwear, leaving them wondering if the fluid is vaginal discharge or urine.
To differentiate between these fluids and amniotic fluid, consider the color and odor.
Amniotic fluid does not smell like urine. It tends to be odorless or slightly sweet-smelling. Amniotic fluid is also pale and straw colored, whereas vaginal discharge is usually thin and white.
Another way to tell is to stand up. If the fluid seems to leak more while standing, it indicates that the water has broken. Also, if the fluid continues to slowly leak over time rather than being a single gush, it is more likely to be amniotic fluid.
If in doubt, call a healthcare provider or go to the hospital.
It is important to note that there will be no pain when the water breaks because the amniotic sac does not have pain receptors.
The water will typically break during labor.
On rare occasions, it may break before labor. If this occurs and labor does not start soon after, a medical professional may induce labor to start uterus contractions. This is due to the risk of infection for the woman and the baby if labor does not begin soon after the water breaks.
In most cases, the sac will break when the woman is at full term (39 weeks to 40 weeks and 6 days). Sometimes, however, the water may break before this. This is known as preterm prelabor rupture of membranes (PPROM).
PPROM affects around 3–10% of all deliveries. It can cause complications such as:
- infection in the woman or the baby
- placental abruption, or detachment of the placenta from the uterus
- umbilical cord problems
If the baby is born prematurely, they may experience other complications.
When PPROM occurs at 34 weeks of pregnancy or later, a doctor may recommend delivering the baby to reduce the risk of complications.
However, if there is no indication of infection, they may allow the pregnancy to continue, under careful monitoring, until labor begins.
When PPROM occurs before 34 weeks, the doctor will try to delay delivery to allow the fetus to develop further.
They will prescribe antibiotics to the woman and administer corticosteroids to help the fetus’s lungs mature faster. They may also administer other medications.
The water breaks when the amniotic sac ruptures. The fetus is inside this sac and surrounded by the fluid, which protects them from injury.
It is necessary for the sac to rupture so that the baby can be born. Medical professionals may sometimes artificially break the sac if it does not break naturally.
Experts do not fully understand how the water breaks, but it may have something to do with brain signals from the fetus.
Occasionally, it can break when the fetus moves into the pelvis in preparation for labor and their head puts pressure on the membranes.
Even when the water breaks, it does not mean that the woman will immediately go into labor.
Sometimes, contractions can begin hours after the membranes rupture. If contractions do not begin within a certain timeframe, however — usually 24 hours — a healthcare provider may induce labor to reduce infection risk.
Once the water breaks, it is vital to follow the instructions of the doctor or midwife. If a woman is unsure of what to do, they should contact their healthcare provider or go to their labor and delivery unit.
Women should take care to avoid infection during this time. They should use a pantyliner or pad to soak up the amniotic fluid, and they should avoid the use of tampons.
It is also important to wipe carefully from front to back after using the bathroom and to avoid sexual intercourse after the water breaks.
Women should call their doctor immediately or go straight to the hospital or delivery unit if the membranes rupture and:
- the fluid smells bad or appears to be green or brown, indicating that the fetus had a bowel movement in the uterus
- the woman has tested positive for group B strep during pregnancy
- the woman is not at full term
- the woman can feel something in the vagina or see the umbilical cord hanging out
In most cases, contractions will begin before the water breaks.
Prelabor rupture of the membranes, wherein the water breaks before contractions begin, occurs in only around 8% of pregnancies, according to the National Health Service (NHS).
If the water does not break during labor, a doctor or midwife may artificially break the sac using a technique called an amniotomy.
An amniotomy involves inserting a thin, plastic hook through the cervix to break the amniotic sac, allowing the fluids to exit.
This procedure should not cause any pain for the woman or the baby, though occasionally the hook can leave a small scratch on the baby’s head.
Women should tell their healthcare provider if they experience any discomfort.
Labor contractions will intensify shortly after an amniotomy.
For vaginal delivery to begin, it is necessary for a woman’s water to break.
Most of the time, this happens spontaneously. At other times, a healthcare professional may artificially rupture the membranes.
Sometimes, it might not happen until right as the baby is being born. If this occurs, the baby may be born “in the caul,” or in the amniotic membrane.
The water may break spontaneously before or during labor.
A woman may experience a sudden gush or a slow trickle of fluid. It can sometimes be difficult to distinguish between amniotic fluid and urine or vaginal discharge.
Those who have any questions or concerns about their water breaking should contact their doctor, midwife, or local labor and delivery unit.