6 Precautions To Take After Water Breaking During Pregnancy

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Water breakage during pregnancy is a crucial event in the third trimester since it signals labor. The amniotic fluid surrounds the baby in the amniotic sac. This sac breaks at the beginning of labor. If you notice the flow of fluid, contact a healthcare professional. However, before rushing into the maternity center, ensure that it’s not urine. Some pregnant women may misinterpret urination (due to uterus’ pressure on the urinary bladder) as water breaks.

Water breaks significantly earlier than the due date can be concerning. Read on to know the causes of water breakage in pregnancy, how to distinguish it from urination, and when to go to the hospital.

What Is Water Break During Pregnancy?

Inside the womb, the fetus is surrounded by a membranous fluid-filled sac known as an amniotic sac. The sac protects and cushions the baby throughout your pregnancy. When this amniotic sac ruptures, the fluid passes out through the cervix and vagina. The rupturing of the membrane is accompanied by the release of certain hormones and chemicals that start the contractions, signaling the start of labor (1).

This fluid is constantly swallowed, inhaled, and expelled by the baby. Moreover, the fluid helps:

  • The fetus to move freely inside the womb.
  • Maintain a constant temperature around the fetus.
  • Proper development of lungs

And when the time comes, it makes your body ready to push the the baby into this world. However, water break doesn’t always indicate labor because, sometimes, it could happen prematurely.

What Causes Water Break During Pregnancy?

Here are the reasons why water break happens during pregnancy:

  1. As you reach full term during pregnancy, the amniotic sac spontaneously ruptures, and you enter labor. This causes a trickle, a slow leak, or a gush of fluid through the vagina (2).
  1. In case the water breaks before full-term but after 37 weeks, it is called premature rupture of membranes (PROM). This may happen due to:
  • Infection of the vagina, uterus, or the cervix
  • Extensive stretching of the amniotic sac (due to too much fluid or carrying multiple babies)
  • Surgery or biopsies of the cervix
  • A history of PROM or PPROM (preterm premature rupture of membrane)

In this case, most of the women go into labor within 24 hours of the water break (3).

  1. If a woman experiences a water break before 37 weeks of pregnancy, then it is called preterm premature rupture of membrane (PPROM). This condition occurs in around 3% of pregnancies and is the reason for one-third of preterm births. The chances of PPROM are high in (4):
  • Women belonging to the lower socioeconomic status
  • Smokers
  • Those who have a history of sexually transmitted infections
  • Women who have had a previous preterm delivery

If your water breaks or PPROM happens between 34 and 37 weeks, the doctor will arrange for your delivery.

However, if the water breaks before 34 weeks, then the doctor will make efforts to postpone the labor by recommending bed rest. You would be prescribed antibiotics to avoid infections and corticosteroids for the baby’s lungs to grow quickly. Labor will be induced once the baby’s lungs grow enough (3).

Once the water breaks, your baby is no longer protected by the amniotic fluid. But your body continues to produce the fluid to facilitate delivery. Therefore, you need to identify the incident to make sure that you get medical help on time.

How Do You Know If It Is A Water Break?

Here is how you can check what’s happening with you:

  1. If you notice a sudden gush of fluid wetting your pants, then it could be the amniotic fluid. You may confirm it through the following steps (2):
  • Make your bladder empty.
  • Collect some leaking fluid on a maternity pad. If it has a stench and is yellow in color, it could be urine. If it is colorless and odorless, then it could be the amniotic fluid.
  • Hold your pelvic floor muscle tight (like a Kegel exercise) to control the flow. If the flow stops it is urine; if it continues to leak, it means water has broken.
  1. Ascertain the time, color, and odor of the discharge.
  1. Water break is usually accompanied by spotting or some flow of blood.
  1. You might have a fever or rise in your body temperature after the water breaks.
  1. Check for your baby movements when you experience excessive fluid flow.

Once you confirm the leak is a water break, do not panic. Instead, call your doctor and take some precautions to make sure that you are holding up until some help arrives.

Precautions To Be Taken After Water Breaks During Pregnancy

Here are some measures you may take when water leaks :

  1. Call up the hospital or the doctor. Inform them of the situation and follow their instructions.
  1. The water break exposes your baby to infections that travel upward from the vagina. If the doctor thinks that you should wait for up to 12 hours, then they will tell you what to do to protect yourself and your baby from infections. Keep the vaginal area clean and take the other precautions as told by the doctor.
  1. If you are at home or traveling to the hospital, then place a plastic cover on the bed or the car seat to prevent it from wetting.
  1. Wear a maternity pad if the flow is slow or use a towel if it is gushing. This helps you keep your clothes clean. A maternity pad also helps you to collect the sample and show it to the doctor because the flow could contain something more than just the amniotic fluid:
  • If the discharged fluid is of brownish or greenish color, it may indicate that the baby has had its first bowel movement (meconium) inside the womb (5). As your baby breathes that amniotic fluid, the meconium might go into their lungs causing breathing trouble. Collect it on a maternity pad for the doctor to examine. Consult your doctor on what to do next.
  • Sometimes, the umbilical cord can get swept into the cervix or even the vagina (umbilical cord prolapse) with the gushing amniotic fluid. This happens when the membrane ruptures and the baby has not reached the pelvis. If you notice a loop of the cord at the vaginal opening, then seek immediate medical attention. Prolapse occurs in 1 out of 300 deliveries (6).

Water break is a normal procedure that leads to labor. But when the water is gushing out, you may not immediately know what to do. Seek help from your partner, mother or somebody who is with you. Ask them to contact the hospital immediately. Most importantly, do not panic as it could distress your baby and complicate matters.

During this time, you will be flooded with several questions. Below, we answer a few such questions to keep you prepared for the event.

Frequently Asked Questions

1. What if the water doesn’t break on its own?

With the onset of labor, the cervix dilates, and the baby’s head drops into the pelvis. If the waters do not break by this time, the doctors use a technique called amniotomy (also termed as artificial rupture of membrane) (1). In this technique, a small hole is made in the amniotic sac using a thin plastic hook to leak the water. This helps start the labor contractions or make them intense if already begun.

2. How does the doctor check for water break?

The doctor can confirm water breaks using two methods. They are:

  1. Placing a speculum into the vagina to check for water pools. The doctor may also collect the swab samples and get them tested for infection.
  1. In the amnicator test, the doctor soaks the swab sample in pH-detecting dye nitrazine yellow. In the presence of amniotic fluid, the nitrizine color changes from yellow to blue-yellow or dark blue, confirming the water break (7).
  1. If both the above tests do not work out, then you need to wait for more fluid flow.

3. What happens if the water breaks with no signs of contractions??

The contractions might usually start 12 to 24 hours after the water break. Even if they don’t, the consultant might ask you to wait if you do not have any related complications. If the labor does not start even after 48 hours, then it will be induced through medical interventions (8).

4. How to know if it is a water break or vaginal discharge?

Amniotic fluid is colorless and odorless, whereas the vaginal discharge is thin, milky white mucus. If you notice a mucous-like discharge streaked brown or pink with blood, it might indicate that labor is imminent (9).

Usually, labor starts within 24 hours following the breakage of water during pregnancy. The colorless and odorless nature of the amniotic fluid distinguishes it from leaking urine towards the end of pregnancy. Water breakage before 37 weeks may also be caused due to infections, overstretching of the amniotic sac, or a history of preterm premature rupture of membrane (PPROM). Your doctor may take steps to delay labor if your water breaks before 34 weeks of gestation. Therefore, seek immediate medical attention if you feel your water has broken. You may also collect some of it in a maternity pad to help doctors examine it.

References:

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Dr. Stuart J. Fischbein

(MD)
Dr. Stuart J. Fischbein is a fellow of the American College of Obstetrics & Gynecology, lecturer, and a published author (Fearless Pregnancy, Wisdom & Reassurance from a Doctor, A Midwife, and A Mom; Homebirth With an Obstetrician, A Series of 135 Out of Hospital Births; Breech Birth at Home: Outcomes of 60 Breech and 109 Cephalic Planned Home and Birth... more

shreeja pillai

Shreeja holds a postgraduate degree in Chemistry and diploma in Drug Regulatory Affairs. Before joining MomJunction, she worked as a research analyst with a leading multinational pharmaceutical company. Her interest in the field of medical research has developed her passion for writing research-based articles. As a writer, she aims at providing informative articles on health and pharma, especially related to... more