One of the most common phone calls we get at the labor and delivery unit where I work goes a little something like this:
“Birth center, this is Chaunie speaking, how can I help you?”
“Um, yes, hi. I'm so-and-so, and my due date is a few days away, but I think my water just broke, but I'm not sure … should I come in?”
As your big day approaches, it can be hard to know when it's “time.” And even more confusing to a lot of women whose water doesn't gush dramatically like they show in the movies is trying to figure out whether or not their water has actually broken. To help you get prepared for what to expect, here are a few facts about your water breaking, along with some questions to ask yourself.
1. You can't be assessed over the phone. As I said, labor and delivery units get a lot of phone calls from anxious mommas-to-be, wondering if they should come because they're unsure if their water has really broken. As much as we would love to be able to magically tell if your water has broken without seeing you, it's just not safe for us to try to assess that over the phone because, really, it's impossible. If you're really questioning if your water has broken, the safest bet is just to head into the hospital to be evaluated or call up your OB — they may be better able to help guide you on what to do. The floor nurses simply can't make that call over the phone.
2. Try standing up. One trick to try to tell if your water has really broken is to do the “stand up” test. If you stand up and notice that the fluid seems to leak more once you're up, it's probably a good indicator that your water has broken, as the extra pressure from standing up can force the amniotic fluid out more than when you're just sitting.
3. Is it mucus? I would guess that in almost half of the cases what women think is their water breaking is just mucus. As delivery gets closer during the last few weeks of pregnancy the cervix softens and women may lose their mucus plug in smaller amounts. Many times the mucus can increase quite a bit in the last couple weeks, even requiring a light sanitary pad. If your fluid is thicker or whiter (it may also have a twinge of blood here and there) in color, it might just be mucus.
4. Amniotic fluid is clear. Something that may help you be able to discern whether or not your water has broken is being aware of what the amniotic fluid (the technical term for your waters!) actually looks like. If your water has broken, it will be odorless and be clear in color.
5. Your water can break in a gush, or leak slowly. I think a lot of women expect the giant gush of fluid that happens in the movies, and while that does happen sometimes, a lot of times a woman's water breaks a little more subtly. Imagine a big balloon full of water — you can prick it a few times with a pin and get a water leak, but it doesn't always necessarily burst.
6. Your nurse can tell if your water has broken. If you head to the hospital, convinced that your water has broken and you will shortly be holding your baby in your arms, only to be sent home in disappointment, rest assured that your nurse really can tell if your water has broken. There are several different ways that they can test to see if your water has broken. The most common way of finding out is by looking at your amniotic fluid on a slide under a microscope, where it will take on a distinctive “ferning” pattern, like rows of tiny fern leaves. If all of that seems to check out, your water did break, and it really is amniotic fluid.
7. Labor usually kicks in after your water breaks. Thankfully – so you're not sitting around all day wondering “was that really my water breaking?” – labor tends to kick in pretty quickly (and intensely) after your water breaks. You might not have much time to question if it was “real” or not when the contractions start …
8. It is possible for a water leak to seal back up. It's rare, but it does happen. If you think of that balloon analogy again, imagine just a tiny pin-prick in the water balloon, with a tiny water leak. Incredibly, in some cases, that tiny leak can seal itself back up. Even if you are sure your water broke, it is possible that the leak may seal itself back up before you get to the hospital to get checked out. Talk about frustrating!
9. Some women's waters never break. If you're sitting around, waiting for labor to start with the dramatic gush of your water breaking, you may be disappointed. Some women's water never breaks until they are well progressed into labor, or even moments before the baby is actually delivered. I am actually one of those women — my water has never actually broken on its own!
Disclaimer: This advice should not replace an actual phone call or visit to your medical care provider if you do in fact suspect that your water has broken. It is simply to ensure you have additional information when you go into the discussion with your nurses and doctors.