Pregnant parents face many unknowns, and as you reach the end of your pregnancy, worrying about where and when your water will break may rate pretty high on the list. Heard of the pregnant mom who lugged around a glass jar of pickles to drop if her water broke in public?
Contrary to your nightmare scenario, this is one worry that you can put to rest: Only about
What moms call water breaking, medical providers call rupturing of the membranes. It means that the amniotic sac surrounding your baby has broken open letting out some of the amniotic fluid.
What triggers this? Probably changes in the composition of the membranes and enzymes work in tandem with the pressure of your baby’s head.
If your doc uses the term PROM (premature rupture of membranes), know that this simply means that your water has broken, you’ve carried your baby full term, and you are about to go into labor. You can smile… soon your baby will be in your arms!
Vocabulary aside, you’ve felt a small trickle or flow and now you want to know if your water broke or if you’ve got bladder trouble. Here’s how to run a quick check on your own.
Most likely, you’ll notice that your underwear is wet. A small amount of fluid probably means that the wetness is vaginal discharge or urine (no need to feel embarrassed — a little urine leakage is a normal part of pregnancy).
But hold on, as there is a chance it could also be amniotic fluid. The amount of runaway fluid when your water breaks depends on a few things:
- how much amniotic fluid you have to start with
- where in the sac the rupture is positioned
- whether your baby’s head is low enough in the pelvis to act like a plug
Depending on these factors you may experience a trickle of amniotic fluid instead of what movies have you expecting — a popping sensation and a gush of liquid. If the amount isn’t giving you a clear indication, move on to color.
See a yellowish color? Then you can put the wetness on your underwear down to urinary incontinence. And it’s not surprising—your baby’s head is putting a tremendous amount of pressure on your poor bladder.
Does it appear clear to white and bit creamy? Then you’re likely dealing with vaginal discharge. It can feel very liquid when it’s coming out, but it will appear thicker in consistency when it collects.
But what if the color you see is clear or much paler than urine and completely liquid? In this case, you’re probably seeing amniotic fluid.
A green or green-yellow color means that your amniotic fluid has been colored by meconium. This happens when your baby has had a bowel movement. Make sure to let your OB or midwife know as this might affect steps they take during delivery to keep your baby safe.
Urine smells like… urine. It’s hard to miss that acidic smell, right? Amniotic fluid, on the other hand, has no smell or a slightly sweet smell.
If you’ve run through the checklist above and you’re still not sure, here are three more easy ways to help you decide if it’s amniotic fluid or urine.
- Remember the Kegels that you’ve been practicing? Well, it’s time to do a few. If this nifty exercise doesn’t stop the trickle that you feel, you’re probably dealing with broken water.
- Try a wait-and-see approach for a few hours. If the gush is a one-time event it’s probably urine or vaginal discharge. If you continue to feed fluid leaking it’s more likely to be amniotic fluid.
- Put on clean, dry underwear, add a panty liner, and lie down for about 30 minutes. Notice fluid pooling in your vagina? Feel a larger gush when you stand up again? Then it’s probably amniotic fluid. And you’re almost at the finish line.
- Make a note of the time when you first felt the wetness and the color of the fluid.
- Make a mental check of what you need to take to the hospital or birth center and get ready to leave. (Or contact your midwife if you’re planning a home birth.)
- Use panty liners to soak up the wetness.
- Give your doctor or midwife a call to discuss your options.
- Don’t use tampons, take a bath, or have sex. Your amniotic sac has kept your baby protected in a sterile environment. Now that it has ruptured, you need to protect your baby from infection.
On that note, you may want to discuss the necessity of vaginal exams after your water has broken with your healthcare provider. There is no current research, but
Still not sure whether that trickle is urine or amniotic fluid? When in doubt, the best practice is to contact your healthcare provider and discuss your symptoms. Here are three tests that can help your healthcare team determine what that wetness really is:
- Sterile speculum exam. This involves the provider having the patient lie down for a while, then inserting a sterile speculum to allow the provider to examine whether there is pooling of fluids in the back of the vagina.
- Litmus test. This sometimes involves a vaginal exam. Your care provider inserts a small strip of litmus paper or a special swab into your vagina. Litmus paper changes color when it comes into contact with amniotic fluid, but not with urine. If your underwear or pad is wet enough, your provider might be able to use that fluid for the test without doing a vaginal exam.
- Ferning test. By examining a small sample of liquid on a slide under the microscope, your care provider can tell if the liquid is amniotic fluid or urine. Dry amniotic fluid makes a pattern that looks like a fern leaf.
These three exams may be used in conjunction to diagnose whether your water has broken. Other hospitals may use proprietary tests, but they also involve getting a swab of fluid from the vagina for testing.
If you’re not sure about anything, reach out to your midwife or doctor to discuss your concerns. If you’re at full term, once your water has broken, you can probably expect to feel the first contractions within 12 to 24 hours.
Because your baby is no longer in the sterile environment provided by an intact amniotic sac, if labor doesn’t start, your provider may recommend an induction of labor. Based on the available
What happens if your waters break prior to 37 weeks? Now you’ll hear your health practitioner using the words preterm premature rupture of membranes or PPROM. That extra “P” makes a difference.
If you have PPROM and you’re at least 34 weeks pregnant, your doctor may recommend delivery. Yup, that’s to avoid the chances of infection. If you’re not there yet (between 24 and 34 weeks), your OB may opt to stall delivery until your baby is better developed. They will also recommend giving you steroid injections to help your baby’s lungs mature.
If you notice meconium in the fluid (remember that green-yellow color?) or if you’ve tested positive for Group B strep (GBS), call your midwife or doctor.
In the very rare chance that you can feel something in your vagina or notice something at the opening of your vagina, call 911.
While it is highly unlikely, the umbilical cord can enter the vagina ahead of the baby and could be compressed, reducing oxygen to the baby. In medical lingo it’s called a prolapsed umbilical cord and it requires immediate emergency care.
Chance are, if your water does break, it will be a small trickle of fluid and not that gush you see in the movies.
Ready to hit the stores for one last onesie before you go into labor? Go for it — you’ve nothing to fear and everything to look forward to.