How do you know if your water is going to break?

As you near the end of your pregnancy, it’s normal to start wondering when your water will break and labor will begin. For many pregnant women, the breaking of the amniotic sac signals the start of labor. But how can you tell if you’re showing signs that your water is about to break?

Table of Contents

What is the amniotic sac?

During pregnancy, the baby grows in a bag of fluid called the amniotic sac. This sac is made up of two membranes called the amnion and the chorion. These membranes form around the developing embryo very early on in the pregnancy to help cushion and protect the growing baby.

The amniotic fluid inside the sac serves several important functions:

It cushions the baby from bumps and injury.
It maintains a constant temperature around the baby.
It allows the baby to move freely and develop muscles and bones.

It allows the lungs to develop properly.

Towards the end of pregnancy, the amniotic sac contains about 1 quart of amniotic fluid on average. The amniotic sac and fluid eventually break, signaling that labor is starting. This breaking of the sac is medically referred to as rupture of membranes (ROM).

When does the water usually break?

There is no set time for when a pregnant woman’s water breaks. For some women, the rupture of membranes happens before the start of labor contractions. This is known as pre-labor rupture of membranes. For others, the sac ruptures during active labor, after contractions have already begun.

Only about 15% of women experience their water breaking before the onset of labor. More often, rupture of membranes occurs once contractions have started.

In most cases, rupture occurs spontaneously on its own as labor approaches. The average time frame when this happens is:

During weeks 37-40 for first-time mothers

During weeks 40-42 for women who have given birth before

However, the amniotic sac may be manually ruptured by a doctor or midwife during a vaginal examination. This deliberate breaking of the water is known as artificial rupture of membranes (AROM).

Signs that your water is about to break

Paying attention to certain signs and symptoms in late pregnancy can give you an idea of when your water may break. Here are some clues:

Pelvic pressure: You may feel increased pressure in your pelvis or cervix, almost like the baby is pushing down. This added weight and pressure can cause the membranes to rupture.
Cramps: Some painless contractions or mild cramps may occur as your cervix starts effacing and dilating. These changes can lead to water breakage.
Backache: An aching lower back can signal impending labor. The baby’s head settling deeper into the pelvis places pressure that can lead to water leaking.

Increase in discharge: You may pass more mucus secretions from the vagina that appear wetter than normal or are tinged with blood.
Diarrhea: Having loose stools may happen in the days before labor as hormones prompt changes in the digestive system.
Nesting instinct: Some women experience a surge of energy 1-2 weeks before labor that prompts them to clean, organize, and get ready for the baby.

Keep in mind that every pregnancy is different. Many women experience one or more of these signs in late pregnancy without going into labor right away. You may feel such symptoms on and off as your body prepares for delivery.

How do you know when your water breaks?

Rupture of membranes is often very apparent when it happens. Here’s what it may feel and look like when your water breaks:

A gush or slow trickle of fluid: You may notice a sudden splash or a steady leaking from your vagina. The amniotic fluid is clear and watery, although it may be tinged with blood.

Wetness in your underwear or pants: You’ll find you’re soaking through whatever you’re wearing as more fluid leaks out. The flow may stop and start.
A damp spot on sheets/furniture: Wherever you’re sitting or lying down when the sac ruptures will get wet from the amniotic fluid.
Relief of pressure: Some women sense a release of pressure once their water releases.

Change in baby’s movement: You may feel the baby shift positions after the rupture since there’s more room.

In some cases, it may be hard to distinguish leaking amniotic fluid from a normal vaginal discharge. The fluid from water breaking is generally clear and odorless. If you’re uncertain, your doctor or midwife can examine you to confirm if your membranes have ruptured.

Causes of water breaking

What leads up to the amniotic sac rupturing? Here are some contributing factors:

Cervical changes: As the cervix starts thinning out (effacing) and opening up (dilating), it puts pressure on the amniotic sac.
Uterine contractions: Regular contractions eventually cause the amniotic sac membranes to tear and rupture.
Baby’s movements: Vigorous kicking or repositioning from the baby can cause the sac to weaken and burst.

Reduce amniotic fluid: Having low levels of amniotic fluid (oligohydramnios) makes the sac more prone to rupturing.
Infection: Certain infections increase prostaglandins that can change the cervix and induce contractions.
Injury: Trauma from a fall, car accident, or poke from a vaginal exam could potentially lead to premature rupture.

Tests/procedures: Amniotomy or membrane stripping intentionally breaks the water to induce labor.

When rupture of membranes occurs before 37 weeks, it’s called preterm premature rupture of membranes (PPROM). This usually results from a defect or weakness in the amniotic sac that causes it to burst too early.

What happens if your water breaks before labor?

Pre-labor rupture of membranes doesn’t automatically mean you’ll start having contractions. Here’s an overview of what happens:

Doctors will confirm your water broke by looking for evidence of leaking amniotic fluid.
You’ll be given a sterile speculum exam to check for umbilical cord prolapse.
You may be hooked up to IV antibiotics to prevent infection.

You’ll be given medication to hasten labor within 24 hours if it doesn’t start spontaneously.
Inducing labor lowers risks like cord compression and maternal infection.

If you’re past 37 weeks and your water breaks but labor doesn’t ensue, you’ll likely be admitted to induce labor medically. This usually involves synthetic oxcytocin (Pitocin) to stimulate uterine contractions.

Risks of water breaking too early

There are certain complications that can occur if the amniotic sac ruptures too soon before labor:

Cord prolapse: The umbilical cord slips through the ruptured sac and gets pinched by the baby, cutting off blood flow.
Infection: Bacteria has a greater chance of entering the uterus and infecting the baby without the amniotic sac as a barrier.

Placental abruption: The placenta may partially or completely tear away from the uterine wall.
Fetal distress: Lack of cushioning fluid puts pressure on the baby that can slow their heart rate.

That’s why doctors typically don’t let pregnancy continue for long once the water has broken and will move to deliver the baby within 24 hours.

When to call the doctor

Notify your healthcare provider right away if you’re less than 37 weeks along and you think your water may have broken. Signs of preterm premature rupture of membranes requiring prompt medical attention include:

Gushing or leaking fluid from the vagina
Undergarments or clothing feeling wet

Fluid that is clear, pink, or brown tinged when it comes out
Watery discharge that keeps flowing with position changes
Any bright red bleeding from the vagina

Strong or constant abdominal cramping

Your doctor will want to check for sure if your membranes have ruptured early. This may involve:

pH testing of the vaginal fluid

Microscope slide test of the discharge
Using nitrazine paper to detect amniotic fluid leak
Ultrasound to measure the amount of amniotic fluid

If you’re full term at 37 weeks or beyond when your water breaks, you should still let your provider know right away. They’ll want to closely monitor you for signs of labor and check on the baby.

How to prevent infection if your water breaks

Once the protective barrier of the amniotic sac has ruptured, precautions need to be taken to avoid infection. Recommendations include:

Avoid sexual intercourse, tampon use, douching, and tub baths to limit bacteria entering the vagina.

Monitor your temperature and watch for fever, chills, foul-smelling discharge.
Change pads frequently and avoid sitting in wet clothing.
Practice good hygiene by showering daily and washing your hands before touching your vaginal area.

Go to all scheduled prenatal visits so your provider can check for signs of infection like high white blood cell count.
Take antibiotics prescribed by your doctor to guard against maternal infection.

With protective antibiotics and good hygienic practices, the risk of infection is very low in the first 24 hours after rupture of membranes. But induction of labor is still recommended during this time period.

Ways to help induce labor if your water breaks

If your water breaks but contractions don’t start, here are some natural ways to help get labor going:

Walk around: Being upright and mobile can help bring the baby’s head down to put pressure on the cervix.
Have sex: Semen contains prostaglandins to help ripen the cervix, plus orgasms can trigger uterus contractions.

Take a warm bath or shower: The water and privacy can help you relax, which causes your body to release oxytocin.
Use breast pumps: Stimulating your nipples releases oxytocin to start contractions.
Take castor oil: The natural laxative stimulates your bowels to prompt a uterus response.

Massage your nipples: Continuous light stimulation prompts oxytocin release to progress labor.

Your doctor may also suggest medications like Pitocin or hormones like misoprostol to help induce labor. But taking something unprescribed could be dangerous, so always consult your provider first.

How much time do you have after your water breaks?

Doctors typically give you around 24 hours to go into labor naturally after the amniotic sac has ruptured. This avoids risks like:

Infection spreading from the vagina to the uterus, affecting the baby
Umbilical cord slipping into the vagina if not compressed by baby
Dangerous bleeding from separation of the placenta

Exceptions are made to wait longer (up to 72 hours) if:

You’ve tested negative for group-B strep
The fluid is clear with no signs of infection

You and baby are closely monitored and not showing distress

However, likelihood of infection significantly goes up the longer you wait. So most providers will recommend inducing labor within 24 hours of rupture of membranes.

How are you induced if labor doesn’t start?

If spontaneous labor doesn’t begin within the allotted time frame after your water breaks, here are some medical techniques used for induction:

Synthetic oxytocin: The medication Pitocin is given through an IV to cause strong uterine contractions.
Foley catheter: A small balloon is inserted into the cervix and inflated to put pressure, prompting it to dilate.
Membrane stripping: The doctor massages the amniotic sac membranes to separate them from the cervix.

Misoprostol tablets: These dissolve behind the cervix to soften and thin it out to induce labor.

Methods like membrane stripping or misoprostol are usually tried first. More aggressive treatments like Pitocin are used if milder induction techniques don’t trigger labor.

Recovery after your water breaks

During the postpartum period after giving birth, you can expect:

Heavy bleeding for the first several days, tapering down over several weeks
Cramping as the uterus contracts back down in size
Sore vaginal area, perineum, breasts as they start producing milk

Potential bladder leakage/incontinence that resolves over time

Sanitary pads can manage the lochia discharge you’ll have after delivery. Pain relievers, sitz baths, and squirt bottles can help provide comfort from vaginal soreness or hemorrhoids.

Be sure to call your provider if you experience heavy bleeding that soaks through more than one pad per hour or pass any large clots bigger than a golf ball.

When to try getting pregnant again after labor

Most experts recommend spacing pregnancies at least 18-24 months apart from the prior birth. Reasons to wait include:

Let your body fully heal and replenish vital nutrients
Decrease odds of complications like preterm birth or low birth weight

Give yourself emotional/physical break between intense demands of pregnancy and newborn care
Reduce risk of uterine rupture if you plan a vaginal birth after cesarean (VBAC)

That being said, it’s a personal choice based on your unique situation. Chat with your provider about when they advise trying to conceive again after giving birth.

Conclusion

Rupture of membranes signals your body is making its final preparations for the start of active labor. While the amniotic sac breaking often happens spontaneously once contractions begin, it may occur before labor too. Being in tune with changes leading up to water breakage can give you a sense of when birth is imminent.

If your water breaks preterm, be sure to promptly contact your healthcare provider. They’ll check that all is well and give instructions on next steps. Often, labor needs to be induced within 24 hours if it doesn’t commence naturally to avoid potential risks of waiting longer.

While rupture of membranes is a definitive sign that delivery is not far off, talk to your doctor about any concerns you have as you anticipate this milestone event.