What happens when your waters break

As their due date nears, most pregnant women start to worry about when and where their waters will break, and most also panic over the prospect of a flood of amniotic fluid soaking them in a public place, followed in short order by labor starting and an emergency birth at home or in the back seat of the car!

In fact, for around 75 percent of women, the bag of waters – the membrane sac containing the amniotic fluid that cushions and protects your baby from infections while he’s in the uterus – doesn’t break until they’re well into labor and almost fully dilated. For many others, the sac ruptures while they’re sleeping, in early labor. The first sign that something has happened may be you waking up and thinking that you’ve wet the bed. If you’re awake when it happens you may feel or even hear a ‘pop’ and while some women do experience a gush of amniotic fluid, others just get a trickle because their baby’s head is blocking the fluid’s exit from the uterus.

Rarely, the membrane sac doesn’t break at all and the baby is born with it intact (this is called a caul and is supposed to bring good luck!). This is more common in preterm babies and won’t harm your baby in any way – your healthcare providers will simply remove it.

How can I tell if my waters really have broken?

If you just get a trickle of fluid it can be difficult to work out if your waters really have broken. If you’re suspicious they may have, or at all unsure, call your OB-GYN or midwife, as they can test a sample of the fluid to check. If it’s difficult to obtain a sample because the flow seems to have eased off, an ultrasound can check the level of amniotic fluid that remains in your uterus.

As a rule, if your waters have broken, any fluid that is escaping will continue to trickle, whereas if you just leaked a few drops of urine the flow will stop. A good way to check is to wear a sanitary pad and lie down for 20 minutes or so. If your waters really have broken, amniotic fluid will pool in your vagina when you’re recumbent and when you stand up you’ll feel a gush as it flows out.

If you’re sure, and you haven’t called your healthcare provider yet, do so now. But don’t panic! Just because your waters have broken doesn’t mean you’re about to give birth (though it may not be very far off if it’s a second or subsequent baby, as birth can be easier and faster once you’ve already been through it). If your healthcare provider confirms that your waters have broken they will likely advise you to rest at home and call them once contractions start or if they don’t start within 24 hours.

“I’d been having leakage for a couple of hours before my mom suggested my waters might have broken. My OB-GYN asked me to drop by the office and she tested it using litmus paper. It changed color straightaway!”
Kathryn Costello, Raleigh, NC

What will it look like?

Amniotic fluid can be clear, or tinged with pink, compared to urine, which is yellowish. It also will have a slightly bleach-like scent – unlike urine which has an ammonia-like scent. If the fluid is tinged brown or green, tell your healthcare provider when you call them, as this can indicate that your baby has passed meconium (his first bowel movement) in the uterus. This can be a sign of distress and your baby will need to be monitored to check his wellbeing.

“I’d wanted a water birth with my second baby, having had one with my daughter. Practically the minute I got in the pool my waters exploded in a brownish cloud – my midwife hauled me out straightaway, saying it was a sign of distress. My baby was fine, though.”
Kadi Jordan, Duluth, MINN

What if my waters break early?

If your waters break more than three weeks before your baby is due, your doctor may give you medications to try to prevent contractions from starting, so that your baby isn’t born pre-term. As it’s the waters that protect your baby from infections, you’ll both be closely monitored to check that he’s OK.

If you’re a week or two away from your due date when your waters break and contractions begin afterwards, your doctor may allow your labor to continue. If your waters break but contractions don’t start spontaneously within 24 hours, it’s likely you’ll be given an induction – the longer the time is between your waters breaking and your labor starting, the more risk there is of your baby developing an infection.

“A day after my water broke nothing seemed to be budging. My OB-GYN said induction was the best option to get my contractions started – she was concerned that bacteria might be able to get into my uterus withoout the amniotic fluid there.”
Toby Ackles, Boulder, CO

When it could be an emergency

Call your OB-GYN or midwife straightaway if:

Your baby isn’t due for three or more weeks.
The fluid is green or brown, or smells unpleasant.
You have a history of genital herpes (whether or not you have any herpes sores right now) or Group B strep (GBS) and have been told you’ll need to take medication to protect your baby from contracting these infections during your labor.
Your baby is in a breech (bottom or feet down) position.
You’ve had a very quick labor with a previous baby or feel pressure in your rectum that suggests your baby might be moving along the birth canal.
You develop a fever.

The information in this feature is intended for educational purposes only. If you have any concerns about your health, the health of your child or the health of someone you know, please consult with a doctor or other healthcare professional.

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Last Modified: 08/02/2009

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