In the movies, mom’s water breaks, everyone leaps into action and the next thing you know she’s being raced down a hospital corridor on a gurney. In real life, I can’t imagine many scenarios where this would happen or be necessary. Only 10-15% of the time do the waters break before mom goes into labor. Most of the time she’s already aware that something is happening, ie: she’s having contractions.
If the water breaks before labor has started (as in the movie version) there’s no reason for her to run screaming to the hospital. The very boring reality is that she’d need to change her underwear and make a phone call. (Not so fun for the big screen).
But so entrenched is this Hollywood narrative, many couples are surprised to know that the water breaking is not the necessary/inevitable sign that labor has started.
So, what’s up with the water breaking?
Here are the basics:
- The amniotic sac—the membranes around the baby– can break before or during labor. Most of the time the bag ruptures during labor and very occasionally a baby is born with membranes intact which is perfectly safe and considered a blessing in some cultures.
- The mucus plug (clear mucus, occasionally tinged with a bit of dark blood) fills the narrow opening in an otherwise closed cervix throughout pregnancy. It comes out before the waters break– sometimes days or a week before, sometimes at or around the same time. Some women notice it come out, other don’t. It doesn’t matter either way. (See picture above.)
- We don’t know exactly what triggers the membranes to rupture, but when they do break there tends to be an initial gush of liquid. Sometimes it’s a trickle and mom may wonder, Uh oh, am I peeing in my pants? (A little incontinence is perfectly normal at the end of pregnancy since there’s a big head literally resting on your bladder 24/7.) Almost always mom realizes, Ah no, I’m not peeing. After the initial gish or trickle, the baby’s head will block the cervix (the opening of the uterus) and fluid will not leak except when mom changes position. Leaking fluid is not an immediate concern though as mom’s body keeps replenishing.
- If your waters break, call your doctor or midwife. You may or may not be instructed to go to the hospital/birth center depending on your particular situation. Since the risk of infection goes up once the membranes have ruptured, it’s important to not put anything in your vagina (finger, tampon, penis, etc).
- Most of the time contractions begin within 12-24 hours of the water breaking. If labor doesn’t start on it’s own, you may be induced to prevent the risk of infection. Opinions vary widely about how long is too long to wait, but research shows that within 24 hours of ruptured membranes 85% of women will go into labor, so that can be very reassuring.
- Occasionally, amniotic fluid is tinged with a green or greenish brown color. This indicates that the baby has passed meconium (the first bowel movement). Meconuim is more likely to be present when a baby is past due; it can also suggest the possibility that the baby is in distress. By itself, meconium is not a sign that the baby is in any danger, however fetal monitoring is often recommended to make sure there are no other indications of problems. Though it’s not all that common there’s a saying among midwives and doctors, “meconium happens.”
- In general, there’s a huge a range of water breaking stories. It happened early, middle, late. It was a gush. It took me a while to realize. Sometimes the waters are broken to help speed up labor or to monitor the baby internally. This used to be more of a routine procedure but since it’s not 100% certain the broken membranes will speed up labor (and as there becomes an increased chance of infection), it’s not performed quite so much these days. If you’ve had a baby, what was it like when you’re water broke?