What to Do After Your Water Breaks

If you're pregnant, you might be rightfully curious about your water breaking, like when it will happen and what it will feel like. Besides that, you will also want to know what to do next. It's important to recognize the signs of your water breaking and know what it means for the timeline of your baby's delivery. No matter how your water breaks - and you should know that it rarely happens like it does in the movies, when the amniotic fluid gushes out of the woman and wets everything. That said, it is almost certainly an important sign that your baby is on the way. Take a deep breath and focus on the task at hand because you are really close to meeting your baby.
 
What Happens When Your Water Breaks?
 
Throughout your pregnancy, your baby is surrounded and cushioned by a fluid-filled membranous sac called the amniotic sac. At the beginning of or during labor, that membrane will rupture. That is what is referred to as your water breaking. However, if your water breaks before labor starts, that is called pre-labor rupture of membranes (PROM). Previously it was known as premature rupture of membranes.
 
When your water breaks you might experience a sensation of wetness in your vagina or on your perineum, an intermittent or constant leaking of small amounts of watery fluid from your vagina, or a more obvious gush of clear or pale-yellow fluid. It's not always easy to tell if your water has broken. For example, it might be difficult to tell the difference between amniotic fluid and urine — especially if you only experience a feeling of wetness or a trickle of fluid. If you're not entirely certain whether your water has broken, call your health care provider or head to your delivery facility right away. Your doctor or a member of your health care team will give you a physical exam to determine if you're leaking amniotic fluid. In some cases, an ultrasound might be done to check your amniotic fluid volume. You and your baby will be evaluated to determine the next steps.
 
The color of the fluid when your water breaks is usually clear or pale yellow, and the fluid has no smell. The fluid level reaches its peak by about week 36 of pregnancy, when there are about 4 cups of fluid, but from then on, the amount of fluid slowly decreases. 
 
Most of the time, if your water breaks at or around term, labor follows soon after. In many cases, it is a sign that labor has already begun. In some cases, however, labor doesn't start. If you experience pre-labor rupture of membranes, your doctor might decide to induce labor, which means they will stimulate uterine contractions before labor begins on its own. This is important because the longer it takes for labor to start after your water breaks, the greater the risk that either you or your baby may develop an infection.
 
What happens if your water breaks too early?

 
If your water breaks before the 37th week of pregnancy, it's known as preterm pre-labor rupture of membranes (preterm PROM). Among the risk factors that can cause the water to break too early include:
•    A history of preterm pre-labor rupture of membranes in a prior pregnancy
•    Inflammation of the fetal membranes (intra-amniotic infection)
•    Vaginal bleeding during the second and third trimesters
•    Smoking or using illicit drugs during pregnancy
•    Being underweight with poor nutrition
•    Short cervical length
 
Among the potential complications of a pre-term PROM can include maternal or fetal infection, placental abruption (which is when the placenta peels away from the inner wall of the uterus before delivery), or possible umbilical cord problems. Those are all in addition to the risks and complications to the baby due to premature birth.
 
If you experience a pre-term PROM and you're at least 34 weeks pregnant, delivery might be recommended to avoid an infection. If there are no signs of infection or fetal health problems, research suggests that pregnancy can safely be allowed to continue as long as it's carefully monitored. If you're between 24 and 34 weeks pregnant, your health care provider will likely try to delay delivery until your baby is more developed. You'll be given antibiotics to prevent an infection and an injection of potent steroids (corticosteroids) to speed your baby's lung maturity. If you're less than 32 weeks pregnant when your water breaks and you are at risk of delivering within the next few days, you might be given magnesium sulfate to protect the baby's nervous system.
 
What if your water doesn't break on its own?

 
During active labor, if your cervix is dilated and thinned and the baby's head is deep in your pelvis, your health care provider might use a technique known as an amniotomy to start labor contractions. If labor has already started, this technique might make the contractions harder, which could shorten labor. During the amniotomy, a thin plastic hook is used to make a small opening in the amniotic sac and cause your water to break.
 
The fact of the matter is, the length of labor and childbirth varies from woman to woman, and everything also depends on other factors including when your water broke, whether this is your first labor, and whether everything is progressing smoothly. The only thing you can be sure of when your water breaks is that the wait is nearly over, and you’ll meet your new baby soon!
 

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