What to expect when your water breaks

When you're pregnant and your water breaks, the fluid-filled sac around your baby has ruptured. This amniotic fluid bag keeps your little one securely in your tummy. Also called a water sac, it gives your baby room to grow, maintains a constant temperature, and protects the umbilical cord so it doesn't get squeezed.

As your body prepares for childbirth, water separates and flows out through the vagina. This can happen before or during work. This is when you start to feel contractions and the cervix thins and dilates to allow the baby to pass through.

If the water breaks before contractions begin, this is called a pre-delivery rupture of the membranes. Along with cravings for pickles and ice cream, a pregnant woman who suddenly breaks her water before labor is a cliché you may have seen on TV many times. In real life, about 10% of term births begin this way. It usually looks more like a stream than a geyser. It can also happen long after the onset of labor. However, it is important that you know the signs.

Signs that your water has broken

It's completely different for everyone. You may notice:

A rapid gush that feels like you’ve peed in your pants
A constant leak
A slow drip
A leak that starts and stops.

You might hear or feel a small pop. And remember, amniotic fluid doesn’t smell like pee.

What to do when the waters break

If you think your water has broken, put on a pad (not a tampon) and call your doctor or midwife right away. They usually advise you to come to their office or go straight to the hospital or maternity hospital. If it's not obvious that your amniotic sac has ruptured, they can do a simple test on a sample of your fluid.

If your due date is less than 3 weeks away, your doctor or midwife may ask you to wait a few hours to see if you are giving birth on your own. Or they may start or induce labor in you. Most women give birth alone within 12 hours.

Research shows that babies born to mothers who received immediate induced stimulation are less likely to contract infections, require less intensive care, and return home from the hospital faster than babies whose mothers watched and waited. Discuss with your obstetrician or midwife what is best for you.

Early water breaking

About 3% of women have a discharge of water before the 37th week of pregnancy. This is called premature rupture of the membranes before childbirth. This is most likely to happen if you:

Are underweight
Smoke
Had a preterm prelabor rupture of membranes with an earlier pregnancy
Have an untreated urinary tract infection
Had vaginal bleeding at any time in pregnancy
Had problems with your cervix during pregnancy
You need to go to the hospital right away for preterm prelabor rupture of membranes.

If you are at least 34 weeks pregnant, your doctor may recommend that you have a baby to reduce the chance that you or your baby will get a serious infection.

If you're between 23 and 34 weeks pregnant, it's usually best to delay delivery so your baby has more time to grow. You will receive antibiotics to help prevent infection and a course of steroids to help your baby's lungs mature faster. You may stay in the hospital until delivery.

If your waters break before 23 weeks, your doctor will talk to you about the dangers and benefits of continuing your pregnancy. Babies born after this early water break are less likely to survive. Those who do are more likely to have mental or physical disabilities.

When your water doesn’t break

If you're already in labor but it's slow, your doctor may cut your water. A sterile plastic hook will be placed in your vagina and pulled on the amniotic sac until it bursts. But studies show that for most women, it does not speed up labor. The doctor should only do this if your baby's head is already in your pelvis and low enough to cover your cervix. Otherwise, your body will usually continue to work on its own until your baby is born.