Water breaking: A flood or a trickle?
Despite Hollywood's claims, water breaking, or "rupture of membranes," is rarely the first sign of labor, and, especially for first time mothers, the birth of your baby does not typically imminently follow the breaking of your water.
When will my water break?
Only 10% of labors beginning with the breaking of the bag of water. That's right, 90% of labors begin with contractions.
Your water can break at any time during the labor: early labor, active labor, or even during pushing.
In rare circumstances, babies can actually be born "en caul" or still within the amniotic sac, or bag of water.
How will I know my water broke?
It might be obvious that your water has broken. You might feel a pop followed by a large gush of fluid. If you're already in labor, it makes sense that this gush of fluid is amniotic fluid.
It's also normal to be unsure if your water is broken, especially if you haven't noticed any contractions. It's possible to have a small leak in the amniotic bag that results in just a little bit of fluid leaking out intermittently. It can be hard to tell if this fluid is amniotic fluid or just increased discharge that is common at the end of pregnancy.
What do I do if I think my water broke?
First, note COAT:
- Color: Is the fluid clear, blood-tinged, or yellowish or greenish? Clear fluid is what we expect, but if the baby passes meconium, their first poop, in the womb, the fluid can be green or yellow. Blood-tinged fluid results from the amniotic fluid mixing with your mucus plug or bloody show occurring as the cervix opens from contractions.
- Odor: Amniotic fluid should be odorless or mildly sweet smelling. A foul odor could indicate an infection.
- Amount: Was it just a small trickle when you stood up? Or were your pants totally soaked?
- Time: Your provider will keep track of how long your water has been broken, so note the time if you're at home when it happens.
Next, call your provider
(if you're not already in the hospital) to report COAT to them. This is also a great time to notify your doula if you haven't already.
Decide what the plan of action is.
Will you stay at home a bit longer or is it time to go to the hospital? Some of these decisions might be dependent on whether your baby is term (more than 37 weeks gestation) or preterm (less than 37 weeks gestation).
Is there a test to know if my water broke?
Your provider and the hospital staff have a couple of tests that can help to confirm your water has broken.
- Nitrazine: A strip or a swab can be used to collect fluid from the vagina. If the strip or swab turns blue, it's likely your water has broken. It's possible to have false positives though--sometimes blood or a vaginal infection can render the test inaccurate.
- Ferning: A sample of the vaginal fluid can be placed on a slide and examined under the microscope. A fern-like pattern may indicate that amniotic fluid is present.
- Pooling: A speculum may be inserted into the vagina to see if fluid pools within it. Typically there would not be enough vaginal discharge to cause pooling, so if a nurse, doctor, or midwife notices this, it's more likely your water has broken.
If you're at home, your provider may have you lay down without underwear on for 20-30 minutes. If fluid is copious enough to run down your leg when you stand up, it's likely your bag of water is broken or leaking.