So you think your waters have broken – or maybe you’re not sure. Perhaps you’ve seen all those dramatic scenes in movies, so you know it’s something that happens, but not exactly what happens. Never fear, read on!
What are my waters?
Your baby is basically surrounded by a big balloon of fluid inside your womb.
The balloon is a sac made of tough “membranes” that act as a barrier to the outside world – importantly, this helps protect baby from infection throughout pregnancy.
The fluid is called “amniotic fluid” and it does several things:
- Acts as a protective cushion around baby
- Helps the lungs and digestive system develop
- Allows baby to move around so the muscles and bones develop properly
- Stops the umbilical cord getting squashed
Colloquially, people refer to the amniotic fluid as your waters.
How much fluid is there?
It depends on how far along you are, but in the third trimester it’s generally somewhere between 500-800mL.
We can check the amount of fluid on ultrasound. Occasionally, there may be too much or too little fluid. If this is the case, you may need some extra tests to work out the cause.
How do I know if my waters have broken?
It might be obvious – a big gush of fluid from your vagina that soaks through your clothes and runs down your legs. Often it’s not quite so dramatic – you may simply notice a persistent wetness on your underwear that doesn’t smell like urine.
What should the liquid look like?
The fluid should be clear or a pale straw colour. Initially it might be a little bit pinkish.
If the fluid looks green, brown, heavily bloodstained or murky, you should go to the hospital immediately.
What do I do if I think my waters have broken?
- Put a pad on. Apart from keeping your clothes dry, the hospital will want to look at the colour of the fluid!
- Make a note of the time
- Call the birth suite at your booked hospital. They’ll ask you to come in for a check-up.
- You should call birth suite even if you’re not sure. I would always prefer you come in and have a false alarm, rather than going undiagnosed!
Breaking your waters after 37 weeks
Once you have passed the 37-week mark, your baby is generally ready to be born. There’s a good chance you’ll go into labour within 24 hours of your waters breaking. It’s usually safe to wait a day for labour to start, as long as you’ve been checked at the hospital and there are no other concerns.
However, there are some circumstances where it’s safer to start your labour immediately with a hormone drip. This will apply if there are any signs of infection, if the fluid is heavily bloodstained or contains meconium, or if you carry Group B streptococcus. Your obstetrician will discuss this with you.
Breaking your waters before 37 weeks
This is called “pre-term prelabour rupture of membranes” or PPROM for short. It complicates up to 3% of pregnancies.
PPROM is a very different scenario to breaking your waters at term. It can lead to serious complications, including premature birth, infection and umbilical cord prolapse.
Management of PPROM, and the likelihood of complications, will depend on how many weeks you are in your pregnancy.
Initially, you’ll be admitted to hospital for medication and monitoring. As well as your obstetrician, you may also need to meet with a Maternal-Fetal Medicine specialist and a neonatologist (baby doctor). They will balance the need to keep baby inside for as long as possible against any signs of problems. It will be a day-by-day approach.