What happens when your waters break?

Only around 8-10% of pregnant people will experience pre-labour rupture of membranes (your waters breaking before contractions have started). So it is more likely that your waters will break during labour or maybe not until baby is born. Babies can be safely born with the bag of waters intact (en caul), and this is considered quite auspicious in some cultures.

Your waters breaking may cause a big gush of fluid (like in the movies) or just a small trickle here and there. This is because your bag of waters may break at the top near babies feet ('hind-water leak'), or closer to the cervix with more pressure behind it.

If you think your waters have broken give your care provider a call to let them know, put on a pad, and take note of the following:

-Colour of the fluid

-Amount of fluid

-Does the fluid have a smell?

-Normal baby movement?

-Any blood?

-Do you have a temperature?

Other important considerations which you should discuss with your care provider include:

-How many weeks pregnant are you?

-What position is baby in, head down, breech, transverse?

-Did you have a Group B Strep swab, if so, what was the result?

-Are you planning a vaginal birth or caesarean?

If you're unsure if your waters have broken then your care provider may recommend a test, carried out similarly to a pap smear, using a speculum and a swab to confirm whether the fluid is amniotic fluid or not.

What next...?

Depending on which evidence you look at, 60-95% of women will go into labour within 24hrs of their waters breaking.

The national and state (QLD) guidelines outline two courses of action for pre-labour rupture of membranes:

Active management or Expectant management

Active management is planned intervention intended to lead to birth within 24 hours of your waters breaking. This includes induction of labour via syntocinon drip or caesarean section. In the absence of other risk factors, IV antibiotics are not routinely recommended until your waters have been broken for 24 hours at which time the risk of infection to you and baby increases.

Expectant management is simply waiting for spontaneous onset of labour, either at home or in the hospital. According to RANZCOG, the ideal candidate for expectant management would be/have:

-Baby head down and engaged

-Negative GBS status

-No signs of infection (high heart rate, fever or uterine tenderness)

-Normal baby movement

-Clear amniotic fluid

-Commitment to regular temperature checks (4 hourly during waking hours), vaginal loss and baby movement

-Plan for review

Lastly...There are a lot of factors to consider before making a decision following pre-labour rupture of membranes. Speak with your care providers and weigh the benefits and risks according to your personal situation.

-If it's safe to do so you may like to try to encourage contractions through active and upright positions. Do a yoga class, attend an acupuncture or massage appointment, go for a walk, try climbing stairs

-Intercourse may be associated with increased risk of infection after your waters have broken

-Showering or bathing is not associated with increased risk of infection

-Avoid vaginal exams in the absence of contractions to reduce the risk of infection