What to Expect When Your Water Breaksby Katlyn Joy | November 9, 2011 8:39 AM
You've seen it on TV and in movies dozens of times. A pregnant woman clutches her enormous pregnant belly, belts out, "It's time!" and then we hear a gush of water hitting the floor. The scene is so common, many people think that's the usual way labor begins. But how realistic is that familiar scenario?
When your water breaks the fluid you see or feel is actually the contents of the amniotic sac. This fluid is made up of 98 percent water and 2 percent salt and cells from the baby. From the start until month four, the amniotic fluid is produced solely by mom, but after this point the baby adds to the contents with urine. The baby swallows the amniotic fluid then actually pees into the fluid in a cycle that continues until birth. Prenatal recycling you might say! By the time the baby is ready to be born, he will swallow up to 15 ounces a day of the fluid. The amniotic fluid's purpose is to keep baby warm and protected and help the baby's digestive and respiratory systems' development. The peak levels of amniotic fluid occur around the thirty-fourth week of pregnancy at 1 liter. By birth, this amount is slightly reduced.
Despite the dramatic scenarios in movies, rarely does a woman experience her bag of waters breaking prior to the start of labor. Usually a woman is well into active labor when her water breaks and is unlikely in public. However, it's most likely going to be a trickle or slow leak rather than a geyser spouting in aisle three of the Piggly Wiggly.
How to Know Your Water Has Broken
For most women, it can be rather tricky. While you might be reluctant to admit it, many women at the end of their pregnancy experience some urinary incontinence or leaking and it can be difficult to tell whether that extra wetness is urine, amniotic fluid or just the increased discharge that is also common towards the end. One way to tell? The sniff test. May not sound scientific but amniotic fluid will not smell of ammonia or urine. Amniotic fluid has no color or odor. However, if the leaking continues, you should pop into your doctor's office or by the hospital if it's after hours and find out for certain.
Typically, labor will start soon after the water breaks if it wasn't underway beforehand. If labor hasn't started within 24 hours most often your physician will induce labor. Longer than this and the risk of infection is too great, so a clock starts running once the water has broken.
Risk Factors for Premature Rupture of Membranes
Anytime your water breaks before the 37th week, it's considered premature. Risk factors include previous history of PROM, smoking, genital tract infection or bleeding that has occurred during two or more trimesters.
Concerns with Water Breaking
Anytime your water breaks, the risk of infection is elevated. For this reason you must be careful to avoid doing anything that may introduce bacteria into the vagina such as douching, using tampons, taking a tub bath, or having sex. Be especially vigilant about wiping from from to back to avoid contaminating the vaginal area when going to the bathroom as well.
When the water breaks there is the slight risk of the cord prolapsing or falling down into the birth canal prior to birth. This is a serious condition where baby's life can be in danger so you'll want to consult with your physician should your water break especially prior to 38 weeks in pregnancy.
If your amniotic fluid appears brown or green, smells bad or you feel something in your vagina, you need to seek medical attention immediately.
When the Doctor Ruptures Your Bag of Waters
Sometimes you'll be in labor for hours without any rupture of the amniotic bag. In this case the doctor may opt to break the bag to help labor along. The procedure is fairly simple and is referred to as an amniotomy. The physician will insert a small instrument with a hook, much like a crochet hook, into the vagina and pierce the amniotic bag. You shouldn't feel discomfort but will feel a release of warm water immediately. This is often part of the early induction of labor measures. Often just this simple intervention will get labor moving and baby sooner to being born.
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