What to Do if Your Bag of Waters Breaks

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It is common to be in labor without your water breaking.  Actually, thirty percent of women experience their water breaking prematurely before the start of labor.

What Is My Bag of Waters?   The bag of waters—or amniotic sac—is a bag or “membrane filled with fluid that surrounds your baby in your uterus during pregnancy.”  The bag of water is very important to your baby’s health.  The fluid protects your baby and gives your baby room to move around.  The bag itself protects your baby from infections that may get into your vagina.

Is it urine or is it amniotic fluid? If you are leaking, it can be difficult to determine if your membranes are leaking or if it is urine.  In most cases, it is probably urine.  There are several ways to tell the difference, but there is no definite answer.  When in doubt, smell it! Urine has a distinct smell and color.  You will leak urine when your bladder is full, when coughing, sneezing, or laughing, or even when you are exercising.

Only two percent of pregnant women will go into premature labor (before 37 weeks) as a result of ruptured membranes.   In most cases, your membranes will rupture as you are nearing the end of your pregnancy, and this is definitely one of the early signs of labor.  If you have visions of a huge gush of water running all over the floor, then you have probably been watching too many movies.  It is most likely going to occur as a slow trickle, or at most, a small gush of fluid of colorless and odorless amniotic fluid that runs down past your mid-thigh.

What Should You Do When Your Water Breaks?  Don’t panic, follow the instructions your healthcare provider discussed with you if and when your water breaks.  If you don’t remember their instructions call your provider.

• Wear a maxi pad, not tampons, to keep the amniotic fluid from wetting your clothes
• When you go to the bathroom, be sure to wipe from front to back
• Do not put anything inside your vagina, sexual intercourse is off-limits

Call your healthcare provider immediately if:

• If you are less than 37 weeks pregnant
• The water is green, or yellow, or brown, or has a bad smell
• You have a history of Group B strep infection (“GBS positive”) or if you were told you are GBS positive
• Your baby is not in the head-down position i.e.: breech
• You have had very quick labor in the past, or feel constant rectal pressure now
• You are worried.
• If you feel something in your vagina, or see any of the umbilical cord at the vaginal opening, get medical help immediately

Some health care providers will want you to come into the office to confirm that the bag of water has broken and listened to the baby’s heartbeat as soon as you notice that the bag of water has broken.  Confirmation of rupture is done by a speculum examination, nitrazine paper, or by looking for ferning under a microscope. If your bag of water is ruptured, you may be treated with medications like antibiotics for GBS or corticosteroids if your baby is premature.

Other providers may suggest you stay home for several hours to wait for labor to start depending on your medical history.

What Do I Do Until Labor Starts?   Most women will go into labor within 48 hours.  If you are waiting for labor to start and your bag of water has broken:

• Hydrate
• Continue with your regular plans for labor.
• Get some rest and relax
• Update your doula