In the movies, your water breaking or the rupture of membranes, is always so dramatic and followed by a flurry of panic and rushing to the hospital. Birth is not usually like this (usually), and your water will not always break so dramatically either!
There are a number of ways to understand HOW your water breaking can influence your labor, plus some other terms related to your water that could be helpful to know prior to your birth.
Rupture of Membranes: 4 Ways to Define Your Water Breaking
If your water breaks, there are four ways we can classify it:
- PPROM: Premature Pre-labor Rupture of Membranes.
- This means you are less than 37 weeks gestationally, and your water has broken.
- If this occurs, see your provider immediately.
- PROM: Pre-labor Rupture of Membranes
- You are 37+ weeks
- You have NO contractions or you are NOT in labor
- And your water breaks BEFORE any contractions
- SROM: Spontaneous Rupture of Membranes
- You are 37+ weeks,
- You are having contractions and in labor (or even pushing)
- And your water breaks
- AROM: Artificial Rupture of Membranes
- Your provider breaks your water for you, usually on purpose, but sometimes it can occur by accident during a cervical or vaginal exam.
- Usually, an induction method!
What to do if your water breaks:
If your water breaks, we want to assess TACO!
- T: Time
- What time did your water break?
- What have you discussed with your provider on a timeframe before heading into your birth location?
- Should you go in right away? Should you wait a few hours to see if labor progresses?
- A: Amount
- Did you have a big gush or a trickle? Remember, the amount of fluid could determine what to expect next!
- Put on a pad, and note how many pads you soak and how quickly!
- C: Color
- What color is the fluid?
- It should be fairly clear, maybe with some slight yellow or pink tinge to it, but fairly clear!
- If there are any colors, such as brown, black, green, or yellow: head to your birth location
- O: Odor
- How does it smell?
- Urine and amniotic fluid have different smells! If it smells like pee, then it’s probably not your water.
- Amniotic fluid has this sweet/salty smell to it; some folks compare it to the smell of semen.
- If it has a foul smell, this could be an indicator of an infection and would be a reason to go in right away to your birth location!
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If your water breaks, it can also be helpful to notify your birth team and ask for guidance if you feel confused!
2 Ways Your Water Can Break: Gush or Trickle
If your water breaks, usually with PROM or SROM, you can either have:
- A big gush
- Trickle
And each of these ways of breaking can have a different meaning and potentially a different course of action!
If you have a big gush, there is a lot of fluid that comes out at once! And then will probably leak throughout your labor as you shift positions. This usually means that the bottom of the amniotic fluid sac has broken.
If you have more of a trickle, this could mean that you have a high leak, or the top part of the amniotic fluid sac has a rip in it.
Learn more about your options in our childbirth education course! We break down what is actually happening, so you be confident in navigating your own pregnancy and birth. Learn the science of birth, plus tons of labor positions, pushing techniques, and how to ask questions to support your birth experience.
1) Big Gush: Labor Begins or Intensifies!
If you have a BIG GUSH of fluid, either before or during contractions, this is a good sign that the lower part of your amniotic fluid sac has broken!
When the lower part breaks, baby’s head then applies more firmly to the cervix and can trigger the labor feedback loop.
When there is pressure against the cervix, we release prostaglandins. Prostaglandins soften the cervix and cause uterine contractions and trigger the brain to release more oxytocin.
Oxytocin triggers uterine contractions, which then pushes baby against the cervix more, and triggers the release of more prostaglandins!
And thus the positive feedback loop begins for labor!
If you are NOT having contractions and you have a big gush:
- You are more likely to start having contractions within the next few hours because baby is more applied to the cervix (and starting that labor feedback loop)
If you are ARE having contractions and you have a big gush:
- Your labor is more likely to INCREASE in intensity with the next contraction!
- If you are not at your birth location, it can be a good idea to head that way in case labor also SPEEDS UP.
2) Trickle: Labor May Not Begin... so what to do?
But what if you have more of a trickle? This could mean that you have a high leak, or the top part of the amniotic fluid sac has a rip or hole in it.
This could be problematic, because baby’s head is not more applied to the cervix, so this does not trigger the labor feedback loop! Without this feedback loop, labor may not begin with a high leak!
For my clients that have a high leak, it has been less likely that their labor begins on its own. They usually eventually need to head into their birth location for induction of labor.
If you are NOT having contractions and you have a trickle:
- Consider heading into your birth location for an induction, since it is less likely that your labor will begin on its own. You don’t necessarily need to start with Pitocin! There are other options.
- Try some natural induction methods, such as a membrane sweep or nipple stimulation, to attempt to kickstart labor.
If you ARE having contractions and you have a trickle:
- You may not notice a change in your labor intensity! Continue to labor, but note TACO.
Is there a way to prevent your water from breaking before labor or too early during labor?? Maybe!
During labor, when our water breaks, increased intensity tends to follow. So it could be helpful if your plan is an unmedicated birth to delay when our water breaks (not that you have a ton of control over it).
And before labor, if our water breaks before labor has begun (after 37 weeks), it could potentially lead to an induction, which may or may not be your preference.
Is there a way to prevent your water from breaking before labor begins (after 37 weeks) or too early during labor? Maybe!
Please note that this is not for PPROM (when your water breaks earlier than 37 weeks, as there are more complications and contributors towards PPROM, and studies support that vitamin C supplementation does NOT seem to prevent PPROM).
The amniotic fluid sac is primarily made up of collagen, which could increase in density based on our nutrition!
During my second pregnancy, a midwife recommended that I take vitamin C to prevent PROM or an early SROM. But when I researched it, I was confused about why vitamin C was the recommendation.
There is mixed evidence on the use of Vitamin C to prevent PROM.
Some studies find that the collagen concentration is lower in the amniotic fluid sac of those who have PROM.
Vitamin C helps with the production and maintenance of collagen, which is a main component of our amniotic fluid sac layers! So in theory, vitamin C could help prevent PROM and early SROM because it helps the absorption of collagen, not necessarily because vitamin C alone thickens the amniotic fluid sac!
Eating a diet rich in collagen (think slow-cooked meats, such as pulled pork or bone broths) and vitamin C (citrus fruits) could increase the density of our amniotic fluid sac and prevent PROM or early SROM. But more research on this could be beneficial!
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References
- Casanueva, E., Ripoll, C., Tolentino, M., Morales, R. M., Pfeffer, F., Vilchis, P., & Vadillo-Ortega, F. (2005). Vitamin C supplementation to prevent premature rupture of the chorioamniotic membranes: a randomized trial. The American journal of clinical nutrition, 81(4), 859-863.
- Rumbold, A., Ota, E., Nagata, C., Shahrook, S., & Crowther, C. A. (2015). Vitamin C supplementation in pregnancy. Cochrane Database of Systematic Reviews, (9).
- Saleem, A., Al-Hilli, N. M., Safar, Z., & Al-Humairi, A. K. (2019). Maternal vitamin c and preterm pre-labour rupture of membranes. Int J Med Research Health Sci, 8(6), 22-29.
- Stuart, E. L., Evans, G. S., Lin, Y. S., & Powers, H. J. (2005). Reduced collagen and ascorbic acid concentrations and increased proteolytic susceptibility with prelabor fetal membrane rupture in women. Biology of reproduction, 72(1), 230-235.