The membranes (amniotic sac) holding your water (amniotic fluid) will inevitably break sometime during you pregnancy. Fortunately this is most likely to happen while you are in active labor at term (spontaneous rupture of membranes or SROM) in the hospital. In case your water breaks outside the hospital before or after labor starts, knowing beforehand what to do will keep you from feeling stressed and anxious.
Go to the Hospital
If you are not in the hospital in active labor when your water breaks:
- Make a note of what time your membranes ruptured because your providers will want to know this information.
- Don't put anything in your vagina to try to check yourself or you could introduce infection.
- You should consult your doctor or midwife and/or go to the hospital shortly thereafter.
- Go to the hospital even if you are just leaking fluid and you are not sure if your water broke.
- Go immediately if you are preterm (less than 37 weeks); especially if you are less than 34 weeks.
Look at the color of the amniotic fluid, which should be clear whitish or straw colored. Go immediately to the hospital if the fluid is:
- Dark or greenish (meconium staining), indicating the baby moved his/her bowel
- Bloody throughout, which could indicate risk of placental abruption
- Foul-smelling, indicating an infection
There are consequences for remaining at home depending on the weeks of your pregnancy. What happens when you get to the hospital depends on if your labor has started and how far along you are.
Important Things to Consider
There are various reasons for your water to break at different stages of your pregnancy. Consider the following important things in the different stages if your water breaks outside of the hospital:
Full Term in Labor
If labor starts at term at home and gets active:
- Consider calling 911 to get to hospital right away, especially if you are not near the hospital.
- This is even more important if you are feeling the pressure of the baby in your pelvis or the urge to push.
Full Term, Not in Labor
If your water breaks at term before your labor starts:
- The risk of infection in you or your baby increases during the next 24 hours.
- Your doctor might decide to wait a few hours to see if you start your labor, or may induce labor right away.
- If you are not in labor usually within the next 12 hours, your doctor will induce labor.
- Contractions might start on their own after your membranes rupture.
Preterm Rupture of Membranes
If your water breaks when you are less than 37 weeks pregnant:
- You and your baby have a risk of infection.
There is a risk of the umbilical cord slipping through the cervix (cord prolapse), causing less blood flow to the baby.
The placenta (abruption) can also peel away from the wall of the uterus before delivery with risk to the baby.
- There are risks of delivering a premature baby outside of the hospital before the lungs are developed.
The earlier you are in your pregnancy the greater the risk of prematurity to your baby and the greater the risk of infection occurs.
- Between 34-36 Weeks
- The chances of survival are good for the baby.
- Early delivery may be better than risking infection.
- After your evaluation, your doctor might decide to induce your labor if you are not contracting.
- Before 34 Weeks
- The chance of baby's survival decreases the earlier you are in your pregnancy, mainly because of immature lungs.
- The quicker you get to the hospital, the better for your baby's survival.
- The risks of delivering a premature baby are greater than the risks of infection.
- Your doctor might decide that it is better to buy some time in the hospital to mature the baby's lungs before you deliver.
- Most people will deliver within a week of membrane rupture.
These important considerations are the basis for the advice to go to the hospital if you have a gush of water or if you think the fluid you are leaking is your amniotic fluid.
Take Calm Action
If your water breaks outside the hospital, knowing the consequences and what to do ahead of time will help you to take calm action. Regardless of your due date or whether or not you are in labor, but especially if your baby is premature, it is best to go to the hospital to be evaluated. This can make a difference to the health of your baby after delivery.