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| |    How Will I Know When My Water Breaks? by Lisa Rodriguez, R.N. and Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. Having heard more than one story about a pregnant woman's water breaking in some very inconvenient public place, most women worry about where--as well as when--it will happen to them. In addition, one of the most common questions pregnant women ask is how they will know if their water has indeed broken. That said, sometimes it's extremely obvious that you broke your water, because you experience a big gush of fluid that soaks through your clothes and simply can't be mistaken for anything else. At other times, however, it happens in a more subtle manner that understandably is mistaken for vaginal discharge or urine leakage--both common occurrences during pregnancy. The timing of membrane rupture Rupture of the membranes, the technical term for breaking the water, may happen before or during labor. When it occurs before labor, it often means that labor is imminent. Your practitioner will need to be notified, and you may be advised to go to your hospital or birth center, even if labor hasn't begun. If you break your water before 36 weeks gestation, medical care and antibiotics may help to extend the pregnancy by days or even weeks. The bottom line: Regardless of your stage of pregnancy, you should always let your practitioner know if you suspect your water has broken. What happens when the water breaks? Your baby has been surrounded and protected by a sac of water called amniotic fluid from the beginning of your pregnancy. The fluid cushions your baby to keep him safe and protects him from infection. Most expectant mothers wonder what it will be like when their water breaks. Many women, as they near the end of pregnancy, are concerned about the possibility of their water breaking in public. They may wonder, Should I keep a change of clothes with me at all times? Should I sit on a rubber sheet in the car? Actually, only about 10 percent of women rupture the sac of amniotic fluid before labor starts, so it may not even happen to you until you are already in labor and checked in at the hospital. And even if you've already been pregnant and through this process before, your previous experience has no bearing on what will occur this time around. When your water breaks, you may notice a popping sensation and either a gush or a trickle as some of the amniotic fluid leaks out through your vagina (it may even run down your leg). Some mothers-to-be are not sure what is happening. Did the baby just kick my bladder or did my bag of water break? (One mom told me that she'd been sleeping in a waterbed and was convinced that the bed had sprung a leak!) Some women first notice that their panties are suddenly wet. This may continue even after several changes of underwear. In this case, you'll want to put on a sanitary pad and lie down for 30 minutes or so. If you feel a small gush when you get up, it's possible that your amniotic sac has indeed ruptured, and you should call your practitioner to find out what to do next. Once your water breaks, the fluid may continue to slowly leak until you deliver your baby. This happens because amniotic fluid primarily consists of fetal urine, which the baby continues to produce even after the amniotic sac has broken. What does the fluid look like? Amniotic fluid can be clear, pink, brown, or green. It also has an unusual smell that some people compare to Comet cleanser. If the fluid looks yellowish and smells of ammonia, you're probably experiencing urine leakage. This frequently happens to women toward the end of pregnancy. If the fluid you see is brown or green, make sure you inform your practitioner of the color when you call. This could mean that the baby had his first bowel movement while still inside your uterus, in which case it is called meconium stained fluid. I can't decide whether my water is broken. What should I do? If you cannot determine on your own if your water is broken, a nurse or doctor can do a test in the office. Using a speculum to see inside your vagina, she may take a sample of the fluid with a cotton-tipped applicator and apply it to litmus paper and to a glass microscope slide. The litmus paper checks the pH level of the fluid. If your membranes did rupture, the paper will immediately show a color change, since amniotic fluid is a lot more alkaline than normal vaginal secretions. Under the microscope, your practitioner will look for a ferning pattern (like the fronds of a fern) made from salts that crystallize as the fluid dries. Sometimes this test doesn't clearly show that the membranes have broken, because fluid can leak intermittently and might not be leaking during your exam. Ultrasound may be helpful in such an event to see how much fluid remains around the baby. What happens next? If you are close to your due date and have ruptured your membranes, labor usually begins within 24 hours. If you are earlier than 36 weeks, labor is less likely. If your water breaks at term and labor has not begun, many practitioners recommend inducing labor in order to prevent infection from entering the uterus now that the protective sac has a hole in it. If inducing labor would result in the baby being born prematurely, the benefits of induction of labor are weighed against the risks of prematurity, and often a "wait and watch" approach is taken. Your practitioner will talk to you about the pros and cons of induction of labor in your specific situation. Breaking your water may be your first hint that the baby is finally on his way! Make sure your bags are packed and your birth team is available. You are about to start a most amazing journey.
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