It never fails.
When birth is portrayed on TV or in a movie, it begins the same way: a giant pool of water at a person’s feet, blind panic from everyone present, and a mad dash to the hospital.
Likely, if this is your first child, that’s how you envision it, too, since you’ve seen it on screen your whole life. The reality, however, is almost always less dramatic.
It isn’t that common!
Actually, only 10-15% of birthing people will have their water break as the start of labor. If it does, it may gush or it may just trickle a bit here and there. You are probably going to spend some time debating if your water broke or you simply peed on yourself (again…pregnancy is rough on the bladder). One way to test it yourself is to lay down for 10-15 minutes and stand up. If fluid comes out, it was probably your water breaking. You can also have the fluid swabbed by a medical professional to determine if it is amniotic fluid, if you’re concerned. This is often done in the office using Nitrazine paper. The paper is specialized to determine the pH level of the fluid.
How does it happen, really?
The technical term for your water breaking is rupture of membranes (ROM), because it is literally the amniotic sac rupturing and releasing the fluid baby has been swimming in. That means that the comfy cushion that has been a buffer between you and your baby will be gone. That fluid will continue to leak throughout the entirety of your labor, and some people find this very uncomfortable- especially since contraction intensity will increase. There are a several ways your water breaking can occur:
Preterm Premature Rupture of Membranes (PPROM) –
When your water breaks before 35 weeks gestation. In this case, your care provider will likely want you to receive steroids to boost your baby’s lungs and antibiotics to help prevent infection if they are unable to stop your labor from progressing.
Premature (or pre-labor) Rupture of Membranes (PROM) –
When your water breaks an hour or more before the start of contractions. If your membranes rupture and you don’t experience any contractions, your care provider will want to augment your labor- in most cases this involves administering medications (like synthetic oxytocin-also known as pitocon) to bring on contractions.
Artificial Rupture of Membranes (AROM) –
When your water is broken, or ruptured by your care provider. Sometimes this will occur accidentally with a vaginal exam, and sometimes a tool called an amnihook will be used. If you have not experienced any (or very little) cervical change, this can be very uncomfortable. Remember, YOU are in charge of your body, and the decision to have this procedure done.
Spontaneous Rupture of Membranes (SROM)-
This is the one that most people expect, and the one that is least likely to occur. Like mentioned previously, it can happen with a trickle, or a gush. This most often occurs during the active stage of labor or during or pushing.
Regardless of how you experience ROM, there are some key things that will need to be shared with your care provider- especially if you are laboring at home before heading to your place of birth. If you are already at your place of birth, these things will be noted in your chart.
TACO
Remember the acronym TACO. You will want to note the following:
Time that you experienced rupture.
Amount of fluid.
-Was it a gush, a trickle?
Color of fluid. It can be any of the following:
-Clear
-Pink tinged
-White flecks (likely vernix)
-Yellow, brownish or green (likely meconium: baby’s first poop)
Odor, if any- could be the following:
-no odor
-slightly like bleach, or semen
-foul smelling is not expected and you should contact your care provider right away
These details help your care provider determine how your baby and you are doing during the labor process.
What should I be concerned about if it happens?
Each method comes with its own risks, and this is truly where the drama enters the picture. Once your water is ruptured, your care provider will want to determine the baby’s heart rate baseline to ensure safety. Primarily, the concern is cord prolapse (the baby’s umbilical cord enters the birth canal in front of the baby’s head and can be compressed, limiting the baby’s blood and oxygen supply). This is considered an emergency and will lead to surgical delivery. Secondly, the concern is the risk of infection. Limiting vaginal exams and staying hydrated will help reduce this risk. Both of these risks are generally low, but should never be ruled out entirely.
Now that you have this information, you can begin to move forward confidently into your birth. We provide our clients with as information as possible to instill confidence and limit fear when it comes to labor, birth and parenthood. If you have any further questions about the rupturing of membranes, please reach out!
Additionally, choosing to participate in our Alchemy of Birth class can help you learn more about the process. This allows you to take the power in your own hands and cultivate the birth experience you truly want.
We can’t wait to meet you!
