For nine months or so, babies live in a warm, safe bubble. We aren't speaking metaphorically. The baby's first home — from conception until birth — is in a sac in his mother's womb, surrounded by amniotic fluid. That sac helps keep him safe and allows him to grow in the perfect environment that expands right along with him.
All moms know that at some point the baby has to come out of that bubble. They wait for that moment with fear and excitement. In movies, it's usually a dramatic moment, where the water gushes from a woman and splashes everyone's shoes. But most of the time, the moment the water breaks is less dramatic. It may only be a trickle and could be overlooked, unless it's odor or color raise red flags. Most of the time, the dramatics happen after the water breaks, when the contractions speed up and the pain grows even more intense. Sometimes, there could even be unexpected emergencies that arise when the sac ruptures and the labor is in full swing. Things may happen that the new mom doesn't expect, so we are here to give you a guide.
Here are 16 things most people had no idea happen when the water breaks.
16 The Countdown Begins
Whether the water breaks before contractions begin or after, it's considered a key moment in the baby's delivery. There could be hours left for the birth or just a few minutes. But one thing is certain, at least in hospital situations, the time that the water breaks begins a countdown for the delivery.
While there is nothing overly dangerous about the moment when the water breaks, that opening into the amniotic sac can allow for the possibility of infection. The risks go up exponentially after 24 hours, so doctors tend to treat the time that the water breaks as the beginning of the countdown. They keep an eye on how things are progressing, and if things don't move quickly enough, they may recommend pitocin, a synthetic drug that can get labor progressing more quickly. With very few exceptions, when the water breaks, the baby will come soon, so it's time to set the clock.
15 Labor Speeds Up
We just mentioned that doctors could consider using medicine to induce labor if it doesn't appear that the baby will be born within 24 hours of when the water breaks. But most of the time, there isn't much of a reason for the medical intervention. That's because most of the time the breaking of the amniotic sac actually speeds up the labor.
That's especially true if the contractions have been going on for a while before the water breaks. If that is the case, the body could be ready to kick into overdrive. The labor will become really active, and it may just be a couple of hours before the mom is ready to push. Some women whose waters break early in labor only have to endure contractions for a few hours before the baby arrives. While that can be intense, it may be better than having to deal with days of contractions before the delivery.
14 Slow Leak
Sometimes the water breaks with a big splash, but most of the time, when the amniotic breaks spontaneously, it's more of a slow leak. That means that the mom will feel a bit of liquid, but it may not be much. In fact, many women wonder if they actually have broken their water or if they have just had a little bathroom accident.
After the initial impact, it may be a good idea to put a pad in your underwear because a little bit of liquid could continue to come out in a tiny trickle for hours afterward. In fact, it may be a good idea to sit on a towel on the way to the hospital just in case it leaks through and starts to make a mess on the seat. The slow leak can keep everything a little gross for the rest of the labor. But once the contractions ramp up, a woman in labor isn't likely to notice a bit of leaking.
13 Smell Matters
No matter when the amniotic sacs breaks, healthcare providers will want to know a little bit about how it happened. That's because details matter, so it's important to jot down a few notes and report back to the doctor or midwife.
The first detail is something that women will only notice if there is something weird going on. We mentioned a minute ago that sometimes women aren't sure if they leaked a little urine or broke their water, but one sure fire clue could be the smell. We all know what pee smells like, so that could be the first clue to the puzzle. If there is any other odor, then there could be something wrong going on. It could be an infection or another issue that we'll get into in a moment.
Amniotic fluid is odorless, so any smell at this point is definitely a something that should be mentioned to the doctor or the midwife.
12 Color Test
The color test is also a big deal for when the amniotic sac breaks. This time, it may not help in determining whether or not it was a bit of incontinence or the water leaking, as both urine and amniotic fluid can be in the range of clear to light yellow, although sometimes urine can take on an even deeper hue.
The real question for the color test is whether there is any blood in the amniotic fluid or, worse, anything brown or green. Those darker colors could mean that the baby had his first bowel movement while still in the womb. The meconium, which is the first black tar-like waste that the baby expels, can be dangerous because the baby could ingest it and get very sick. After the baby's delivery, the doctor will need to suction out the meconium from the baby's throat, and the baby could need antibiotics and other medical interventions. It's a very serious complication, so be sure to note the color and tell your doctor.
11 Popping Out
Like many experiences during pregnancy, the breaking of the amniotic fluid involves many of the five senses that all humans possess. We've talked about three of them so far — how the amniotic fluid feels warm (touch), how it smells or how it shouldn't stink (smell) and how it looks (color). It's hard to say how amniotic fluid tastes because, well, who really wants to give it a try? But there is one sense left — hearing — and it's possible that it could be triggered during the big event as well.
It doesn't happen all the time, but many women say that they hear the moment their water breaks. They describe it as a kind of popping sound, although it's very subtle and sometimes only the mom-to-be really ever picks up on the noise. Some women say that they didn't hear anything at all, but enough women note the popping sound that it's worth mentioning as a possible noise. The popping sound could happen when the water breaks and that could clue women in on what is going on with their bodies.
10 Testing The Waters
As we have mentioned a few times, sometimes a woman can have a hard time figuring out whether or not her water has broken. It's no surprise, as so much is going on in a pregnant woman's body that it is often hard to distinguish true contractions as well. So there are some tests that doctors or midwives can do to determine whether the bag of waters is still in tact.
Usually, the tests involve getting a small sample from inside the vagina, using the speculum to get a small bit of fluid. Normal vaginal discharge has a pH value of between 4.5 and 6.0, according to Healthline. Amniotic fluid usually tests at between 7.1 and 7.3. So a simple pH test could reveal if the water is leaking. (The website notes that semen has a higher pH level, so recent intercourse could interfere with getting accurate results.)
Doctors could also send the sample off to be seen under a microscope. The amniotic fluid will look a bit like a fern under the microscope because of the way it crystalizes. The results can be read quickly, so a mom-to-be can know whether to head to the hospital soon.
9 Romance Killer
It's not that breaking the water isn't sexy — some people like that kind of thing, we suppose — but the amniotic sac's rupture should signal the end of intimacy for parents-to-be, at least for a few weeks.
The breaking of the sac doesn't just mean that the baby can come out. It also means that things can get into the womb. There is an open path into the uterus at that point, so women need to be concerned about the possibility of infection. While sex can be considered a natural and fun way to induce labor, it isn't safe after the water breaks, even if contractions haven't begun. We understand if a couple wants to enjoy one more tumble in the hay before the baby arrives, but even if a couple is free of infection, they could have issues if they do the deed after the water breaks. It's better to be safe than sorry and consider doing something else for pleasure for a while.
8 Premature Possibilities
There is the possibility that the water could break before 37 weeks, which is the point at which the baby is considered full term. That is the only time that doctors will hesitate before considering the breaking of the amniotic sac a countdown to when the baby will be born. Instead, there is a possibility that they could try to stop the labor and give the baby more time to develop in utero.
Some premature labors stop with medication, and sometimes when that happens, a hole in the sac might actually close back up. But in general, even a few more days could make a big difference to the development of a baby, especially if doctors can have time to give steroids to help make the baby's lungs stronger. The possibility for infection still exists, so doctors will be sure to monitor the mom and baby closely, but they are hoping for more time for the baby to be born closer to term.
7 Cord Complications
Most of the time, the water doesn't break until the baby has moved into position for birth and contractions have positioned the head toward the cervix. Sometimes though, the sac can rupture early, and that means that there isn't anything to block the cervix. Unfortunately, that means that things can get in the way of the baby.
Sometimes an arm creeps out first before the baby's head, but the most likely and problematic culprit is the umbilical cord. That is called a cord prolapse, and if it happens, there may be a need to have an emergency C-section. Until the baby takes his first breath, he is reliant on the cord to bring him blood and oxygen. If the cord is in the birth canal, it can get squished by the baby during the delivery, and that can mean that the baby is deprived of oxygen and could suffer brain damage or even death. Whenever the water breaks prior to contractions, doctors will keep an eye on things to make sure that if the cord comes out before the baby's head is in place that there is a way to get the baby out as safely as possible.
6 Embolism Emergency
The amniotic fluid has to come out of the body at some point. It usually comes through the vagina before the baby's birth, but there is actually a possibility that the fluid could get into the mother's blood stream. Doctors think it usually happens when there is a problem in the delivery, such as preeclampsia, a C-section or a placenta issue such as placenta previa or abruption. But it also happens for moms who are induced or have excess amniotic fluid or for a reason that the doctors never understand.
Amniotic fluid embolisms are very dangerous and they can cause issues such as shortness of breath, low blood pressure, seizures, coma, fetal distress and even maternal death. An embolism is an emergency situation, and doctors will have to treat it immediately. If the baby hasn't been born yet, it'll likely be delivered by emergency C-section, and doctors will do all that they can to save the mom and the baby.
It's certainly not something that moms expect when their water breaks, but it happens in up to 12 per 100,000 births, according to the Mayo Clinic.
5 Big Sweep
There are times when the water breaks on its own, and then there are times when labor is going slow or the baby is overdue and either the mom or the doctor want to try to get things going. Of course, there are many methods of induction that could work and that might be worth a shot. It's definitely a good idea to try walking or other forms of exercise, and sex is known to be pretty effective, although spicy foods don't have the same reputation.
Some people think sweeping the membranes are a good way to get things going. It's possibly the first step in breaking the water. Doctors or midwives can do it by inserting two fingers in the cervix and gently loosening the amniotic sac from the uterine wall. It may be enough to get things moving on and for the water to break on its own. That's when things will get really hopping, and it could allow for a mom to avoid a C-section.
4 Getting The Hook
If sweeping the membranes doesn't work, there is another step that doctors and midwives can perform that can break the water and bring on the most intense part of labor. It's called the artificial rupture of membranes or an amniotomy.
The procedure is pretty simple. It involves using a small plastic or metal device that has a tiny hook at the end. A medical professional inserts the instrument into the cervix and then uses the hook to make a small hole in the sac. Usually, it's enough to let out a small amount of amniotic fluid and get the contractions to intensify. It may be enough to get things moving and avoid using pitocin for a medical induction. Most women find it totally painless, although there may be some discomfort when the instrument is inserted — as much as there is for any cervix check. It may be worth a try if the labor isn't working as quickly as everyone hoped.
3 Staying In The Sac
It isn't always necessary for the water to break for the labor to do its job. That's why it's hard to predict at what point it will happen — and for some it might not happen until after the sac is outside of the body. That is, the baby might be delivered within the amniotic sac.
That phenomenon is called being born in the caul, which is another word for the sac. It occurs only in about 1 in 80,000 births. Historically, a baby that is born within an intact sac is believed to have good luck, and mothers used to keep the caul as an heirloom whenever it happened.
Of course, eventually the baby has to come out, and doctors and midwives are trained in breaking the water once the baby is born. It's an amazing moment, almost like a second birth. And it is definitely a memorable experience.
2 Painful Truth
The amniotic sac is a pretty amazing thing. Not only does it encase all of the fluid that the baby will use to practice breathing and ingesting, but it also provides a protective cushion for the baby. It's really useful when a mom-to-be in her third-trimester can barely walk to the bathroom without bumping into something.
But women will really find the sac useful when they realize that it actually also protects them — from the worst pain of contractions. Many women only realize this when that barrier goes away. They learn that once the water breaks labor goes from a 5 to a 15 on the pain scale.
Yes, when the water breaks, the contractions not only get more intense, they hurt more. It's like letting the amniotic fluid go morphed the uterus into a torture device, and the only end in sight is either the baby's birth or your death, whichever comes first.
1 Baby's Birth
We've mentioned many different times and circumstances where the water can break in a pregnancy. It can happen early, before the baby reaches full term. It can happen before labor begins or it can even happen after the baby has been fully birthed and the doctor has to help get the sac off of the baby. In all these scenarios, there is one eventuality that always happens — a baby is born.
When the water breaks almost always surprises everyone, even when the doctor is going in with an amniotic hook and he knows that in a second he may take some fluid to the face. It's a moment that is highly anticipated but is often less dramatic than you expect — unless something goes wrong off course. When the water breaks, the excitement begins, and soon the baby will be here. It may not make the baby book, but it's definitely a page turner in the birth story.
Sources: Mayo Clinic, Healthline, Baby Center