From watching all the movies and dramas on television these days, you couldn’t be blamed for thinking labour starts with breaking of the waters (or ROM – rupture of membranes) but in reality, your labour is more likely to start with contractions.
Even those who find their waters break as the first sign of labour, they usually break overnight, or as they get up out of bed, noticing a leak when they wake up. You might like to pop on a waterproof mattress cover for protection.
“I woke up at 1am to go to the toilet, still 3 weeks away from my due date. I went back to bed and as I was falling asleep my waters broke. In my tiredness I actually thought I was wetting the bed! I got up and walked to the shower where they gushed. My husband was at work so I called him to come home. Apparently he was so calm no one at work believed him when he said he was leaving to have a baby! Contractions started a couple of hours later.”
If you suspect you have broken your waters, pop a pad on (do not use tampons) and call your midwife or labour ward who will ask a few questions to help distinguish what has happened. Sometimes it may be a bladder leak – don’t feel embarrassed if this is the case, as it’s quite common in the latter stages of pregnancy.
If you are anxious about your waters breaking in public, it’s really a slim reality, although one BellyBelly member did experience this (and I can assure you, it is a rare occurrence!):
“My waters broke very unexpectedly 15 days early at Coles! I was having some ‘pains’ just beforehand and was finding it very hard to walk. Then I felt a POP, a tiny drip, then it didn’t stop gushing! I was finding it hard to breathe through all the embarrassment/excitement/anxiety/nervousness etc and my husband was speechless!”
Don’t confine yourself to indoors just because you are close to your due date – getting out of the house and distracting yourself is very good for you! Its also a good idea to put towels down on your carseat as you approach your due date, as waters seeping into your carseat can not only smell but it can erode the internal parts to your seat.
Some indicators that your waters have broken
- Having no control over the flow
- A panty liner is inadequate to absorb the fluid
- The pad is wet more than once, and
- It doesn’t smell like urine
Some women describe their waters smelling a bit like ‘semen’, so if you do notice a smell, mention this to the midwife. Your waters should be clear or may have a pink tinge to them. If they are green, brown or any other colour you should get checked out by your doctor or midwife.
“My waters broke naturally at home in bed. It was about 1am on the day my daughter was born. It was the first sign of “real” labour for me. I had been getting lots of braxton hicks contractions all day, and I was really excited thinking labour was going to start very soon! The braxton hicks were a little painful – not very, but enough for it to be difficult for me to fall asleep, so I ended up just lying down in bed. Just as I was about to drift off to sleep, I felt a painful contraction and a pop low down in my tummy! I knew straight away what it was, so I told my hubby, then ran to the bathroom and stood in the shower as I was leaking everywhere! It was a strange feeling. Within minutes I was getting proper regular contractions 3 minutes apart! My husband called the hospital and they told us to come in! Needless to say, we were both very excited. I wasn’t even nervous. I was surprisingly more calm than I thought I would be.”
When waters do break, some women hear a pop sound, some don’t, and they may have a gush or just a trickle – it’s different for everyone. But left alone to break on their own, and ideally, waters often break just before second stage (pushing stage) of labour, when you are nearly fully dilated, due to the pressure of your baby coming down.
The Amniotic Sac & Waters
The amniotic sac surrounds your baby, protecting it from infection. When your baby engages, the amniotic fluid will be above and below your baby’s head. The forewaters are like a cushion for your baby, located between the baby’s head and the cervix. The hindwaters are above the head (assuming your baby is head down!), surrounding the baby’s body.
If your waters break and there is only a small gush or trickle, this could be because it’s only the forewaters that have escaped, with the hindwaters still above the baby – the head engaged in the pelvis can block the flow of the hindwaters which will eventually release (you may get little trickles or gushes with each contraction) as labour progresses or as your baby is born. You could also get a hindwater leak, which may even reseal and stop leaking!
“I had a little gush and began trickling at 1am in bed but I also had an ARM (artificial rupture of membranes) at 5cm dilated during my induction as the gush turned out to be a hindwater leak. I am still shocked at the difference in the pain of my contractions before and after my ARM. OMG it was so much more painful after the ARM!!”
The fact that waters have broken at the start of labour doesn’t mean labour will come on hard and fast and your partner needn’t race home, as the thing you need are the contractions for labour to be happening.
Also, amniotic fluid constantly replenishes itself, so don’t worry about having a ‘dry birth’.
How Long Will It Take For Contractions To Start Once My Waters Have Broken?
When your waters break, contractions may or may not start right away. Some women will initially start to feel period pain, which gets stronger and progresses to strong contractions. Some women will wait hours after the waters breaking before they get any contractions, some will wait days and some will not have any contractions at all, and end up being induced. This may happen if the baby is in a bad position (i.e. posterior) but does not mean your body has failed or does not know how to birth. Most importantly, this does not mean it will happen next time, so don’t think that it’s your body’s fault – malposition can be just bad luck!
“my waters broke naturally lying in a hospital bed waiting to be induced! As I was in one of the delivery suites, I could hear other women in the throws of labour and I’m sure my water’s broke after hearing one particular woman in the last stages of birth – I’ve never heard anything so shrill. Within half an hour my contractions started.”
Waters Breaking and Infection
Once the waters have broken, the seal around your baby is no longer there to prevent bacteria reaching your baby. It is for this reason why internal vaginal examinations are best avoided once your waters have broken. You are at higher risk of infection if your waters are artificially ruptured by your doctor or midwife (AROM – artificial rupture of membranes) as they are reaching in your vagina, up to your cervix where the baby’s head is, to break the waters or do exams etc.
However if your waters rupture spontaneously without help (SROM – spontaneous rupture of membranes) then you have less risk of infection since there is a downwards flow of fluid and for bacteria to reach your baby, it would have to migrate up against the current of waters, which is not anywhere near as easy than if they were given an express ride up to your baby by an internal or tool. An example of this is having an internal scalp monitor clipped onto the baby’s head to measure the heart rate. This means that a foreign object is being placed directly on your baby, so there is a chance for bacteria to go with it.
If your waters are broken artificially to start labour, you will likely be told that you need to be started on antibiotics immediately or within 4 or so hours to prevent infection depending on the hospital/Obstetrician’s policy/preference. This is usually done by injection or possibly a drip, but it’s best to avoid the need for it in the first place if there is no medical problem. Antibiotics not only kill the bad bacteria in your body, but the good bacteria too – they can’t tell the difference. It can throw yours and your baby’s gut bacteria out of balance and is not ideal. So it’s best to let the waters to break on their own unless there is a medical emergency.
“At 37.5 wks, I didn’t realise my waters were leaking, it was such a small amount of liquid. My waters leaked for two days before I called the hospital an they told me to come in to see what was going on. The doctor had a go at me for waiting for so long to come in… how was I to know??!! I was monitored and then induced a few hours after being admitted. Turned out to be my hind waters leaking and the doctor had to rupture my forewaters anyway. My daughter was born after a 24hr labour. She really was not ready to come. Next time I will not be talked into being monitored, induced or having ARM.”
Speeding Up / Inducing Labour By AROM (Artificial Rupture Of Membranes)
Some doctors or midwives will recommend breaking your waters to speed up your labour if it is slow or has stalled. If your waters are broken before 4cms, there is the possibility it may slow your labour down, or even do nothing. This means that you’ll on the antibiotics anyway, as well as a syntocinon drip, which is a synthetic version of the labour hormone, by i/v drip, restricting you to the bed as you’ll also need to be monitored. Cables and more cables everywhere! This may start or speed up your labour but it also may not – and failed inductions mean caesarean sections. If the labour does not start or speed up with the drip, the next port of call is a caesarean section – which carries its own set of risks.
If labour hasn’t started after the rupture of membranes and you have the syntocinon drip which does work, you are at a high risk of needing further pain relief, especially an epidural, as well as a caesarean section should your baby go into distress from the syntocinon. You may not feel your intense contractions from the drip but your baby does. So you can see, something so simple can result in a whole heap of complicated stuff, often very quickly.
If you do need to be induced for a medical reason, rupturing your membranes is a better option than syntocinon, however you may also need to argue your case to have your waters broken without other interventions. Many doctors will want waters broken and the drip started straight away, as they’d rather not wait and see. On the other hand some are happy to rupture your membranes first, and see what happens.
Even then, some may have an unrealistic time limit of an hour or two or even four hours for your body to be labouring. Hopefully your body is ready to labour and labour does get started fairly soon, but you have to remember that labour is a complex system of hormones and it does need time for those hormones to circulate and be in sync with mother and baby, especially when your own body hasn’t initiated labour – someone else has, when your body didn’t signal it was ready. You may need to insist you would like time for labour to establish, it is your right to do so – and always know that you can’t be forced into anything against your own will – it’s grounds to sue under uninformed or no consent obtained. So you have more power than you might think. Sounds drastic but its a fact all women need to know, that something is protecting their rights as a ‘patient’ in hospital where they try their best to enforce their policies onto you (which is not law, just policy).
For some ideas on natural labour induction, check out our article on various natural induction methods you can do without seeing a doctor!
What All This Means…
If your water breaks, remain calm, know that this is the start of a long process that could last minutes, hours, even days before contractions begin. Get rest, as you have a long way to go, and let your labour unfold how it’s meant to. Hopefully long before this you have found out what your carer/hospital’s policy is for how long they ‘recommend’ a woman can go with broken waters. If you and baby are healthy, you can negotiate for more time. If you need to, you can negotiate with things like coming in for monitoring, and if you are happy to, you can agree to antibiotics and also self monitoring of your temperature, reporting any changes right away.
Unless there are any signs of problems, and there probably aren’t, you are unfortunately in a medical system where you are treated as if you have a problem unless proven otherwise – which is fine for those that have a problem but not the majority who do not, who cop all the ‘just in case’ interventions and treatment.
“I had a couple of days of pre-labour erm… bowel cleansing shall we say? hehe.. In this time I lost my plug and after a while the stomach cramps became regular contractions. My waters broke at 8pm as I was sitting eating my dinner. I was squirming my way through an unusually uncomfortable contraction and decided I’d better run to the loo. On the way up the stairs I felt some of the waters, and when I sat on the loo I swear the REST of it all came out in one big gush! Of course it wasn’t the rest of it… it continued to leak until DS was born! But my waters breaking stalled everything. I was hooked up to the drip next morning.
Have since asked my Obstetrician why I was hooked up to the drip so soon – and even he doesn’t know! Grrr. He said normally he goes by the next 8am + 24hrs. He looked in my file and couldn’t find a reason why, he would have done it the next day.”
Further recommended reading:
- The Thinking Woman’s Guide To A Better Birth by Henci Goer.