Water breaking worries? Prepare yourself for childbirth by getting the facts about this important sign of labor. By Mayo Clinic Staff

If you're pregnant, you might be curious about your water breaking — when it will happen, what it will feel like and what to do next. Recognize the signs of water breaking and know what it means for the timeline of your baby's delivery.

During pregnancy, your baby is surrounded and cushioned by a fluid-filled membranous sac called the amniotic sac. At the beginning of or during labor, your membranes will rupture — also known as your water breaking. If your water breaks at or around the time of your due date and labor doesn't soon begin, it's called premature rupture of membranes (PROM).

When your water breaks you might experience a sensation of wetness in your vagina or on your perineum, an intermittent or continuous trickle of small amounts of watery fluid from your vagina, or — just like in the movies — a more obvious gush.

It's not always easy to tell if your water has broken. For example, it might be difficult to tell the difference between amniotic fluid and urine — especially if you only experience a feeling of wetness or a trickle of fluid.

If you're uncertain whether your water has broken, consult your health care provider or head to your delivery facility right away. Your doctor or a member of your health care team will give you a physical exam and might use lab tests to determine if you're leaking amniotic fluid. Be sure to note when you think your water might have broken and be prepared to describe any noticeable color or odor. You and your baby will be evaluated to determine the next steps.

Don't do anything that could introduce bacteria into your vagina. Sex isn't a good idea if you think you might be leaking amniotic fluid. It's OK to take a shower after your water breaks — but your health care provider might recommend skipping it and heading straight to your delivery facility.

Typically, after your water breaks at term labor soon follows — if it hasn't already begun.

Sometimes, however, there's a delay. If you experience premature rupture of membranes, your doctor might stimulate uterine contractions before labor begins on its own (labor induction). The longer it takes for labor to start after your water breaks, the greater the risk of you or your baby developing an infection.

If your water breaks before the 37th week of pregnancy, it's known as preterm premature rupture of membranes (preterm PROM). Risk factors for water breaking too early include:

  • A history of preterm premature rupture of membranes in a prior pregnancy
  • A genital tract infection
  • Vaginal bleeding during pregnancy
  • Smoking during pregnancy
  • A low body mass index

If your water breaks too early, your health care provider will evaluate you and your baby. It's sometimes possible to extend pregnancy for a short time after the membranes rupture, but generally there's no turning back. Most women who have preterm premature rupture of membranes deliver within one week of their water breaking.

Potential complications include maternal or fetal infection, placental abruption — when the placenta peels away from the inner wall of the uterus before delivery — and umbilical cord problems. The baby is also at risk of complications due to premature birth.

If your health care provider believes the amniotic sac should be opened during active labor — when your cervix is at least partially dilated and the baby's head is deep in your pelvis — he or she might use a technique known as an amniotomy to rupture the membranes. During the amniotomy, a thin plastic hook is used to make a small opening in the amniotic sac. The procedure might cause some discomfort.

If you don't go into labor on your own, your health care provider might do an amniotomy as part of a planned induction to encourage labor to begin.

It's natural to feel anxious about labor and delivery. Try to relax. While you might not be able to predict when your water will break, you can take comfort in your knowledge about the next steps.

July 18, 2013