After my water breaks, when will labor begin?

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.

What happens if my water breaks too early?

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
  • Inflammation of the fetal membranes (intra-amniotic infection)
  • Vaginal bleeding during the second and third trimesters
  • Smoking or using illicit drugs during pregnancy
  • Being underweight with poor nutrition
  • Short cervical length

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 you have preterm PROM and you're at least 34 weeks pregnant, delivery is generally recommended, to avoid an infection. If you're between 24 and 34 weeks pregnant, your health care provider will try to delay delivery until your baby is more developed. You'll be given antibiotics to prevent an infection and an injection of potent steroids (corticosteroids) to speed your baby's lung maturity.

Corticosteroids also might be recommended starting at week 23 of pregnancy, if you're at risk of delivering within 7 days. In addition, corticosteroids might be recommended if you're between weeks 34 and 36 and 6 days of pregnancy, at risk of delivering within 7 days and you haven't previously received them. You might be given a repeat course of corticosteroids if you're less than 34 weeks pregnant, at risk of delivering within 7 days and a prior course of corticosteroids was given to you more than 14 days previously.

If you're less than 24 weeks pregnant, your health care provider will explain the risks of having a very preterm baby and the risks and benefits of trying to delay labor.

What if my water doesn't break on its own?

During active labor, if your cervix is dilated and thinned and the baby's head is deep in your pelvis, your health care provider might use a technique known as an amniotomy to start labor contractions or make them stronger if they have already begun. During the amniotomy, a thin plastic hook is used to make a small opening in the amniotic sac and cause your water to break.

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

Oct. 18, 2016 See more In-depth