Due to media and movies, many people envision labor starting with a gush of water and then a hectic ride to the hospital. For the majority of women, this isn’t the case. 8-10% of women’s membranes will rupture before labor starts, but for most it usually happens in active labor or when pushing.
WHAT DOES RUPTURE OF MEMBRANES MEAN?
Inside the uterus, your baby is surrounded by the amniotic sac, which contains amniotic fluid. This provides the baby cushioning and protection from bacteria. Like a balloon, the sac, or membranes, surrounding the fluid can tear. If it is a small tear, you may notice some leaking. The membrane may even self heal. If there is a large tear, there may be a more noticeable gush of “water”. Your water breaking may not be obvious; some women question whether they peed on themselves before they realize that it is amniotic fluid.
If this happens before you are full-term (full-term is considered 39-41 weeks gestation by The American Congress of Obstetricians and Gynocologists (ACOG)), call your doctor and ask what they recommend.
The focus of this blog is a full-term, low-risk mother and her “water breaking” to start labor.
SO, NOW WHAT?
Take a breath.
Smile. You are in labor!
Put on a heavy pad or a Depends (adult diaper). You will continue to leak as you hydrate yourself.
Follow your labor plan. Is it in the middle of the night? Try to go back to sleep. Early labor can take a while and rest is important.
Are you well rested and want to get moving? Go for a walk.
THINGS TO CONSIDER
What color is the fluid? It should be clear, maybe with white specks in it. It should also be odorless, or with a slightly sweet smell. If this is not the case, call your care provider and notify them.
What does your care provider recommend if your water breaks? This is a great question to ask your care provider during a prenatal appointment. If you forget to ask beforehand, you can also call the office. The answer to this question will vary among providers.
CONCERN WHEN MEMBRANES RUPTURE
The biggest concern is infection. The amniotic sac creates a barrier, protecting the baby from infection. Once the water breaks, this protection is gone.
Evidence Based Birth has a great article that discusses Term Premature Rupture of Membranes that discusses the fears of care providers and the current research.
HOW TO MINIMIZE RISK
So how can you protect the baby after this barrier is gone?
Drink tons of water! Think gallons. This may be easier than you think. During labor women often get very thirsty, so keep the fluids coming! Coconut water and laborade (water, raw honey, and sea salt) are also great alternatives to water. The amniotic fluid will replenish itself. If you have a small leak, the amniotic sac may fill again if the tear repairs itself. If it is a large tear, the fluid might just drain back out – that’s okay. If the head is engaged in the pelvis, it will also block some of the amniotic fluid from exiting.
Take your temperature. If you decide to labor at home for a while, take your temperature regularly. 100.4 degrees Fahrenheit is considered a fever. Call your care provider. Usually if the increased temperature is due to infection, there will also be other signs such as increased heart rate of mom and/or baby, and smelly amniotic fluid.
Take only showers; no baths. Germs have an easier time traveling up the vaginal canal when you are soaking in water. If your water breaks in active labor, it is considered safe to take a bath without increasing risk of infection.
And, finally, the number 1 thing you can do is say NO to vaginal exams, or minimize them. It does not matter how careful medical staff are and that they use sterile gloves. When they do a cervical checks, bacteria is pushed from the vaginal tract up to the cervix (the opening to the uterus). The number of vaginal checks is linked to increased occurrence of infection.
SO, WHAT HAPPENS IF AN INFECTION DOES DEVELOP?
Medical personnel monitor you closely, regardless of your birth place. If you show signs of an infection, they usually suggest antibiotics.
They will often give the newborn antibiotics, as well, and observe him/her in the Neonatal Intensive Care Unit (NICU) after birth. If you do receive antibiotics, consider taking a probiotic to replenish your good bacteria.
If baby shows signs of distress during labor, such as the heart rate lowering at atypical times, or staying lower or higher than normal, they will likely suggest a cesarean if a vaginal birth isn’t imminent.
Another factor to consider, is that the cushion is gone. Amniotic fluid provides cushioning for mom and baby. It is, also, easier for baby to get into a good position with the extra fluid to float in.
So, contractions may be intense sooner. Think about the comfort measures you learned in your childbirth class and use them! Also, if you hired a doula, call, and develop a game plan.
Also, if you are pregnant and reading this, start seeing a chiropractor. If possible, get a chiropractic adjustment during labor as well. Chiropractic adjustments have been shown to improve fetal positioning. Ideally, find a chiropractor that has extra training and experience with pregnancy, like a Webster Certified chiropractor. To find a list of providers near you, http://icpa4kids.org is a great place to start. If you are in the Lafayette and Eunice, LA area, you can also contact me for suggestions.
Birth, like life, often does not go according to plan. However, you can still have an AMAZING birth!
Did your labor start with a gush? What did you do? Comment below!
I am a registered nurse, and certified Birth Boot Camp Instructor & Doula in the Lafayette and Eunice, LA areas. For more information about me and my services, visit M.Y. Birth & Baby.