Everything You Need to Know About Waters Breaking in Pregnancy

When a mother’s waters break in a movie, it’s usually a dramatic scene as she rushes to hospital before the baby pops out. In real life, it may not be so dramatic. You might only experience a slow trickle of water, or your baby may take their time coming into the world.

Read this guide to find out the signs that your waters are breaking, how long you to deliver after your waters break, and other helpful tips. Remember, your midwife and maternity unit are at hand to support you through this important time. As you prepare for labour, tools like the Pampers Club App can help you track your pregnancy and get personalised support, alongside advice from your midwife.

What Happens When Your Waters Break?

During pregnancy, your baby is surrounded by a bag of fluid called the amniotic sac, which cushions and protects your baby from infection. Amniotic fluid also helps your baby's lungs, digestive system, muscles and bones to develop. At the start of labour, later during labour or, in some cases, before labour starts, the membranes of the sac break and the amniotic fluid drains out through your vagina. This is referred to as your 'waters breaking in pregnancy'. It is often one of the early signs of labour.

Your midwife or maternity notes may use clinical terms to describe when and how your waters break. Rupture of membranes (ROM) is the general medical term for your waters breaking. When this happens before labour begins — but at or after 37 weeks — it is called pre-labour rupture of membranes (PROM). If your waters break before 37 weeks of pregnancy, before labour has started, this is called preterm pre-labour rupture of membranes, or PPROM.

What Are the Signs That Your Waters Are Breaking?

For most women, the waters will break during labour, but it is also common before labour. The signs waters are breaking include feeling a slow leak or a sudden gush of water. The fluid that is released when your waters breaking in pregnancy is usually clear or pink in colour, but sometimes it can become yellow or green due to your baby passing their first poo (meconium) inside the sac.

Once your waters have broken, you'll continue to leak some fluid until your baby is born, so it's a good idea to bring a change of clothes and wear a thick sanitary pad on your way to the hospital or birthing centre.

Once you suspect your waters have broken, contact your midwife or maternity unit, especially if this happens before contractions start, or if the fluid smells unusual or you notice bleeding.

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How Can You Tell It's Amniotic Fluid?

It is not always easy to know whether you are leaking amniotic fluid or urine, especially in late pregnancy.

• Colour: Clear or pink vs urine yellow

• Smell: Mild or none vs urine smell

• Control: cannot stop flow

• Amount: gush or trickle

How Long After Your Waters Break Will You Deliver?

If you suspect your waters have broken, make a note of the time. You may also want to time your contractions if you’ve started having them.

You may already be in labour, but if not, labour typically begins within 24 hours of your waters breaking in pregnancy. If you're in labour, you can check out some comfort measures in Stages of labour and delivery to help make your experience more comfortable.

At term (37 weeks or more), labour usually begins within 24 hours of your waters breaking. If it does not, your midwife or obstetrician will discuss the option of induction with you. This is because once the rupture of membranes occurs, the protective barrier around your baby is no longer intact, and the longer the time between your waters breaking and delivery, the greater the chance of infection developing — for both you and your baby. Your midwife will explain your options and support you in making the right decision for your circumstances.

Contact your midwife or maternity unit as soon as your waters break to get advice and discuss if you need to be induced. The risk of developing an infection increases the longer the time between your waters breaking and giving birth.

Remember: The long months of waiting are nearly over, and you’ll meet your baby soon enough!

When Should You Call Your Midwife or Maternity Unit?

If you're full-term and your waters break, contact your midwife or maternity unit for advice on when to come in. Put on a clean pad so you can note the colour and amount of fluid. If you notice signs waters are breaking may be happening, it’s always OK to call — especially if you’re unsure whether the fluid is urine or amniotic fluid. Your midwife can explain what to do when water breaks next.

You should contact your midwife or maternity unit straight away if:

• Your waters break before 37 weeks of pregnancy (preterm)

• Your baby is moving less than usual

• You have vaginal bleeding

• The fluid is green, brown, or has an unpleasant smell — this may indicate meconium or infection

• You have a raised temperature (generally above 37.5°C)

• You are in pain between contractions

If you are advised to go in, make sure your Hospital bag checklist is ready and take your birth plan.

If you cannot reach your midwife or maternity unit, call 111. If you believe you or your baby are in immediate danger, call 999.

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What Should You Do and Avoid Once Your Waters Have Broken?

After the rupture of membranes, your baby is no longer as protected from infection as they were inside the fluid-filled sac. Your midwife may suggest a few simple steps to lower infection risk and keep you comfortable while you wait for advice or assessment. Here are some general what to do when water breaks tips — your midwife can advise you based on your situation.

Do:

• Check your temperature every four hours while you are awake; contact your maternity unit if it rises above 37.5°C

• Wear a clean sanitary pad (not a tampon) so your midwife can check the colour and amount of fluid

• Have a bath or shower if you wish (NHS guidance notes bathing or showering does not increase infection risk)

• Rest and find comfortable positions

• Keep your hospital bag to hand

Don't:

• Have sexual intercourse — this may increase the risk of infection once your waters have broken

• Use tampons

• Ignore any changes in your temperature, the smell or colour of the fluid, or your baby's movements

What If Your Waters Don't Break?

If your waters don't break and your midwife or doctor needs to intervene to help induce labour, they may rupture the membrane during a vaginal exam. This artificial rupture of the membrane is referred to as 'ARM', and often makes your contractions stronger. If your contractions cause you pain, talk to your midwife about pain relief options.

What if Your Waters Break Preterm?

What Is PPROM?

Preterm pre-labour rupture of membranes (PPROM) is when your waters break before 37 completed weeks of pregnancy and before labour has started. PPROM is a type of premature rupture of membranes and it can sometimes (but not always) lead to premature labour waters breaking. It happens in around 3 out of 100 pregnancies. The exact cause is not always known, but possible factors include infection, problems with the placenta, or carrying more than one baby.

If you think your waters may have broken before 37 weeks, contact your midwife or maternity unit straight away. Do not wait to see if labour begins on its own. You will usually be assessed in hospital to confirm whether your waters have broken and to check for any signs of infection.

If you and your baby are well with no signs of infection, your team may advise close monitoring and, in some cases, continuing the pregnancy for longer. If there are signs of infection or other complications, you may be advised to give birth sooner.

What Will Happen if I Have PPROM?

Once you contact your maternity unit, your care team will assess you and your baby. Depending on your circumstances, you may be offered:

• Antibiotics: To reduce the risk of infection and help the pregnancy continue for longer.

• Steroid injections: If you are between 24 and 36 weeks pregnant, steroids may be offered to help your baby's lungs mature.

• Monitoring: Regular checks for infection (including temperature checks), your baby's heartbeat, and blood tests; you should also monitor your baby's movements.

• Hospital stay or home monitoring: You may stay in hospital for a period, or go home with clear guidance on when to return.

• Planning for delivery: If there are signs of infection or other complications, your team may recommend giving birth sooner.

Your midwife or maternity unit will offer you advice and support during this time.

The Bottom Line

That exciting time is near as labour begins and you feel that slow leak or sudden gush of liquid when your waters break. Whether the baby arrives within 24 hours of your waters breaking, or you must wait a little longer for your little one, your midwife or maternity unit are always at hand to guide you through the process or offer you advice and support if you have any concerns.

No matter how your waters break, it's an important signal that your baby is getting ready to meet you – you're so close now! Get ready for your new arrival with this ultimate checklist of newborn baby essentials.