What Happens if My Water Breaks Before Contractions Start?
In Hollywood your water breaks with a big pop and a gush and everyone panics, grabs the hospital bag, races to Labor & Delivery, and a baby is born about seven minutes later.
But in real life? You might not even realize your water broke.
Sometimes your water breaks after hours of labor. Sometimes it can break after baby is born!
And sometimes your water breaks and...not much happens.
When your water breaks before labor begins, it's called prelabor rupture of membranes, or PROM.
This happens in roughly 8% of pregnancies.
So, what do you do next?
How Do I Know If My Water Broke?
Sometimes it's pretty obvious.
You feel a gush of fluid that you know is definitely not pee.
Other times, it's much harder to tell.
You might notice a small trickle, damp underwear, or fluid that continues to leak periodically. And at the end of pregnancy, when discharge and bladder pressure are already part of everyday life, it isn't always easy to know what you're experiencing.
A few important things to note:
When did you first notice the leaking?
Was it a gush or a trickle?
Has it continued to leak?
What color is it?
Does it have an odor?
Is your baby moving normally?
Are you having contractions?
If you're not sure whether your membranes have ruptured, call your birth team. They can talk through what you're experiencing and may recommend a test to confirm whether the fluid is amniotic fluid.
How Do Providers Confirm Your Water Broke?
Sometimes it's obvious that your water has broken. Other times, it can be surprisingly difficult to tell.
If you're unsure, contact your doula and medical provider. They may recommend testing to determine whether the fluid you're leaking is amniotic fluid.
Depending on your circumstances, this may include an exam or using a test to identify amniotic fluid.
You don't have to figure this out on your own, and you don't have to wait until contractions begin to reach out!
But if you are GBS negative and your pregnancy is low risk you can relax at home for a few hours and wait for contractions to begin, even if your water has broken.
Who Should I Call If My Water Breaks?
Your medical provider can give you guidance based on your pregnancy, gestational age, GBS status, baby's movement, the appearance of the fluid, and any other individual risk factors. They will want to know when your water broke, how much fluid was present and whether there is any concern about meconium being present or risk of infection.
And your doula?
We want to know, too.
This doesn't necessarily mean we're immediately grabbing our doula bag and meeting you at the hospital. But something has changed, and now we can help you navigate what comes next.
Maybe that's talking through what your provider recommended. Maybe it's helping you formulate questions. Maybe it's reminding you to eat, rest, shower, or finish packing if your medical team says it's appropriate.
Sometimes our job in this moment is simply helping you resist the urge to immediately enter BIRTH MODE when your body isn't quite there yet.
What Happens If My Water Breaks Before Labor?
That depends on a few factors! There isn't one universal plan for what happens after your water breaks.
Your care team will consider things like:
how many weeks pregnant you are
your GBS status
the color and odor of the fluid
how your baby is doing and moving
whether you have any signs of infection
your individual medical circumstances
whether contractions have started
This article is primarily talking about water breaking at or after 37 weeks. If your water breaks before 37 weeks, that's considered preterm PROM, or PPROM, and the considerations and recommendations are different.
How Long After My Water Breaks Will Contractions Start?
Typically after the water breaks at contractions begin spontaneously sometime afterward. About 45% of people will begin labor within about 12 hours (Shalev et al. 1995; Zlatnik 1992), and the large majority will begin labor within roughly the next 24 hours.
But that still leaves a group of people whose contractions don't begin right away.
And that's where conversations about waiting (expectant management) versus inducing labor (active management) may begin.
Why Might Induction Be Recommended?
Once the membranes have ruptured, your baby is exposed to any outside elements that might travel up the birth canal. This presents an infection risk
Though there is risk, it is often safe to wait for contractions to start spontaneously.
But infection risk does increase as the amount of time between water breaking and delivery increases. Because of this, your care team will consider whether induction of labor is recommended based on how long your membranes have been ruptured alongside other factors.
In the United States, ACOG recommends induction for most people with term PROM who are candidates for vaginal birth. For appropriately counseled people without another reason to expedite birth, a period of expectant management may also be considered.
This is one reason it's helpful to ask your provider questions like:
What are you recommending?
What are the benefits of doing that now?
What are the risks of waiting?
Is waiting an option in my specific situation?
If we wait, when would we reassess?
The goal isn't to find the universally "correct" number of hours. It's to understand how your individual circumstances affect the options available to you.
What If I'm GBS Positive?
Your Group B Strep status becomes particularly relevant after your water breaks.
If you are GBS positive, your care team will discuss antibiotics during labor to reduce the risk of transmitting GBS to your baby. Current guidance recommends that GBS prophylaxis not be delayed simply because you're waiting for contractions to begin.
GBS status may also change how your provider approaches expectant management versus induction after your water breaks.
What Can I Do While I'm Waiting?
First, follow the guidance your own care team gives you.
Depending on your circumstances and their recommendations, you may have some time before you need to go to the hospital or before induction begins.
If that's the case, this may actually be an opportunity to slow down rather than speed up.
Rest.
Eat and hydrate.
Take a shower.
Finish packing.
Spend some quiet time with your partner.
Pay attention to your baby's usual movement.
And keep your provider updated about anything they've specifically asked you to watch for, including changes in the fluid, baby's movement, your temperature, contractions, or how you're feeling.
Generally, after your water has broken you should avoid putting anything into the vagina.
The strange thing about PROM is that something significant has happened, but labor hasn't necessarily happened yet.
You don't have to use all of your physical and emotional energy simply because your water broke.
What Does Doula Support Look Like When Your Water Breaks Before Labor?
This is one of those gray areas of birth where doula support can be particularly helpful.
There may be excitement, anxiety, uncertainty, and a whole lot of waiting.
But there may not actually be much labor yet.
Your doula can help you slow down enough to understand your options and answer any questions you might have.
We can help you prepare for different possibilities.
We can remind you that just because your water broke does not mean we all have to jump into action.
Sometimes we'll join you early because that's what you need.
Sometimes we'll stay in close contact while you rest at home.
And sometimes PROM eventually becomes an induction, and our support shifts along with it.
The goal is to keep asking:
What is happening right now?
How are you coping?
What does your medical team recommend?
What is your intuition telling you?
And what kind of support would be most useful to you at this point?
Knowing What Might Happen Isn't the Same as Predicting Your Birth
Your water breaking before contractions begin can feel like you've suddenly crossed some invisible starting line.
But birth isn’t always straightforward!
Sometimes your water breaks and contractions quickly follow. Sometimes you wait. Sometimes you rest. Sometimes induction becomes part of the conversation.
Knowing what might happen isn't about predicting which path your birth will take.
It's about having enough information to understand what's happening, ask questions, and make informed decisions about what comes next.
Source
https://evidencebasedbirth.com/evidence-inducing-labor-water-breaks-term/
FAQs
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Yes! Your water can break before labor begins. This is called prelabor rupture of membranes (PROM). Sometimes contractions begin shortly afterward, while other times there may be a longer wait.
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Not necessarily, but you should contact your doula and provider promptly, even if contractions haven't started. They'll help determine whether you need to go in for an evaluation and what your next steps should be.
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Usually! For people at or beyond 37 weeks with uncomplicated pregnancies, a period of expectant management may be an option. Your doula and provider can help you understand the benefits, risks, and recommendations based on your circumstances.