You are nearing the end of your pregnancy and you have begun to wonder what causes your water to break. This is a perfectly normal curiosity. When your amniotic membranes rupture, a light yellowish-brown liquid begins to leak. The liquid, which is amniotic fluid, somewhat resembles urine, both visually and odor-wise. When your “water” starts coming out, it usually means your labor has started and your baby will be arriving soon.
What Causes Your Water to Break?
When you are pregnant, your amniotic fluid protects your baby by providing a cushion against concussion and pressure. For example, many pregnant women have fallen down at some point during their pregnancy from the imbalance created by their pregnant bellies. The baby is protected from the shock of falling by this fluid.
So how does your water break? Biologically, your body knows when it is time for your water to break. It triggers a series of events that causes the amniotic membranes to rupture, thus releasing the fluid and starting active labor. However, there are times your water can break early or prematurely because of other things going on with your body.
Spontaneous Rupture at Term (SROM)
Usually when your labor starts, your baby will naturally move towards the birth canal and the pressure from this movement is what makes your water break. When this happens, you will feel a rush of warm liquid, which is the amniotic fluid being pushed out by the pressure of your baby.
If your labor is induced, your doctor will probably tear your amniotic membrane which is what makes your water break if this is the case. A hook made of thin plastic is inserted and used to rip a hole in your sac. While it may be a little uncomfortable, the procedure does not hurt and helps labor progress.
Premature Rupture at Term (PROM)
Occasionally, a woman may experience premature rupture of membranes but the chances of this happening is only around 10%. If it does happen, it usually occurs around 24 hours before your normal labor starts, which is around weeks 37 to 42. But what causes your water to break? There are several reasons your water may break early. They include:
- Stress caused by carrying a large baby
- Early activation of membrane enzymes
- Pre-labor Braxton Hicks contractions
- Multiple baby pregnancy
- Infections of the kidney, bladder, cervix, vagina or uterus
- A condition called polyhydramnios, which means there is too much fluid in your amniotic sac.
Preterm Premature Rupture of Membranes (PPROM)
When your water breaks before 37 weeks, it is considered a preterm premature rupture of your membranes. About a fourth of all premature births are caused by this because once your amniotic sac breaks, it is best birth occurs as soon as it is safe. Your baby no longer has a protective barrier from infection and needs to come out as soon as possible. Factors that can cause your sac to break early include:
- Early activation of membrane enzymes
- Inflammation or infection of the amniotic membranes
- Having more than one baby in an amniotic sac
- Kidney, bladder, uterine, cervical or vaginal infections
- An injured or weak cervix
- History of premature births
- Low level of collagen in amniotic tissues
- Occurrences of vaginal bleeding during more than one trimester
- Excess fluid in the amniotic sac
- A procedure called cerclage done in early pregnancy to prevent a premature birth
- A baby in a breeched position
- Amniocentesis done early in a pregnancy
- A cone biopsy done previously due to an abnormal Pap smear
- Engaging in sexual intercourse
- Exercising too much or in a manner that puts too much stress on your body
- Smoking or substance abuse
- Poor diet and nutrition
- Copper, vitamin C or zinc deficiencies
What Happens When Your Water Breaks?
When considering what causes your water to break, it is important to remember it is a natural part of childbirth that usually occurs right before or early in the process of labor. Surprising to some, the chances of your water breaking while you are sleeping in bed is very high. Some women even think they may have wet the bed.
A small popping sound or feeling occurs with some women when their water breaks. The amniotic flow differs from one woman to the next, with some feeling just a little damp and others experiencing a big gush of water from their vagina. Shortly after your water breaks, you will start to have contractions if you haven’t already. If you do not go into active labor within 24 hours, you may be experiencing premature labor.
While amniotic can be a light yellowish-brown color with a slight odor resembling urine, it is can also be clear and odorless. If you are not sure if your water has broken, you should call your doctor who can conduct tests to see if your amniotic membranes are leaking.
It is important to pay attention to the color and odor of the fluid because if it is brown or green you must call your doctor right away. Sometimes babies have a bowel movement while still in your uterus and this can cause serious conditions. Also, when your water breaks you are at a greater risk of exposing yourself and your baby to infections. It is important to use a pad, not a tampon, to capture the fluids. You should not soak in a bath, but you may shower. It is also best to avoid sexual intercourse once your amniotic membrane has ruptured.
What If Your Water Breaks Early?
When and how your water breaks can affect your labor and the birth process. If it happens around 37 weeks, your doctor will usually wait to see how things progress before initiating any special procedures. About 30 percent of the time, a woman’s water breaks before active labor starts.
If your water breaks and your pregnancy is in week 33 to 36, it will be considered mildly preterm labor. If you do not start your contractions within the next 48 hours, your doctor may induce your labor. However, if your pregnancy is less than 32 weeks, it will be considered extremely preterm. In that case, your doctor will most likely try and delay labor in order to allow your baby more time to mature in the womb.
Of course, all of these decisions depend on the condition of you and your baby. If either of you are not well, there is large amounts of vaginal bleeding or there are any signs of infection, your doctor may decide to go ahead and deliver your baby no matter how premature.
There are several treatment options if your water breaks early. They include:
- A course of antibiotics to prevent infection and assist in prolonging your pregnancy as long as it is safe for you and your baby.
- Injection of steroids in order to reduce the chances of your baby having breathing difficulties, also known as respiratory distress syndrome. Your doctor may give you these if your water breaks before 34 weeks.
- Administering contraction suppressants if your labor is extremely premature and there are no health complications that would warrant not doing so. It is given in tablet form or through an IV.