Umm…my water just broke!

alright bestie, first, take a deep breath,

Unlike the movies, your labour will most likely not start immediately! Shocker. You are now a part of a smaller statistic of individuals who experienced their waters breaking before labour. You are more likely to experience your waters breaking during labour when you are having consistent contractions.

Okay, but what exactly is breaking when we say “waters”?

Baby is a pretty cool little alien right now, in the sense that they are living and practicing breathing by swallowing and swimming in their amniotic fluid or “water”!. When this “breaks”, it is actually the protective membranes that surround the baby within the uterus that are breaking or tearing. There are many layers that keep the baby safe and tucked away, all with important functions. Your baby’s first home is within this double membrane, fluid-filled sac. Yes, there are actually two layers to this membrane, the fetal-facing membrane in which the baby, amniotic fluid, along with their umbilical cord, are attached to the fetal side of the placenta. Then there is the maternal-facing membrane, which is attached to the maternal side of the placenta. This all then sits comfy within the uterus. A helpful visual could be to picture a water balloon that has an extra balloon surrounding the water-filled one.

So when your water breaks, in reality, it is actually both layers of the membranes surrounding the baby, tearing and releasing the amniotic fluid. Which finds its way past the cervix, through the vagina and suddenly all over your bed.

Okay, but maybe I just peed myself…

• Amniotic fluid has a distinct smell to it, and it does not smell like urine. Oddly sweet or odourless.

• Test your theory! Depending on the size of the tear, you will continually leak…if you keep switching out pads or undies, then it’s most likely amniotic fluid.

• Amniotic should be clear-ish.

• It may feel like a dramatic gush or come in small trickles, but it will continue to trickle until the baby is born.

here's what to do if your water has broken:

1. You do not need to be 100% certain; trust your intuition. Call your midwife on their pager. Or if you have an OB, pack up and head out to maternity triage. Pro Tip: Throw your overnight bags in the car now if you are having a hospital birth. Just in case the party starts earlier than expected.

2. Have your partner make a note of the following acronym TACO:

   • T - ime - approximately what time it broke or began leaking.

   • A - mount - was it a large gush? Small trickle?

   • C - olour - was it clear? Murky or brown?

   • O - dour - is it odourless or smell funky?

3. Take a moment to gather your thoughts. This probably wasn’t what you anticipated happening, and could now change your birth plans. But you are capable of pivoting, capable of handling change and making wise decisions. Mentally prepare yourself for conversations about your birth plans, for this new player could change the game.

Remember to use your b.r.a.i.n

If you’ve heard of PROM (premature rupture of membranes), then the classic saying surrounding this is “you're now on a clock”. To a degree, this is true; with rupture of membranes, your risk for infection has now risen. But assessing risk can be difficult. Make sure to seek out research on your own and ask good questions to feel 100% informed before making any decisions. Anticipate a conversation surrounding induction and options that are now at play with your water broken before contractions. A quick statistic, 75% of those who’ve experienced PROM will deliver by the 24h mark (whether because their body went into labour on its own, or they chose induction). Yes, you are on a clock…but it isn’t a race. Take a breath, slow down and think. Here is a helpful tool to guide you through the next 24-72 hours of decision-making ahead of you.

Bring your B.R.A.I.N to the Induction Conversation…

Benefits

• Induction:

  • What are the benefits of agreeing to a medical induction? P.S. Your mental health can be a deciding factor. Are you physically capable of continuing to wait?

  • Are there any benefits to opting for a non-medical induction? Do they offer me other benefits, for example, acupuncture will also help release stress and anxiety.

• Wait:

  • Am I coping well enough to wait? Think of your environment, do I prefer to wait at home or be admitted to the hospital now? This baby knows it needs to come! Can I wait for my body and baby?

Risks

• Induction:

  • What risks come with opting for a medical induction? Note, certain forms of induction will be unavailable as now inserting anything into the vagina could introduce infection. Does it put my birth plan at risk of further intervention? How do babies cope or respond to inductions?

  • Are there any risks to certain forms of natural methods of induction?

• Wait:

  • What risks are there to my baby if I wait for labour to occur on its own? What if it takes longer than 24 hours? Do I feel safe to wait? My own feeling of safety is important! What are the actual rates of infection?

Alternatives

• Induction:

  • What are all my available forms of medical induction? Can my care provider help educate me on their risks and how invasive they are?

  • Does my care provider have a natural form of induction they prefer or would suggest? Is there a timeline we could create together? I try A, B and C, and if those don’t work, then I’ll opt for a medical induction.

  • Doula Tip: If I had to recommend any form of natural form of induction, it would be pumping. Put on a movie and pump for 15- 20 min on and 20 min off, for at least 1 hour! Or acupuncture, an excellent and safe option. Always check with your care provider first before trying anything suggested by anyone (even me) on the internet.

Intuition

• What is my intuition saying to me? What does my partner see and feel about this situation?

Nothing

• Yes. Nothing is a decision in itself!

additional information

I’ve linked here a great Canadian resource by the Ontario Midwives describing PROM, risks and statistics. This can feel like a lot, after all, it’s being treated very seriously. Asking your care provider a simple question like “on a scale of 1-10, how serious or concerned are you?”. This may help you gauge their personal bias on PROM and help you see where their advice is coming from.

This is probably very different than what you imagined.

Therefore, it feels scary, for it is unknown territory! But those feelings do not equal an emergency. Until there truly is greater risk at play, you have time, and you are still in the driver’s seat. I believe in you!

www.ontariomidwives.ca/sites/default/files/2020-06/When-your-water-breaks-before-labour-English.pdf

Cheering you on from afar!