WHAT TO DO WHEN YOUR WATERS BREAK?
Countless myths surround waters breaking. Movie and TV dramas would have us
believe that it always heralds the onset of full-on-labour; a huge splash followed
by a mad dash to the hospital. Then there's the myth that if your waters break
in the supermarket you'll get a year's free shopping.
It's very unlikely that your waters will break at the shops, and if they do
it'll probably be a trickle rather than a gush. So how will you know what to
do
if it happens to you?
What are your waters? |  |
What happens when your waters break? |  |
What will it look like? |  |
What should I do? |  |
What are your waters?
The liquid that appears when your waters break is the amniotic fluid that surrounds and protects baby while she grows inside you. The fluid cushions your baby and keeps the temperature in your uterus constant.
Amniotic fluid is contained within the amniotic sac or membranes. It begins
to collect around your baby at around week four of pregnancy and the amount
increases as your baby develops. It's made up of around 99 percent water as
well as a mixture of fetal cells, microorganisms and waste products. The fetal
cells contain genetic information about your baby, which is why the amniocentesis
test takes a sample of amniotic fluid to determine whether baby has any chromosomal
abnormalities.
During the first two trimesters (weeks 0-12 and 13-28) your baby's skin isn't
waterproof yet, so amniotic fluid is absorbed into her body. At around 14 weeks
of pregnancy, your baby's kidneys begin to work and she starts to swallow amniotic
fluid. This swallowing action is thought to help mature her lungs. She then
excretes the fluid back
into the amniotic sac.
Amniotic fluid never gets stale, as it's constantly being absorbed across
the amniotic sac back into your circulation and replaced by your baby's urine.
The total amount of amniotic fluid your uterus increases from 600ml at 22 weeks
to one litre at 34 to 36 weeks.
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What happens when your waters break?
At the start of labour, you'll have a show (the mucus plug sealing the cervix
comes away), your waters will break and contractions begin. These three things
can happen in any order. "Waters breaking"
literally means that the membranes containing amniotic fluid rupture and the
fluid leaks out. The usually happens when your cervix begins to dilate, so very
often it's a signal that labour has started.
If lots of fluid leaks out, you'll probably be sure your waters are breaking,
but if there's only a small amount you may think you're leaking urine. A sanitary
towel can tell you whether or not it's urine. If not, you can assume your waters
are breaking. Your caregiver can
also check to see if they've broken. Another tip is to smell it. If it is "sweet"
then it could be your waters.
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What will it look like?
The fluid should be clear or a light straw colour and smell a little like
almonds. If a dark green liquid is present in the waters, this probably means
it contains traces of meconium (baby's first bowel movement), which she normally
passes in the first days after birth. Passing meconium during labour may indicate
that baby's in distress, so contact your caregiver at once.
Amniotic fluid contains prostaglandis, hormones that help your uterus contract.
When your waters break, your baby's head moves down further into your pelvis
and presses on your cervix. This causes a hormone, oxytocin, to be released,
which helps establish contractions. This chain of events means that around
seven out of 10 women whose waters break before they have contraction will
go into labour during the next 24 hours. Nine out of 10 women go into labour
within 48 hours of their waters breaking.
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What should I do?
Once your waters have broken and you've told your caregiver, she'll probably
want to see you to make sure everything is normal with you, baby
and baby's position. If all's well, you'll probably be advised to go home and
relax until contractions kick in, and to
stay in touch as things develop.
If you think your waters have broken, but aren't sure, your midwife can examine
you with an instrument similar to the one used when you have a cervical smear
test, to see if any amniotic fluid is collecting in front of your cervix (neck
of the uterus). If there's no fluid, it's unlikely that your waters have broken
yet. Otherwise, there are various stages
of labour that you could be in.
If you're not having contractions, or if they're irregular and coming at varying
intervals (each longer than 10 minutes), your caregiver will probably advise
you to stay home until you're in established labour. If you feel at any stage
that you can't cope, call your caregiver again, or go to hospital.
If your contractions still aren't coming regularly around 24 hours after your
waters have broken, you may be induced, as there's a risk of infection.
If you're having regular contraction (every 10 minutes or more frequently)
and your cervix is steadily dilating but your waters haven't yet broken, your
caregiver might suggest that you stay at home and wait for them to break naturally
or have them artificially ruptured.
If you're having regular contractions, your waters have broken and an examination
shows your cervix is dilating, and then baby's finally on the way and you're
about to become a mom.
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