Waters breaking

Waters breaking means that the amniotic sac surrounding your baby has ruptured and amniotic fluid is draining through the vagina. It can happen during labour, but for some people it happens before contractions begin.

It does not always look like the dramatic gush often shown on television. The NHS explains that you may feel a slow trickle or a sudden gush of fluid that you cannot control. If you think your waters have broken, contact your midwife or maternity unit for advice, even if you are not having contractions yet.

What does it mean when your waters break?

During pregnancy, your baby develops inside a fluid-filled membrane called the amniotic sac. The fluid inside it is called amniotic fluid.

When the membranes rupture, the fluid can begin to drain through the vagina. This is what people mean when they say their waters have broken.

Waters commonly break during labour, although they can break before labour begins. If your waters break before 37 completed weeks of pregnancy and labour has not started, this is known as preterm prelabour rupture of membranes, or PPROM.

What does waters breaking feel like?

There is no single experience.

Some people notice a sudden gush of warm fluid. Others experience a steady trickle, repeated dampness or a smaller leak that is difficult to distinguish from vaginal discharge or urine.

Unlike passing urine, amniotic fluid may be difficult to control. The NHS advises using a period pad rather than a tampon if you think your waters have broken. This can also help your maternity team assess the colour of the fluid.

If you are unsure, do not feel that you have to work it out by yourself. Contact your maternity unit or midwife and explain what you have noticed.

What colour should amniotic fluid be?

The NHS describes amniotic fluid as normally clear and pale. It can sometimes be slightly bloodstained when the waters first break.

Contact your midwife or maternity unit immediately if the fluid is coloured or smells unpleasant. You should also contact them straight away if you are losing blood.

These changes need assessment because your maternity team may want to check you and your baby promptly.

How can you tell if your waters have broken?

It can genuinely be difficult to tell.

Pregnancy can bring increased vaginal discharge, and leaking a little urine is also common. Both can make unexplained dampness confusing.

A useful clue is that waters may continue to leak and the fluid cannot be controlled in the same way as urine. However, appearance and sensation alone cannot always confirm what the fluid is.

If you think your waters may have broken, put on a period or maternity pad, not a tampon, and contact your maternity team. They can tell you whether you need to come in for assessment.

Do contractions start as soon as your waters break?

Not necessarily.

Your waters may break after contractions have already begun, during established labour or before you notice contractions.

The NHS says it is usual for labour to begin within 24 hours after waters break at term. If labour does not begin, induction is usually offered because the risk of infection increases after the membranes have ruptured.

Your maternity team will discuss what happens next based on your stage of pregnancy, your health, your baby’s wellbeing and your individual circumstances.

What should you do when your waters break?

Contact your midwife or maternity unit if you think your waters have broken. The NHS lists waters breaking as a reason to contact the maternity team urgently.

Try to notice the colour, smell and approximate amount of fluid, as your maternity team may ask you about these details. Wearing a pad rather than a tampon can make this easier.

You may also be asked about contractions, vaginal bleeding and your baby’s movements.

Follow the advice your own maternity team gives you. They may ask you to attend for assessment, particularly if there are concerns about the fluid, your baby’s movements, bleeding or the stage of pregnancy.

What if your waters break before labour starts?

Waters can break before contractions begin. At term, this is often called prelabour rupture of membranes.

According to the NHS, labour commonly begins within 24 hours. If it does not, induction is usually offered because there is a small increased risk of infection once the waters have broken.

This does not mean every person will follow exactly the same plan. Your midwife or doctor should discuss your circumstances and options with you.

If you are waiting for labour to start after your waters have broken, follow the monitoring and safety advice given by your maternity team and contact them if anything changes.

What if your waters break before 37 weeks?

A gush or trickle of fluid before 37 weeks needs urgent maternity assessment.

The NHS advises contacting your midwife or maternity unit if you are less than 37 weeks pregnant and have a gush or trickle of fluid from the vagina, as this could be your waters breaking.

RCOG describes waters breaking before 37 completed weeks and before labour as PPROM. It is associated with a higher chance of premature birth and an increased risk of infection, so you and your baby will need assessment and appropriate monitoring.

PPROM does not automatically mean that labour will begin immediately. What happens next depends on your individual circumstances, and your maternity team will discuss your care with you.

What happens if your waters break but labour does not start?

If your waters break at term and labour does not start, your maternity team will discuss the next steps with you.

The NHS states that induction is usually offered if labour has not started within 24 hours because the risk of infection increases once the membranes have ruptured.

If your waters break before 37 weeks, management is different and depends on factors including how many weeks pregnant you are, whether there are signs of infection and how you and your baby are doing.

This is why contacting your maternity team rather than waiting without advice is important.

Can your waters break slowly?

Yes. Waters breaking can be a trickle rather than a gush.

You might simply notice that your underwear keeps becoming damp or that watery fluid continues to leak. This can make it harder to distinguish from urine or normal pregnancy discharge.

If the leaking continues or you think it could be amniotic fluid, contact your midwife or maternity unit. They can advise whether you need to be assessed.

When to get professional advice

Contact your midwife or maternity unit urgently if you think your waters have broken. This applies even if you are not having contractions.

Tell them immediately if the fluid is coloured or smells unpleasant, if you have vaginal bleeding, or if your baby is moving less than usual.

If you are less than 37 weeks pregnant and have a gush or trickle of fluid, contact your maternity unit or midwife urgently because this may be PPROM and needs assessment.

You can also contact your maternity team whenever you are unsure or worried about possible labour symptoms. If you cannot reach your midwife or maternity unit and need urgent advice, call NHS 111.

Call 999 if you think your baby is coming immediately and you have a strong urge to push, or in any other life-threatening emergency.