Midwife on call, Rachel Fitz-Desorgher is here to help with all your questions around pregnancy, babies and toddlers.
This week’s column takes a look at the subject of “My Waters”. Mums ask me lots of questions about their waters breaking and we’ll look at some of those in a minute, but first, let’s think a bit about what the waters are and what they do ...
What happens when your waters break?
Whilst our babies are growing inside us, they are surrounded by a fluid-filled membrane sac. Although we often describe this sac as “my waters” it actually belongs to the baby and is all as one with the placenta (afterbirth), the umbilical cord and the baby herself. As well as protecting the baby from knocks and bumps, the stretchy sac and it’s fluid also gives the baby the space to move around and exercise.
The fluid is a wee bit thicker than plain water and so gives some resistance to the muscles and joints as your baby moves which helps ensure she is really toned and strong when she is born. Imagine doing aqua aerobics for 9 months! The membranes (there are two and they stick together like two-ply toilet tissue) are very strong and stretchy so no amount of kicking can damage them.
As your baby grows, he starts to swallow and breathe the fluid. This helps his gut and kidneys to stay healthy and also exercises the intercostal muscles between the ribs so that he will be able to breathe and cry lustily at birth. The fluid keeps the temperature inside the womb nice and steady and also helps to ease the strength of the labour contractions for the baby by spreading their power across the whole body surface
The amniotic fluid itself is made from mum’s plasma as well as from the baby’s urine and lung secretions. The fluid is swallowed by baby and reabsorbed and more is made - a constant refreshing of the fluid. Baby gets some nutrients from the fluid as well as some infection-fighting antibodies. By the time you reach about 36 weeks of pregnancy there will be around 800mls of fluid and then the amount gradually reduces until, by the end of pregnancy, there will be closer to 600mls. The bigger your baby is the more fluid there will be and, if you’re pregnant with twins, there is likely to be A LOT!!
So let’s deal with some of your questions:
Are there any signs my waters are about to break?
Probably not but you might get signs that they have broken BEFORE the fluid comes out and this can give you some precious moments to make it to the loo! Many women feel the bag pop. It feels like someone has blown up a brown paper bag inside you and then popped it - a sudden loss of pressure and a sense of something “going”. Some women get a very audible “BANG!” and sometimes other people in the room can even hear it.
With my 4th son, my waters went at 5 am and the bang was so loud that it woke my husband up! As soon as you feel the bag pop, immediately clench your pelvic floor muscles strongly and get to the loo. Once there, relax and the fluid will end up going there instead of all over your bed or carpet. If you’re too late, remember that that is why we have household insurance ...
How can I tell if my waters have gone or if I’ve just wet myself?
It’s not always easy to tell, especially if there is only a tiny leak in the membranes and only little squirts of water come out. However, pop a pad in place - you’re going to keep making amniotic fluid even after the bag has burst so you do need to protect your pants - and you will notice that amniotic fluid isn’t the same colour as pee. Amniotic fluid is clear, slightly milky or very light pink (very light pink indeed). It also smells different from pee. It smells like a body fluid with its own distinct odour which is fresh and not at all horrid. If you are at all unsure, call your midwife so she can check and let you know whether this is amniotic fluid or if you simply need to be doing some more pelvic floor workouts! If the fluid is bloody, brown, green or smelly, you need to see a midwife as soon as possible so that both you and your baby can be checked, so call the hospital and make your way in.
How long after my waters have broken can my baby survive?
The membranes are evolved to stay put until the time is right for them to break. Because the fluid is constantly being made, absorbed and made again, the baby doesn’t “dry out” if your waters go. In fact, you’ll just have rather a leaky labour! If you are in very early pregnancy and your waters go then your baby might not survive. This is because your labour is likely to start and baby might be too little and weak to be born.
If your labour doesn’t start then there is a greater chance of infection which can threaten the life of a premature baby but, if you stay well and labour doesn’t start then your baby might carry on growing and be born safe and sound, although potentially weaker than you might otherwise expect and so need special care for a while. If your waters go at the end of pregnancy and there is no labour then the chances are VERY high that labour will start naturally within a day or two and your baby is well developed to cope with this. Most hospitals offer induction within about 24 hours of the membranes breaking, along with antibiotics to reduce the risk of infection, and your midwife will be able to reassure you that your baby is perfectly fine and you can look forward to cuddling her soon even though your waters went a little sooner than expected.
What happens if my waters break but I don’t have contractions?
Despite what we always see on TV, the membranes do not have to break for labour to start. In fact, for most women, the contractions come first. The membranes are evolved to stay put right through labour as they help to protect your vaginal tissues from the bony head of your baby, and also ease the strength of the contractions for both of you. Some babies are even born in the sac (sometimes called a caul) and some people consider this to be good luck!
Whenever your waters break, whether before or after contractions have started, you should call your midwife or birth centre (you will have been given a phone number) who will check you and the baby and advise whether or not it’s ok to stay at home for now or to come into the birth centre. The amniotic fluid and the hardness of a baby’s head on the cervix (neck of the womb) both cause contractions to start so, within 72 hours of the membranes breaking, the vast majority of women will have started in labour naturally. Most hospital these days don’t wait that long and so, to reduce the risk of infection, it is likely you will be offered an induction to start things off within about 24 hours if nothing has happened. There are other options to being induced if contractions don’t start, so make sure to ask questions so that you can make a fully informed choice.
WATCH: Rachel explains what happens when your waters break:
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