How to Tell If Your Water Broke During Pregnancy

As your estimated due date approaches, worrying about your water breaking can become a full-time job. You might wonder if you'll be able to tell the difference between leaking amniotic fluid and normal pregnancy discharge, and whether it'll be as crazy as it's portrayed in Hollywood.

Thankfully, water breaking is usually a lot less dramatic than people think, says Joyce Gottesfeld, MD, OB-GYN for Kaiser Permanente in Denver. "Some people experience the telltale gush of clear fluid, while others have nothing more than a slow trickle that resembles leaking urine or watery vaginal discharge," she says.

So, how do you know if your water broke, and what should you do afterward? We spoke with experts to learn more about this sign of approaching labor.

What Does It Feel Like When Your Water Breaks?

Many pregnant people aren't sure that they'll know when their water has broken. Here are the biggest signs that what you're experiencing is, in fact, your water breaking, rather than vaginal discharge or urine.

Sign #1: The leaking is uncontrollable

When your water breaks, you may feel a gush of amniotic fluid, or you might only notice a slow trickle. The amount depends on whether you have a tear or gross rupture.

"If the amniotic sac is rupturing below the baby's head, then fluid has built up and will gush out. But if the rupture happens higher in the womb, the fluid will have to trickle down between the sac and uterine lining, so the flow won't be as heavy," says Ashley Brichter, certified cooperative childbirth educator, birth and postpartum doula, and founder and CEO of Birth Smarter.

In all cases, though, the flow of liquid can't be controlled, and you can expect a total of about 2 1/2 to 3 cups of fluid to eventually empty from the amniotic sac. You can reduce any mess and wetness by wearing a panty liner or sanitary pad (never a tampon) or sitting on a clean towel.

Sign #2: It's mostly clear and odorless

In general, amniotic fluid is odorless, although some people detect a sweet smell like semen or chlorine. It's also usually clear or lightly tinged pink with streaks of blood. It will not have a yellow hue like urine.

Sign #3: You feel painless pressure or popping

Some people detect pressure when their water breaks. Others hear a popping noise followed by leakage. Neither situation is painful. "However, contractions may increase in frequency and intensity after the water breaks," says Ilana Ressler, MD, a reproductive endocrinologist with Illume Fertility in Norwalk, Connecticut.

Remember that you should be at the hospital (if that's where you're delivering) when your contractions feel strong and last about 45 to 60 seconds. Also, in active labor, contractions are about three to five minutes apart.

Sign #4: It might feel like leaking urine

Water breaking could feel like urinary incontinence, which is common during the third trimester of pregnancy. "People will sometimes say, 'I went to the bathroom in my pants but the water kept coming,'" says Dr. Gottesfeld.

Here's how to tell the difference: Urine has a yellowish color and smells like ammonia, while amniotic fluid is usually odorless, says Brichter.

If you still can't tell whether it's amniotic fluid or urine, try this trick from Brichter: Sit down for several minutes, then stand back up. If there's still fluid trickling out, it probably indicates that your water broke.

How to Know If Your Water Has Broken

Check with your health care provider if you're experiencing signs of your water breaking. At the hospital, they might use diagnostic tests to determine if your water has broken, such as the following:

• Introducing a small piece of paper, called litmus paper, during a vaginal exam. This paper changes color when it's exposed to amniotic fluid. If the paper doesn't react, your water hasn't broken.
• Taking a small sample of fluid and looking at it under a microscope. When amniotic fluid is dry, the pattern looks like a fern plant and is therefore called ferning.

Why Does Your Water Break During Labor?

To better understand water breaking signs, it helps to know why it happens in the first place. "During a pregnancy, the baby grows within a person's uterus and is contained within a sac filled with amniotic fluid," explains Dr. Ressler.

This amniotic fluid serves a few purposes:

• Cushioning your baby
• Regulating the temperature of the womb
• Helping with fetal development
• Preventing umbilical cord compression

At some point before delivery, the amniotic sac membranes will rupture and the fluid will come out of the vagina. This "rupture of the membranes," as it's technically called, is commonly referred to as your "water breaking."

How Soon After Your Water Breaks Will You Deliver Your Baby?

It's hard to predict when, exactly, your baby will arrive after your water breaks. If contractions are still infrequent and mild, your doctor or midwife may encourage you to rest at home until they progress, says Brichter. On the other hand, you may be checked into the hospital or birthing center right away.

Your health care provider may speed up the process by inducing labor. This reduces the chances of an infection, which can happen because the amniotic sac no longer serves as a protective barrier against bacteria. Indeed, to prevent infection, many practitioners recommend inducing labor within 24 hours of the water breaking.

What to Do After Your Water Breaks

You don't always need to rush to the hospital immediately after your water breaks. Typically, you will deliver your baby around 24 to 48 hours afterward. Contact your provider to determine the proper next steps.

That said, certain circumstances warrant heading to the hospital right away.

• Your water breaks before 37 weeks: If your water breaks before you're considered full-term, your provider may take steps to delay labor to give your baby more time to develop.
• The amniotic fluid smells foul, looks greenish or brownish, or contains lots of blood: These qualities could indicate fetal distress, or that the baby has passed meconium (the first bowel movement), explains Brichter. In this case, your provider will want to check on your baby.
• Contractions haven't started within 24 hours of your water breaking: If significant time passes after the amniotic sac ruptures, there's a greater chance of developing an infection that can harm the baby, says Dr. Gottesfeld. If your water breaks but labor doesn't start or fails to progress, your provider may give you intravenous (IV) antibiotics to prevent infection or recommend induction with Pitocin.
• You've tested positive for group B Streptococcus (GBS): Pregnant people are generally tested for GBS between 36 and 37 of pregnancy, and if they're found to be a carrier, they'll need treatment with antibiotics before birth. If you have group B strep, your provider may want to see you soon after your water breaks to start treatment and lower the risk of your baby being exposed during labor and delivery.